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many journeys

2010/11 Annual Review

inside: st vincent’s hospital 54 sacred heart 76 st vincent’s private hospital 82 mater hospital 96 st joseph’s hospital 106 st joseph’s village 114 1

St Vincents & Mater Health Sydney


94 Mater Hospital

112 St Joseph’s Village

104 St Joseph’s Hospital

Contents 28 Moree Outreach How doctors from St Vincent’s Hospital have improved health services in a remote town. 30 A rt Connections An art therapy group for Aboriginal women reconnects one family with their proud heritage. 42 making a difference Visiting PNG laboratory technician Gelinde Narekine found his fact finding mission to St Vincent’s very eye-opening. 44 Shot at a Cure An Australian trial of injecting a substance formerly used as a food dye is giving new hope to melanoma sufferers.

46 Chance of a Lifetime Kristin Atkinson has no doubt inclusion in a trial to treat her scleroderma saved her life. 49 A Life saving Trial When doctors told Herb Harris he was too old for surgery, he was included in a day surgery trial that saved him.

62 Home at Last Homeless and sick, Les Gordon was “in God’s waiting room” when a partnership led by St Vincent’s Hospital stepped in. 64 The Waiting Game A year on from receiving Australia’s first total artificial heart, Angelo Tigano considers each day a gift.

66 A New Voice 50 Nature’s Secrets With the aid of St Vincent’s speech Sydney scientists Lawrence Lee pathologists, John Hodge learns to and Daniela Stock unlock the secrets speak again following a laryngectomy. of one of nature’s most advanced 68 Song of Hope biological machines.  Thanks to a lung transplant, teenager 60 K inghorn Cancer Centre Ayla Sutherland can run and sing with Every step of the patient journey will her friends at last. be improved when the Kinghorn 70 Sw eet Sound of Success Cancer Centre opens in 2012. A cochlear implant gives Karen Baker the opportunity to realise her dream of becoming a school teacher.

St Vincents & Mater Health Sydney


80 St Vincent’s Private Hospital

74 Sacred Heart

72 Message of Love When Adam Freney learned he would lose his brave battle for life, he created a video message for his baby daughter.

52 St Vincent’s Hospital

106 nothing to fear Once diagnosed with prostate cancer, Rodney Eirth has made a full recovery via the latest in robotic surgical treatment.

126 A Perfect Start Having had five babies there, Anu Suttie tells why she is a dyed-inthe-wool Mater maternity mum.

128 M ater Celebrates 108 Home Sweet Home 94 A place of peace Hundreds of nurses past and present were recognised with an event to mark Leading Sydney silk Mark Tedeschi, A new in-home rehabilitation 100 years of nurse education at Mater. offering takes the sting out of hip QC, captures the warmth, dignity replacement surgery. and true spirit of Sacred Hospice 136 The Art of Healing with a photographic essay.o 110 The Sweetest Thing An art therapy group for senior citizens 96 A Gentle Touch provides welcome respite for some A touching wedding ceremony in solitary souls. the Intensive Care Unit goes some Sacred Heart volunteers Dot Hunt way to saving a life. and Julie Goold offer a welcome 138 Helping Hands smile during their patient visits. 112 Help at Last Student Hardik Sanghadia finds a t 105 10 Questions home away from home at St Joseph’s A new era begins for the treatment Hospital, Auburn. of mental health conditions for Mrs Roslyn Packer explores the young adult Australians. close relationship with St Vincent’s 146 Strong Connections Private Hospital and her family. 124 Taking Control Residents Charles and Margaret Dulhunty are known as the lovebirds Diagnosed with breast cancer while at St Joseph’s Village. pregnant, Melissa Hayes-Smith refused to let the disease take control. Annual Review 2010/11

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01 St Vincents & Mater Health Sydney brings the healing ministry of Christ to all who are served

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St Vincents & Mater Health Sydney


many journeys. one vision. | 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 in the spirit of love, hope, compassion and justice. Our vision, which is now under the stewardship of the Trustees of Mary Aikenhead Ministries, is to lead transformation in health care inspired by the healing Ministry of Christ. 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.

Our Mission Annual Review 2010/11

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Compassion:

Unity:

We accept people as they are and display kindness and sensitivity to them.

We create a community in which we collaborate with gentleness as a sign that we value one another.

Justice:

Mercy:

We act with integrity and believe that people have the right to good healthcare without discrimination.

We respond to those in need be providing the best possible treatment and care.

Human Dignity:

Hospitality:

We act with integrity and believe that people have the right to good healthcare without discrimination.

We welcome people with kindness and do all that we can to assist their health and wellbeing.

Excellence:

Respect:

We excel in all that we do so that we can positively promote the healing ministry within our society.

We are open to all people who need our care and our time, acknowledging that they have the right to our services.

01 The Darlinghurst campus treats up to 10 patients from East Timor each year and medical supplies are provided to the Bario Pite Clinic

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St Vincents & Mater Health Sydney


many journeys. one vision. | OUR VALUES

Our

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Annual Review 2010/11


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Corporate information 8

St Vincents & Mater Health Sydney


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.

many journeys. one vision. | 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 Vincent’s Health Australia is the health ministry of Mary Aikenhead Ministries.

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 joining together of the Sisters of Charity health facilities at Darlinghurst and the Mater Hospital, which was formerly owned by the Sisters of Mercy. In March 2005, St Joseph’s Hospital and St Joseph’s Village at 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, drug and alcohol, community health and homeless health 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. 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 one of the first times a public juridic person of Pontifical Right has been granted in Australia and sets an important precedent for other religious orders in the country. In 2011, St Vincent’s Hospital, the Mater Hospital, St Joseph’s Hospital and St Joseph’s Village recognised the change to Mary Aikenhead Ministries with the unveiling of the Mary Aikenhead Ministries crest.

01 The gardens at Sacred Heart Annual Review 2010/11

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St Vincent’s Hospital

Sacred Heart Hospice

St Vincent’s Private Hospital

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.

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 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.

The hospital has a long standing reputation for treating patients with acute, complex needs from across NSW and Australia.

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.

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Special Health Network Status

Affiliation with St Vincent’s Clinic

On 1 January 2011, Special Health Network status was granted to St Vincent’s Hospital, Sacred Heart Hospice and St Joseph’s Hospital. Under a new legislative structure, agreed through the National Health Reform Agenda, St Vincent’s Health Network (SVHN) is one of three Special Health Networks in NSW. The other two Special Health Networks focus on children’s health and forensic mental health. Operating under the same governance arrangements, SVHN has retained its independent board and now reports directly to NSW Health, instead of area health services.

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 & diagnostic services for patients referred from across NSW.

St Vincents & Mater Health Sydney


St Joseph’s Hospital

St Joseph’s Village

Established by the Sisters of Mercy in North Sydney in 1906, the Mater Hospital is a leading private hospital renowned for its quality care and compassion.

Having provided significant services to the western Sydney community for over 125 years, 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 St Vincent’s Health Network.

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.

Located on Sydney’s North Shore, the Mater specialises 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. The Mater Clinic is also located on the campus.

many journeys. one vision. | CORPORATE INFORMATION

Mater Hospital

01 Madeline High with volunteers Dot and Julie – see feature on page 98

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Annual Review 2010/11

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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 shared facility of SV&MHS and 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. 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.

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. These include: University of New South Wales Australian Catholic University University of Notre Dame Australia University of Sydney University of Tasmania University of Technology, Sydney University of Western Sydney Charles Sturt University University of Wollongong Macquarie University University of Newcastle University of Queensland. 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.

Urban Mental Health Research Institute: Faces in the Street – 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.

Social Outreach & Advocacy Associated Organisations Mercy Foundation

Sisters of Charity Outreach Sisters of Charity Outreach was commenced in 1990 based in St Vincent’s Clinic, and is committed to supporting people in need within NSW through the active participation of trained volunteers and staff. Funded substantially by St Vincent’s Private Hospital, Outreach is a compassionate, diverse service supporting society’s most vulnerable, with an emphasis on women and families. Outreach is committed to providing holistic care and being a human presence through

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St Vincents & Mater Health Sydney

its service of education, hospitality, counselling, visiting, transport and endeavouring to be a voice for the voiceless. Some key services include a domestic violence crisis centre for women and children, transport and accommodation services for country people visiting the city for medical reasons, court support, confidential counselling and visiting programs to the socially isolated.

The Mercy Foundation is conducted 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 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.


Trustees’ foreword

many journeys. one vision. | TRUSTEES FORWARD

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October 2010 marked a significant transition in the history of St Vincent’s Health Australia (SVHA), the largest ministry of Mary Aikenhead Ministries, namely the move to a unified, national governance structure. The approval of this governance change, and the associated appointment of a new national Board of Directors, involved the Trustees in lengthy and deep discernment. We are grateful for the generosity of spirit of the members of the continuing boards who, in the interest of SVHA as a whole, unanimously agreed to resign to enable the national structure to be adopted. We are also grateful to each individual who accepted an invitation to serve in the demanding role of SVHA director. The Trustees are very pleased that many non-continuing board members agreed to join the Community Advisory Councils which have been established in Brisbane, Sydney and Melbourne. These councils can make an important contribution to ensuring that our mission and values are always at the forefront of the work of our facilities and that community relationships are fostered. The Trustees acknowledge the generous commitment of all those who work for SVHA. We are proud of the significant position SVHA has in the Church and the Australian community and commend its leadership for ensuring that the mission of God and the values of love, hope, compassion and justice underpin everything it does, consistent with the traditions passed down by the Sisters of Charity. On behalf of the Trustees of Mary Aikenhead Ministries, I am pleased to commend to you the 2010/2011 Annual Review for St Vincents & Mater Health Sydney.

Mr Richard Harpham Chairperson, Trustees of Mary Aikenhead Ministries 01 Mr Richard Harpham

Note: Mr Harpham retired as Chair and was succeeded by Mr David Robinson on 1 January 2012.

Annual Review 2010/11

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Chairman & CEO’s foreword

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With the push of the “send” key on Kings Cross GP, Ray Seidler’s desktop computer, the St Vincent’s campus became the country’s first health site to accept electronic patient records as part of the Federal Government’s eHealth program.

The program will give all Australians the chance to sign up for an eHealth record from July next year. Currently, St Vincent’s is one of the Government’s 12 lead eHealth sites. For Dr Seidler it is “the most exciting thing that has happened in the last 15 years in my practice, in trying to connect to a hospital just 1 km away.” Across St Vincents & Mater Health Sydney (SV&MHS), on any one day, we provide care for over 1,800 patients across the inpatient, outpatient and community settings. While these 1,800 patients undertake a myriad of journeys, some in the acute setting, some perhaps at home, some even at a virtual clinic; we know that our objective in terms of each and every patient will be the same; to do all that we can to assist in their health and wellbeing. The 2010/2011 St Vincents & Mater Health Annual Review is themed Many Journeys, One Vision. Never before in the organisation’s history have our patients, staff and volunteers undertaken so many and such varied journeys, be it new partnerships, new areas of endeavour, or new geographical landscapes. Paradoxically, these journeys have been undertaken with a firm focus on one solitary vision – one singular end goal intractably focussed on our mission and values.

01 Chairman of St Vincent’s Health Australia John Gurry with fellow Board Director Paul Robertson at the 2011 SVHA Quality Awards 14

St Vincents & Mater Health Sydney

It is no coincidence that we put our hand up to partner with the Government in their push towards an electronic medical record. This is a pioneering project that will eventually help fix a vexing problem, enabling clinicians at different locations to have accurate up-to-date patient information at their fingertips.


Our patient loads are not just getting larger but we are treating patients with more complex and acute needs. It is more timely than ever to help in the push towards a seamless medical record to ease the journey for the patient and clinician. Obviously in this foreword, we can only share some of the journeys that we have embarked upon in the past twelve months, but we strongly encourage you to take the time to read on and experience the journeys that have been shared. This year we have adopted a magazine style approach to sharing these stories, to offer the reader a genuine opportunity to get an insider’s view of our activity, achievements and the patient’s journey. Visitors to the St Vincent’s campus in recent times will have noticed the amount of construction work and physical change that has taken place. In many ways these physical changes are reflective of the dynamic nature of the organisation’s endeavours. At the centre of these endeavours is the SV&MHS Strategic Plan, which responds to Australia’s projected population growth, shifts in disease patterns, increasing healthcare costs and evolving healthcare trends and is in keeping with the Commonwealth’s health reform agenda. Fundamentally this plan is about remaining true to the SV&MHS mission of responding to community need. During the past year, St Vincent’s has made some major inroads in establishing the Campus Planning Project which builds on the recommendations from the Campus Clinical Plan. Currently underway is a multifaceted consultation process involving the engagement of architects to develop concept work around Capital Master Planning that will ensure the campus has the appropriate physical resources to support the clinical, research and teaching endeavours of St Vincent’s well into the future. From a governance perspective, the past 12 months have been a watershed period for SV&MHS. Following the commencement of the National Health Reform, we were delighted by the establishment of St Vincent’s Public Health Services as a Special Health Network (SHN) in January this year. This change in governance is significant for St Vincent’s as it provides a simplified management and operational structure at a regional level. Furthermore, the establishment of St Vincent’s as a SHN works in well with the national governance changes within St Vincent’s Health Australia (SVHA). This has already seen some exciting opportunities present as a united group, particularly in relation to expanding its mission to become an undisputed leader in innovative, quality compassionate healthcare across the Australian landscape. As well as increasing potential for greater synergies between the organisation’s public hospital, private hospital and aged care services at a group level. On the St Vincent’s campus we have continued to invest heavily in research. Consequently we were able to develop a range of innovative diagnostic, treatment and prevention strategies to improve the quality of the care we provide. Furthermore, our collective contribution to new knowledge

– which drives quality and innovation in health care – is significant, with SV&MHS and its key research partners publishing in excess of 700 peer reviewed articles in any given year. It is increasingly evident that we cannot meet the challenges of healthcare alone. Partnerships will be the hallmark of 21st century medicine. In many instances we have established long standing and new organisational partnerships where there is natural synergy in the goals we share. For instance, our well established partnership with the University of New South Wales continues to produce some of the best trained doctors in the country. From longstanding partnerships to newer ones. This year we received, from the Commonwealth Department of Health & Ageing’s Innovative Clinical Teaching and Training Grants program, a $5.4 million funding grant to develop the Murrumbidgee Teaching and Learning Centre in Griffith, a partnership with Griffith City Council and the University of Wollongong. We believe the addition of the Teaching and Learning Centre will allow the Griffith community to realise a vision that involves a health precinct encompassing not just public and private healthcare, but additional teaching and learning facilities to help train the future health workforce in the Riverina.

many journeys. one vision. | CHAIRMAN & CEO’S FORWARD

Why we share this one journey, in the context of the hundreds of thousands of journeys undertaken each year across St Vincents & Mater Health, is that it is a poignant example of our vision to respond to community need and be part of the solution, not part of the problem.

Clinically the St Vincent’s campus continues to embrace pioneering new treatments to further improve patient outcomes. One major area where St Vincent’s has become an international leader is in the development of heart and lung mechanical assist devices. In previous years, about one quarter of patients on the heart transplant list died before receiving a new heart. Today, thanks to the mechanical devices that St Vincent’s has helped pioneer, the number has dropped to five percent of patients. In a major development on this front, St Vincent’s recently performed the southern hemisphere’s first Total Artificial Heart (TAH) transplant. In 2010 St Vincent’s opened the O’Brien Centre; Australia’s first facility to integrate community and mental health with drug and alcohol services. We are pleased to report that since its commissioning, the O’Brien Centre is proving a wonderful physical environment for creating new paradigms of healthcare. The physicality of the O’Brien Centre ensures that the patient is the focal point of care, as well as a co-ordinated effort to maximise patient outcomes. A case in point is the St Vincent’s Homeless Health Framework, where these St Vincent’s units are working in unison to provide one integrated and cohesive model of care. The hospital has intensified its efforts to address homeless health issues and provide a more holistic and cohesive service which is central to the hospital’s mission of caring for the sick, the poor and the marginalised. Located in an area characterised by a population with Australia’s highest concentration of homelessness, St Vincent’s provides community outreach in streets, parks and general community settings. The traditional design of health services tends to support a fragmented approach to care, with limited integration between specialities. Homeless individuals frequently present with a range of co-occurring health conditions along with housing and other psychosocial issues. St Vincent’s has identified key opportunities for improving access to a wider range of services as well as strategies for the delivery of cohesive, multi-speciality care co-ordination, resulting in a range of outreach and campus based services designed to meet each individual’s health needs.

Annual Review 2010/11

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The final initiative is establishment of a novel homeless healthcare centre, a medicottage – a partnership with the State Government. Services will include sub-acute medical care, including post-surgical recovery and convalescence following an inpatient admission; stabilisation on treatment programs and sub-acute care for individuals with mental health problems.

St Vincent’s Private Hospital is soon to establish a state-wide mental health service for young adults 16 to 30 years – the first such unit in NSW. Located in the recently opened O’Brien Centre, the 20-bed unit will address the gap in services for those with early onset psychosis or major mood disorders such as depression or bi-polar disorders.

By facilitating collaboration in care planning between health specialties and other community agencies, the medicottage will offer an assertive and holistic approach aiming to generate more sustainable change to help break the cycle of homelessness.

A unique model within Australian private mental health, the development has been inspired by the hospital’s mission to care for those with mental illness and acknowledges that for many the journey of mental illness is often a silent and misunderstood reality.

Guided by the SVHA Reconciliation Action Plan, the facilities of SV&MHS have initiated specific programs that are working to foster and support equity and access to healthcare in Aboriginal and Torres Strait Islander communities. Many initiatives are already under way, whilst others are soon to be finalised.

In another first, St Vincent’s Private Hospital has become Australia’s only private hospital to attain Magnet recognition. An international and prestigious quality award, Magnet recognises excellence in patient care services. Magnet recognition assures patients of exemplary care, exceptional nursing and innovative nursing practices, in line with the proud tradition and mission of the Sisters of Charity of providing excellence in compassionate care.

Through ongoing investment in research, St Vincent’s has made major inroads in developing one of the country’s largest research hubs - the St Vincent’s Research Precinct – which will facilitate the development of novel diagnostic, treatment and prevention strategies to improve the prevention and management of disease. We are creating the appropriate physical facilities befitting of such research. Construction work of the $120 million Kinghorn Cancer Centre – a partnership between St Vincent’s and the Garvan Institute of Medical Research - is progressing well, with the centre scheduled to open on time in the middle of 2012. The centre will integrate world class cancer research with best practices, rapidly translating research findings to patient care. New buildings and equipment are exciting and tangible reflections of the SV&MHS mission. In essence though, kind and compassionate care should always be the hallmark of what we do. This is why SV&MHS was particularly delighted when Paul Esplin, a Registered Nurse with the St Vincent’s Hospital Homeless Health Outreach team, was awarded Nurse of the Year at the 2011 HESTA Australian Nursing Awards in Melbourne.

01 CEO of St Vincents & Mater Health Sydney Steven Rubic reviews plans of the Kinghorn Cancer Centre with Paul Robertson

Magnet identifies healthcare organisations that attract and retain the best in the nursing profession and offers patients peace of mind in knowing that St Vincent’s Private Hospital is a world leader in patient care. In attaining Magnet recognition, St Vincent’s Private Hospital met some 88 stringent quality and safety based criteria that cover four main areas of transformational leadership, structural empowerment, exemplary professional practice and new knowledge innovations and improvements. Following the submission of evidence to support the four main criteria, three appraisers from the American Commission on Magnet visited St Vincent’s Private Hospital in February 2011. They particularly commended the work of staff at St Vincent’s Private Hospital in reaching out to the community as well as the ways in which the hospital recognises and rewards nursing staff and empowers them through involvement in decision making. Like the St Vincent’s campus, the Mater in North Sydney underwent several changes during the past year. The Patricia Ritchie Centre for Cancer Care and Research was opened by Governor of NSW Marie Bashir. The centre – which is housed within the historic Claverton building – has brought together sophisticated patient care facilities in a homelike and supportive environment as well as accommodating research and teaching facilities. The Patricia Ritchie Centre for Cancer Care and Research was previously housed in the cottage next door to Claverton. In that time it has developed a unique home away from home reputation throughout NSW, owing to its non-clinical feel for patients receiving chemotherapy treatments. The move to the larger facility has increased the centre’s treatment capacity and its ability to conduct more clinical trials, such as the “the penguin cold cap system” trial, which saves the hair follicles for some patients receiving chemotherapy. Furthermore the new centre will accommodate more Sydney University academic positions and medical student training. Once the Patricia Ritchie Centre moved into the convent building, the Mater Day Therapy relocated to this site. The internal area was completely refurbished and is functioning well.

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St Vincents & Mater Health Sydney

The Mater undertook a minor upgrade of the Day Surgery Unit to allow a greater volume of patients to be admitted as DOSA (day of surgery admittance) patients. An increased number of patients are now being admitted directly to the


St Joseph’s Village, Auburn, opened a new unit for people with dementia in late March 2011. The Carinya Dementia Unit enabled St Joseph’s to expand its dementia specific beds from 10 to 18, creating a secure haven for members of the community to live in a caring and safe environment.

DOSA unit. This now frees up bed capacity in line with the strategy to increase complex overnight surgery. Furthermore, Theatres 5 and 6 in the main Operating Suite were upgraded over the Christmas/January 2011 period. The Mater is developing a business case to expand its Special Care Nursery, as there is not sufficient space within the current hospital footprint. An opportunity exists to combine the project with expansion works in other key areas of demand, including critical care beds and operating theatres. In 2011 the Mater Hospital was named the best provider of private maternity care in NSW. This followed a major survey of Medibank Private patients which evaluated the experiences of over 2,000 patients who have recently given birth in private hospitals across Australia. Parents rated hospital performance, environment, staff and support throughout the pregnancy, birth and early parenthood. Surveyed topics in the maternity index range from preadmission care, such as antenatal classes and hospital familiarisation, to breastfeeding support and caring for newborn advice. A newly formed group of cardiologists, “Cardiology at the Mater” opened consulting rooms at the Mater Clinic in April 2011. It is envisaged that the addition of this group will result in increased cardiology, interventional cardiology, cardiac surgery and thoracic surgery volumes at the Mater. In particular there is now a more comprehensive interventional cardiology service available at the Mater. Following a nomination by the Mater, Mr Greg Poche was awarded the 2010 Macquarie Group Foundation Great Australian Philanthropy Award at the Research Australia Awards ceremony held at NSW Government House in November 2010. The Australian Council on Healthcare Standards Periodic Review took place at the Mater in June 2011 with excellent results. The report presented by the surveyors was an overwhelmingly positive view of the Mater as a hospital, its services and systems and, in particular, doctors, staff and volunteers. The report highlighted that the number of EA (Excellent Achievement) ratings increased by five to a total of twelve.

At the same time, St Joseph’s opened Bethany, a refurbished section of the hostel on the campus to care for 10 residents with high care needs. The new facility has allowed some residents, who would previously have been transferred to nursing homes, to remain at St Joseph’s Village for a longer period of time, fulfilling their wishes and those of their families. The development of Carinya and Bethany at St Joseph’s is an important milestone in our ability to provide more integrated care to respond to community need. In relation to our dementia services, Carinya is an outstanding facility, not only because of its increased capacity but because it has been carefully designed around the unique needs of our residents with dementia. Similarly, Bethany will enable us to respond more effectively as our residents’ needs become more complex.

many journeys. one vision. | CHAIRMAN & CEO’S FORWARD

to establish Local and Special Health Networks, St Joseph’s now forms part of the St Vincents Health Network. This alignment will enable greater collaboration and expansion of services, securing a bright future for St Joseph’s and the many people that it serves.

In 2012, SV&MHS will take over the state-wide Huntington’s Disease Service, with a new Huntington’s Disease Unit on the St Joseph’s site in Auburn. The new unit will be owned and operated by SV&MHS in partnership with WSLHD Huntingtons Service at Westmead Hospital. The relocation of the residential component will be undertaken with a revised model of care. This requires a 20 bed dedicated facility to be constructed, comprising 14 residential aged care beds, four neuropsychiatric beds and two assessment and monitoring beds. Construction on site is scheduled to commence in January 2012 and the unit will be ready to receive patients in September 2012. We are proud of these and the countless other journeys undertaken by the organisation in the past year, but most importantly and reassuringly, we take pride in the fact that these journeys have been undertaken with one destination in mind. Our mission and values shine as a beacon of light towards this destination as brightly today as the day we were founded.

John Gurry Chairman, St Vincent’s Health Australia

Over at St Joseph’s Auburn, 2011 saw the hospital celebrate 125 years of service to the community, and staff past and present, volunteers and friends gathered in February to mark this great achievement. St Joseph’s continues to play a vital role in providing sub-acute, aged care and palliative care services to the community. Following the decision of NSW Health in 2010

Steven Rubic CEO, St Vincents & Mater Health Sydney

Annual Review 2010/11

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Service profile

St Vincent’s Hospital

Sacred Heart

St Vincent’s Private Hospital

Department Separations

Department Separations

Department Separations

Aged 1,739

Palliative Care

766

Cardiology 2,330

Cardiac 3,239

Rehabilitation

428

Cardiothoracic Surgery

Emergency Medicine

Pre-Rehabilitation

3

Endocrinology 167

Total

1197

General Medicine & Surgery

Total Admissions including day only

1,187

Gastro Medicine & Surgery

2,711 3,101

Endocrinology

56

Gasroenterology

947

General Surgery

923

Gynaecology and Obstetrics

1,309

Haematology 1,754

Haematology

178

Immunology/HIV 1,263

Head & Neck Surgery

280

Mental Health

Immunology & Infections

127

Neurosciences 1,444

Medical Oncology

297

Oncology

Neurology

334

Ophthalmology Orthopaedics Plastic Surgery Renal

1,328

1,095 272 1,456 539 9,676

Neurosurgery

1,255

Ophthalmology

1,068

Orthopaedics & Rheumatology 3,009 Other

2,167

Sttroke Unit Care

247

Otolaryngology

1,188

Therapeutics

518

Plastic Surgery

1,098

Thoracic Medicine and Surgery 2,859

Renal

184

Urology

954

Thoracic Medicine

702

Vascular

535

Urology

4,002

Total

38,476

Vascular Surgery

Day Only Admissions

21,252

Total

22,521

Total Admissions including day stay

22,517

Total Bed Days Total Bed Days including day only Emergency Admissions Total Non Inpatients

18

3,579

601

131,735 133,971 15,633 666,064

St Vincents & Mater Health Sydney

Day Only Admissions Total Bed Days

466

7,878 81,766


many journeys. one vision. | SERVICE PROFILE

Mater Hospital

St Joseph’s Hospital

St Joseph’s Village

Department Separations

Department Separations

Licences Available

Cardiology Cardiothoracic Surgery Chemotherapy & Neoplastic Disorders Ear, Nose and Throat Endocrinology

804 68 6,088 942 23

Gastroenterology

2,864

General Surgery

1,043

Gynaecology and Obstetrics

4,769

Haematology

501

Head and Neck Surgery

524

Medical Oncology

247

Neurology

63

Neurosurgery

365

Opthalmology

70

Aged Care Assessment and Rehabilitation Unit

186

Hostel Apartments

80

Medical Rehabilitation Unit

162

Independent Living Units (self care)

27

Palliative Care Unit

379

Community Aged Care Places

35

Aged Care Psychiatry and Neurosciences Unt

114

Total

841

Day Only Admissions

6

Total Bed Days

20,720

Total Non Inpatients

31,556

01 Residential aged care services at St Joseph’s Village, Auburn.

Orthopaedics & Rheumatology 3,808 Other

1,828

Plastic Surgery

1,005

Renal

69

Thoracic Medicine

86

Urology Vascular Surgery

1,128 612

Total

26,907

Total Admissions including day stay

27,802

Day Only Admissions

14,648

Total Bed Days

70,752 01

Annual Review 2010/11

19


Governance St Vincents & Mater Health Sydney, a member of the St Vincent’s Health Australia group, comprises the following facilities: 

Board 

• The Mater Hospital

A single board governs all St Vincent’s Health Australia facilities and replaced the former regional and national boards on 1 October 2010. In fulfilling its role the St Vincent’s Health Australia Board acts within the delegations and approvals provided by the Trustees of Mary Aikenhead Ministries.

• St Vincent’s Private Hospital1

Mr John F. Gurry (Chairman)

• St Joseph’s Hospital

Fr Frank Brennan SJ AO

• St Joseph’s Village

Sr Helen Clarke RSC (Retired 31 December 2011)

• St Vincent’s Hospital Sydney • Sacred Heart Hospice

1. St Vincent’s Private Hospital is conducted by the Sisters of Charity and managed by St Vincents & Mater Health Sydney in accordance with a management agreement. St Vincent’s Hospital Sydney, Sacred Heart Hospice and St Joseph’s Hospital form St Vincent’s Health Network which also reports to NSW Health.

Mr Brendan Earle Ms Patricia Faulkner AO Mr Gary Humphrys Ms Belinda Hutchinson AM Mr Paul Robertson AM Prof Peter J. Smith RFD Mr Greg Sword AM

20

St Vincents & Mater Health Sydney


many journeys. one vision. | GOVERNANCE

Community Advisory Council The St Vincents & Mater Health Sydney Community Advisory Council focuses on local stakeholder engagement, service planning, and mission.  Mr Paul Robertson AM (Chair) Prof Donald Chisholm AO Mr Peter Collins AM QC Mr Jim Dwyer OAM Mr Liam Forde Mr Bruce Hawker Sr Joanne Kirk rsm Mr Ian Martin Mr Robert McCuaig Ms Sandra McPhee Prof Peter Smith Sr Clare Nolan rsc

Senior Executive Team St Vincents & Mater Health Sydney 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, St Vincents & Mater Health Sydney

Mr Jose Aguilera Director of Nursing & Clinical Services, St Vincent’s Private Hospital

Mr Jonathan Anderson Executive Director, St Vincent’s Public Health Services

Ms Vicki Dean General Manager, St Joseph’s Village

Mr Robert Cusack Executive Director, St Vincent’s Private & Mater Hospitals

Ms Leslie Everson Director of Operations, St Vincent’s Hospital

Mr Mark Hales Director of Mission & Corporate Relations, St Vincents & Mater Health Sydney

Mr John Geoghegan Director of Operations & Nursing, St Joseph’s Hospital

Ms Kerrie Field General Manager Human Resources, St Vincents & Mater Health Sydney

Ms Helen Miller Director of Aged Care & Sub Acute, St Joseph’s Hospital, St Joseph’s, Village & Sacred Heart Hospice

Mr Harry Chiam A/Chief Financial Officer, St Vincents & Mater Health Sydney Ms Shaune Noble General Manager Corporate, Governance & Planning, St Vincents & Mater Health Sydney

Ms Barbara Paris Director of Nursing, Mater Hospital Ms Maeve Tumulty Director of Nursing & Patient Care, St Vincent’s Hospital

Mr David Roffe Chief Information Officer, St Vincents & Mater Health Sydney

Dr Brett Gardiner Director of Clinical Services, St Vincent’s Hospital

Ms Michelle Wilson Executive Director, St Vincent’s Clinic

Ms Grainne O’Loughlin Director of Allied Health, St Vincent’s Hospital

Annual Review 2010/11

21


Stewardship The facilities of St Vincents & Mater Health Sydney (SV&MHS) have a strong tradition of responding to the needs of their communities. Inspired by its founding Congregations of the Sisters of Charity and Mercy, SV&MHS is challenged to go the extra mile in supporting and caring for those most in need. Central to this mission is service of the poor and commitment to work with, and for, those most marginalised in the communities served.

22

St Vincents & Mater Health Sydney

Throughout 2010/2011 SV&MHS contributed in excess of

$28 M


The report summarises the contributions that have been made in the previous financial year and is divided into four areas: works of charity, community benefit, social accountability and in kind donations – which are donations that do not incur a direct cost to SV&MHS. Throughout 2010/2011, SV&MHS contributed in excess of $28 million.

Works of charity Works of charity are one-off responses to identified individuals or community needs. They reach out to care for the marginalised and disadvantaged and are not part of a planned service. In 2010/2011, more than $4.5 million was spent on works of charity by SV&MHS, ranging from acts of charitable writeoffs for various hardships faced, to supporting overseas trained Thai nurses and funding an upgrade to the kitchen and new crockery for a clinic in Timor Leste. Another example of these activities is the pro-bono specialist medical treatment for asylum seekers offered by St Vincent’s Clinic for clients of the Asylum Seekers Centre. After much negotiation and consultation with the medical practitioners in St Vincent’s Clinic, St Vincent’s Private Hospital and SydPath, the program became operational in July 2001. The program offers specialist medical services, such as pathology for patients being treated by participating doctors, radiology, medical imaging and nuclear medicine services including bone scans.

Community benefit

Social accountability

Community benefit is a planned, managed, organised and measured approach to a healthcare organisation’s participation in meeting community need. Inspired by its mission and values, community benefit at SV&MHS comprises services which are provided in addition to core services. In particular SV&MHS targets those who are poor and marginalised, preventative health, wellness and holistic care.

Social accountability is a planned, documented and evaluated approach to service provision for core services beyond the level provided by key sources of funding.

A snapshot of these activities includes: Bereaved support at the Mater At the Mater Hospital more than $35,000 was spent on three initiatives to help care for the bereaved. Support groups for those experiencing pregnancy after the loss of a baby are an important step in recognising the special challenges faced by these mothers. Stormanston House bereavement support groups offer support for families who have experienced the loss of their baby as a result of stillbirth or death in the newborn period. There was also continued support with the service of remembrance, an annual service for bereaved families. Southern Sudanese Educates Girls [SSEG] Appeal In partnership with SSEG, St Joseph’s Hospital is undertaking a three-year program to raise money to help build a clinic within a Catholic High School in Aweil, Southern Sudan. The program was launched in March, 2011 in the presence of Mr Warren Hopley, Chairperson of SSEG, and 15 Sudanese women who were promoting the project in Australia. Six rooms of the high school are already complete and it is hoped the clinic will be built, furnished and operating within the next three years. The clinic will specifically support women and their children.

Greening SV&MHS

many journeys. one vision. | STEWARDSHIP

Each year a stewardship report is produced. The report attempts to capture the activity and contribution SV&MHS facilities have made in fulfilling its mission to care for the poor, the marginalised and the broader community served.

Environmental initiatives have continued to be rolled out across SV&MHS. These include the installation of additional recycling bins and facilities to separate general and recyclable waste in kitchenettes. There was also the addition of a battery and cartridge recycling facility to all floors of the hospitals. There was a review of all toilets in St Vincent’s Clinic and regular maintenance of flush systems to prevent water wastage. In an effort to limit electricity use, motion activated lights were installed in staff bathrooms, tea rooms, conference rooms and lecture/ function rooms and chillers were replaced with models offering a more environmentally friendly operation.

In kind donations In kind donations are those which are given but incur no immediate direct cost to the organisation. This may include the donation of equipment, furniture and excess catering. Another important facet of the in kind donation program is the provision of pro-bono treatment.

Annual Review 2010/11

23


Mission In 2011 a special celebration was held at Darlinghurst to bless commissioned portraits of Sister Baptist Delacy and John Hubert Plunkett, the founders of St Vincent’s, Australia’s first Catholic hospital. The two portraits sitting side-by-side are a powerful symbol of the partnership between the Sisters of Charity and their lay companions, in bringing to life their vision for a Catholic healthcare ministry that would reach out to all people in the community in need. This spirit of partnership and relationship is at the centre of the St Vincents & Mater Health Sydney mission as it has grown and developed over 150 years. Similar stories are shared by St Vincent’s Private Hospital, Sacred Heart, the Mater campus with the Sisters of Mercy and at St Joseph’s, and the work of the Sisters of Charity in the Western regions of Sydney. The foundation mission expressed through these portraits shares the same source and meaning that continues to be expressed in 2012. At the heart of the mission is the ministry of Jesus and the Gospel values which have shaped the organisation’s commitment to the healing Ministry. The mission statement for St Vincents & Mater Health Sydney (SV&MHS) expresses this commitment when it states; “Our Mission is to bring the healing ministry of Christ to all we serve in the spirit of love, hope, compassion and justice.”

24

St Vincents & Mater Health Sydney

When Monsignor Jose Redrado OH, Secretary of the Pontifical Council for Health Workers (Holy See) was asked in 2009: “How is a Catholic hospital different from any other hospital?”, his response was that when someone comes to one of our facilities, their experience should make them feel more loved. The virtue of love was central to Jesus’ teaching and an invitation to accept all people who come to us. The Sisters of Charity could not have expressed this more perfectly than when they established the St Vincent’s mental health facility and named it the Latin word for love or ‘Caritas.’ The Gospel understanding of hope is more than just a sense of optimism in terms of adversity. Rather, it is the ability to embrace life fully; recognising that both the blessings and the challenges we experience are an invitation to embrace an openness to all that life offers. This is not always easy, especially during times of great suffering, and yet our mission was forged on this sense of hope, which has sustained our hospitals and healthcare communities for more than 150 years. It has also enabled us to care for our patients, their families and loved ones with a sense of the sacredness of life.

For the Sisters of Charity and Mercy, compassion was at the centre of their care and as they established each facility and service. Most significantly, the value of compassion speaks powerfully that we walk the journey ‘with’ patients. Each of our hospital facilities and healthcare services aims to make that difference in the way we extend our care, acknowledging the dignity and worth of all who come to us. To care for the poor and marginalised is central to the SV&MHS mission, and is a core part of how we measure how authentically we are living our Catholic identity. Each year SV&MHS audits what has been contributed, both financially and through the many programs of support offered. The stewardship report reminds all of us that while we proudly provide outstanding healthcare through our facilities, we also must be challenged to make a difference for those whose lives are impacted through poverty or who have been marginalised and disadvantaged due to circumstance, illness or hardship.


Pastoral Care

Volunteering

The Mission Office facilitates a range of services across the facilities of SV&MHS. With a mission leader on each campus, the work of Mission is varied and responds to the needs of both the leadership in each facility as well as how staff are connected to the organisation’s purpose and Catholic identity.

Catholic healthcare treats around one-in-ten patients in Australia and cares for around one-in-five aged care residents. These statistics reflect the significant presence we play in the Australian healthcare landscape. The commitment to holistic care is an important part of how we honour the distinctive character of our Catholic tradition. A patient is much more to us than merely a procedure or a measured length of stay, they are someone who has spiritual, emotional, and social needs as well as physical.

Around 450 women and men volunteer across the facilities of SV&MHS. The service, which is based in each facility, offers a range of support to staff and the patients who come to us for care.

The core functions include: • Orientation and induction • Retreats • Formation initiatives • Liturgy and rituals • Prayer • Feast days and celebrations • Major religious festivals (Lent, Easter, Christmas) • Foundation days and acknowledgement of staff service • Leadership development (in partnership with Human Resources) • Stewardship, social justice and outreach initiatives • Team days and mission integration • Reconciliation Action Plan (RAP) • Bioethics (including the Bioethics Committee and partnership with the Plunkett Centre) • Religious art and iconography. Although the mission staff may be based on different campuses in the Sydney region, they work together as a team, utilising their strengths to build a network of mission support across the region. Initiatives such as the Gift retreat program are presented by the whole team in an off-campus residential program, and the mission team moves around the facilities supporting each other in the delivery of programs and presentations. This strengthens our Catholic identity and commitment to mission.

Our Pastoral Care staff are part of our multidisciplinary team caring for patients and they provide their service through:

The volunteers range in age from 18 to 93 years, and they are an enthusiastic and committed group of supporters who willingly give of their time to our hospitals. Some of the areas and services which volunteers support include: • LinkAGE (companioning for lonely or isolated residents living in aged care around Sydney) • Flower arranging in patient rooms

• Establishing relationships of trust

• Escorting patients to their rooms and around the hospitals

• Reflective listening

• Administration support

• Assessing spiritual & emotional needs

• Little Shop (of which all proceeds support projects at St Vincent’s Hospital)

• E xploring issues of faith and meaning • Accompanying patients and families as they tell and reflect on their story

• Medical Records

• Providing an important link to chaplaincy and the sacramental resources of the Catholic Church

• Assisting patients at meal time

• Providing links to chaplaincy (ministry) of the different faiths and beliefs of a diverse patient population

• Errand support for patients

• Providing meaningful rituals, prayer and liturgy • Helping patients to identify their own interior resources and external supports • Providing support during times of relational conflict

many journeys. one vision. | MISSION

Mission Office

• Accompanying patients • Company for palliative care patients • Lolly trolley and jolly trolley around the wards • Fundraising In May 2011, the volunteers of SV&MHS were honoured by Her Excellency Prof Marie Bashir AC, the Governor of NSW, at a reception at Government House. This was an extraordinary celebration and a great tribute to the commitment and service of our patients to our hospital communities.

Annual Review 2010/11

25


corporate information

Reconciliation Action Plan St Vincents & Mater Health Sydney has embarked on an industry leading mission to further its vision of a reconciled Australia, where all peoples and communities share in the health and prosperity that the nation has to offer.

01

Leading the way, St Vincent’s Health Australia (SVHA) is the country’s first healthcare group to commit to reconciliation and to formalise its responsibility to Aboriginal and Torres Strait Islanders with its Reconciliation Action Plan. A broad and visionary document, the Reconciliation Action Plan is a living work, which is being created in partnership with the nation’s peak Aboriginal and Torres Strait Islander bodies, as well as organisations delivering healthcare to Indigenous communities. Mark Hales, Director of Mission and Corporate Relations for SV&MHS, said the Reconciliation Action Plan was being developed in close consultation with local elders and the wider community. “We want to stand side by side and have the conversations which will enable us to listen, learn and build trust. This plan provides us with an extraordinary opportunity to demonstrate our commitment to Aboriginal and Torres Strait Islander communities,” Mark says. Guided by the Reconciliation Action Plan, SV&MHS is working with these communities to foster and support equity and access to healthcare, making important steps in the mission of SV&MHS to close the gap experienced by Aboriginal and Torres Strait Islander communities and the non-Indigenous broader population.

A snapshot of Reconciliation Action Plan initiatives includes the collaboration between St Vincent’s Clinic, as well as St Vincent’s and Mater Hospitals, to provide a fortnightly orthopaedic specialist clinic at Redfern Aboriginal Medical Service in Redfern. Offering a wide range of musculoskeletal services and trusted by clients, the three hour clinic is attended by those with referrals and aims to assess and refer 15-20 patients each session. Facilities across SV&MHS also offer outreach to remote areas, which would otherwise have limited access to specialist healthcare. In the state’s far west, ear nose and throat surgeons from St Vincent’s Hospital conduct bimonthly visits to Pius X clinic at Moree. The clinic has run for the past eight years and has helped hundreds of local residents. Further, in conjunction with Condoblin Aboriginal Health Service, heart lung surgeons have established a cardiology clinic. Separate outreach occurs in the form of a renal clinic established in the Torres Strait.

01 SV&MHS hosts and participates in significant events of cultural education and celebration with local Aboriginal and Torres Strait Islander communities 02 Affirmation of the Welcome to Country and Acknowledgement of the Land is an important first step in developing a broad level of respect across the organisation 26

St Vincents & Mater Health Sydney


many journeys. one vision. | reconciliation action plan

02

Further Reconciliation Action Plan initiatives include Connections, an Aboriginal women’s art therapy program which is run by St Vincent’s Hospital and has united and nurtured the talents of more than 150 mental health consumers. In recognition of the importance of the Reconciliation Action Plan, facilities across SV&MHS proudly fly the Aboriginal flag next to the Australian flag and artworks have been commissioned from local Indigenous artists for display in several hospitals. The new role of Aboriginal Liaison Officer Co-ordinator has been created at SV&MHS, and healthcare professionals across the organisation have been invited to participate in an online cultural orientation program that can be accessed from clinical workstations. The program is designed to create better understanding of the needs of Aboriginal and Torres Strait Islander patients. In 2012, St Vincent’s Private Hospital will embark on a new era with an Aboriginal and Torres Strait Islander nursing cadetship. The annual cadetship will be offered to two students undertaking a Bachelor of Nursing and will provide a minimum of 12 weeks employment every year, for three years, as well as additional financial support and invaluable experience in working at a leading private and Magnet accredited hospital.

Open to Aboriginal and Torres Strait Islander students undertaking a Bachelor of Nursing degree over three years, the cadets will be employed as an Assistant in Nursing. The program, which will be managed through the hospital’s Education, Training and Development Department, will be advertised at universities, local high schools and in indigenous publications. Partially funded by the Department of Education, Employment and Workplace Relations, graduates will be eligible to apply for the new graduate program at St Vincent’s Private or any other hospital upon completion of the Bachelor of Nursing.   As the first private hospital in Australia to offer an Aboriginal and Torres Strait Islander nursing cadetship, the program reinforces the hospital’s long-term commitment to enhance an inclusive and diverse workforce through programs and strategies that provide employment and development opportunities for Aboriginal and Torres Strait Islander peoples.  

Annual Review 2010/11

27


F

Feature Article

Our Stories

01

02

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St Vincents & Mater Health Sydney

03


“Like any remote area, Moree has some difficulty accessing specialist care, not just ENT but all sorts of specialties” Dr Nigel Biggs Ear Nose and Throat Surgeon

many journeys. one vision. | MOREE OUTREACH

04

Moree outreach Six times a year, doctors from St Vincent’s Hospital journey to the far west of NSW to offer their expertise to the residents of Moree. What started in 2003 as a small part of the Pius X Indigenous Medical Service has become an essential facet of the rural centre’s healthcare services. Moree

In the afternoon the pair travelled across On a recent outreach visit, Ear Nose town to Pius X, where they offered help and Throat (ENT) Surgeon Dr Nigel Biggs for conditions ranging from a burst and ENT trainee Nicholas Jufas, treated more than 30 patients, in a day which saw eardrum to providing hearing aids. them perform two surgeries and diagnose “We see a lot of problems, which can an entire family with hearing difficulties. be simple ear problems in adults and children, through to occasionally “Like any remote area, Moree has some picking up a much more serious difficulty accessing specialist care, not problem, such as head and neck just ENT but all sorts of specialties,” Dr cancer,” Dr Biggs said. Biggs says of the clinic, for which people travel hundreds of kilometres to visit. “There are a lot of issues in indigenous healthcare and a lot of it is to do with “It’s a service that is based in the Pius X difficulty in access. Partly due to this, Clinic, which is an indigenous medical indigenous people tend to have a service, but of course there is no proportionately large amount of ear discrimination and so you don’t have problems and this is something we to be indigenous to see us.” have to be particularly conscious of.” The August outreach visit was typical, Dr Biggs said the outreach wouldn’t starting with two minor operations, be possible without the dedication of a tonsillectomy and the insertion of Ros Rose, the Nurse Unit Manager grommets, at Moree Base Hospital. at Pius X. “Ros is really the driving force behind the whole place and she organises not just us but several other specialties to visit,” he said.

Sydney

01 8.30am Drs Nigel Biggs and Nicholas Jufas arrive to Moree for the bi-monthly ENT outreach clinic 02 Dr Nigel Biggs performs paediatric ENT surgery at Moree Base Hospital 03 Dr Nigel Biggs, ENT Surgeon, examines a patient at the Pius X clinic, an indigenous medical service in Moree 04 A local boy prepares for his tonsillectomy Annual Review 2010/11

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F

Feature Article

Our Stories

Art Connections Connections - Aboriginal Women’s Art Therapy Group has reunited Rachael Munro with what she describes as her Aboriginality, something denied to her as a child. Not only a place of cultural importance, Connections has provided Rachael and her five children with a place of comfort, belonging and healing. Having left a relationship fraught with domestic violence in 2002, Rachael was put in contact with the art therapy group – a joint venture between St Vincent’s Hospital and the Aboriginal Medical Service in Redfern. Not an artist, but knowing that she would enjoy the experience, Rachael was surprised at what she was to find. At the weekly meetings, Rachael found a group of women proud of who they are. “These women became a support network for the whole family,” she said. The group itself is very much in touch with the feelings and emotions of others. It really is a unique group of women from different walks of life but with one thing in common, we are all Aboriginal.” In a community centre in the back streets of Chippendale, the women meet and sit around a large table, chat and paint. “I grab the paints and go from there. Over the years my artwork has evolved. I used to just dabble but I can now say that I am an artist. I have come a long way with my art. The first thing I painted was an Emu, it was a funny looking chook to me and is a reminder of where I started off,” says Rachael. Rachael believes that “the group lets me be me” and has provided her with a new found confidence, that has led Rachael to speak at mental health conferences throughout the state.

30

St Vincents & Mater Health Sydney

01

“We are a group of women with mental health issues, we know about it, we are living with it and I would like to help younger people. It is empowering as prior to joining Connections I could not talk about it,” she says. Kaylene Simon, Aboriginal Health Worker at St Vincent’s Hospital, explains “Rachael has moved in her journey from someone isolated in the home to being an integral part of the Connections community.” Having formed strong bonds with the others in the group, Rachel adds “If I don’t turn up to the group the other ladies will ring me to see if everything is OK – it is great as I know they care.” The name Connections evolved from the Aboriginal concept of kinship. Kaylene says, “Historically kinship has been lost and Connections is about bringing this kinship back. Through the art-making process, the women are taken back to their traditional and spiritual roots by way of traditional art and craft processes.”

02

Established in 2002, Connections aims to meet the holistic needs of Aboriginal women, carers and their families with social, emotional, health and wellbeing issues and to decrease isolation. Kaylene says “It is a space for women to debrief and a supportive environment for Aboriginal women who live with mental health issues.”

03


many journeys. one vision. | ART CONNECTIONS

04

01, 02 & 03 Kaylene Simon (02) Aboriginal Health Worker at St Vincent’s Hospital, helps bring women back to their traditional and spiritual roots with Connections – Aboriginal Women’s Art Therapy Group 04 In the back streets of Chippendale Rachael Munro paints and connects with Aboriginal women from all walks of life

Annual Review 2010/11

31


Research

St Vincents & Mater Health Sydney (SV&MHS) continues a long and proud tradition of excellence in teaching and research. Across the campuses SV&MHS shares a vision to improve human health through scientific discovery. As an organisation, SV&MHS looks towards innovations that improve human health locally, nationally and internationally, and works to translate these findings into everyday clinical practice. Uniting those in laboratories with those at the frontline of healthcare delivery, SV&MHS is experiencing an increase in its medical research endeavours. This growth is driving the evolution of everyday healthcare practice and makes real life differences for the individual patient. The result: better patient outcomes.

Overview On the St Vincent’s campus, the long awaited St Vincent’s Research Precinct (SVRP) development became reality with the Phase 1 opening of the precinct; the Lowy Packer Building. The building houses the Victor Chang Cardiac Research Institute and the St Vincent’s Centre for Applied Medical Research (AMR), which came into existence in 2008 and incorporates the Clinical Research Program (CRP). The AMR-CRP provides a high quality clinical trials service across the Darlinghurst campus. In recent times, AMR programs have actively participated in the Darlinghurst campus capital master planning process. One of the major outcomes is the overwhelming need to realign and focus on the development of structures and processes to integrate all Darlinghurst-based research and teaching initiatives. The Darlinghurst campus, one of Australia’s largest and most successful bio-medical research hubs, will support and enable a greater focus on translational research where there is an intersection of clinical and research expertise. During this time of continued transition the facilities of SVRP are working together, under the direction of AMR, on the Darlinghurst Campus Translational Research Steering Committee. The likely result of this review is that AMR will cement its position as the peak research body for the campus, while recognising the important contributions of the co-located but independent Garvan Institute of Medical Research and Victor Chang Cardiac Research Institute (VCCRI). Their close physical proximity reflects the strong working relationships of these organisations, with many core facilities being shared among the University of NSW, the Kirby Institute, VCCRI and Garvan. The ultimate aim to be achieved from this initiative is the critical mass required to support quality translational research, world class research talent and greater research funding. The vision is to create a world-leading health services and research campus that conducts a continuum of high quality applied and translational, discipline-based and multidisciplinary research, that is mission aligned and contributes actively to the relief of human illness and suffering. The combined efforts of AMR and the Kirby Institute (formerly the National Centre in HIV Epidemiology and Clinical Research) came together in July 2009 to form a single unincorporated joint venture and successfully qualified for State Medical Research Support Program infrastructure

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St Vincents & Mater Health Sydney


research projects

and provides ethical review for over

external entities

many journeys. one vision. | RESEARCH

700 40 st vincent’s oversees approximately

Research Office funding, ranking in the top three of the funded organisations in NSW. This partnership has an independent board of management, housed within magnificent facilities on the St Vincent’s Research Precinct. Since a donation of £100,000 in 1961 for establishment of St Vincent’s first clinical research unit, which facilitated the opening of the Garvan Institute of Medical Research in 1963, research endeavours across SV&MHS have grown in scope, practice and partnerships. Moving beyond clinical and laboratory settings such as the Clinical Research Unit for Anxiety and Depression which focuses on developing online education and treatment programs for mood and anxiety disorders, the St Vincent’s campus also focuses on uniting academia and clinical practice. A case in point being the newly established Nursing Research Institute, which provides a base for nurse-led multidisciplinary research and constructs a bridge between theory and practice whilst promoting evidence-based implementation.  No matter what the area of activity, all SV&MHS research endeavours enhance the organisation’s services. For example, Faces in the Street, the Urban Mental Health Research Institute, is complementing the work of the Inner City Health Program at St Vincent’s Hospital. The institute is identifying the needs of vulnerable populations within the inner city, evaluating hospital and community services, and supporting the development of innovative programs based on this research and evaluation. Similarly, the Cunningham Centre for Palliative Care has expanded partnerships. In just three years since its establishment the centre is involved in more than 20 active studies and is providing advice on palliative care at a state and national level. All research initiatives across SV&MHS are grounded in Christian tradition. Guided by the organisation’s Catholic ethos, vision, mission and values, the Plunkett Centre for Ethics focuses on ethical, social and religious challenges associated with the provision of healthcare services. Over on the Mater campus, the opening of Melanoma Institute Australia in the Poche Centre in March 2010, coupled with the relocation of the Patricia Ritchie Centre for Cancer Care and Research to a new facility with greater capacity for research, reinforce the growth of research across SV&MHS.

The Research Office is located at St Vincent’s Hospital and is the focal point for research both within the organisation and in collaboration with the research entities on the St Vincents & Mater Health Sydney (SV&MHS) campuses, including the Garvan Institute of Medical Research, Victor Chang Cardiac Research Institute, St Vincent’s Private Hospital, Mater Hospital, The Cunningham Centre for Palliative Care, Melanoma Institute Australia, Patricia Ritchie Centre for Cancer Care and Research, St Vincent’s Centre for Applied Medical Research – Clinical Research Program, St Vincent’s Urban Mental Health Research Institute and Nursing Research Institute. The office manages all activities relating to the Human Research Ethics Committee (HREC) and is responsible for research governance across SV&MHS. In addition to this the Research Office: • Promotes the SV&MHS campus as a leading centre for research. • Encourages and supports all employees to participate in research. • Facilitates the translation of research into clinical practice and health policy. The Research, Ethics and Public Health Training Branch is responsible for developing, communicating, implementing and evaluating policies, frameworks and guidelines to ensure that ethical considerations are given proper weight in medical and clinical practice and research within the NSW public health system. Human Research Ethics Committee The Human Research Ethics Committee is responsible for ensuring researchers who work under its auspices fulfil their ethical and legal responsibilities to the people who volunteer to take part in research, in accordance with the National Health and Medical Research Council’s (NHMRC) National Statement on Ethical Conduct in Human Research (2007). These responsibilities reflect the core ethical values of respect for human beings, research merit and integrity, justice and beneficence. The St Vincent’s Hospital Human Research Ethics Committee (HREC) is a lead HREC under the NSW Single Ethical Review model and is also accredited by the NHMRC under the HoMER initiative for both ethical and scientific review of multi-centre research proposals. The HREC overseas approximately 700 research projects and provides ethical review for over 40 external entities.

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SV&MHS Research

Research Governance

The Cunningham Centre for Palliative Care

The Research Office is responsible for research governance across SV&MHS and also provides research governance support to the Garvan Institute for Medical Research and the Victor Chang Cardiac Research Institute.

The Cunningham Centre for Palliative Care enjoyed a productive year of research in 2010/2011. The centre was officially opened in August 2008 and is a collaboration between Sacred Heart Hospice, The University of New South Wales, The University of Notre Dame Australia and Calvary Healthcare Sydney. Each institution has contributed significantly to the development of the centre, as has the Cancer Institute of New South Wales through that organisation’s Academic Chairs Program. Sacred Heart’s support has been made possible through the generous philanthropic contributions of many individuals and organisations over the years.

Research governance is a framework through which institutions are accountable for the scientific quality, ethical acceptability and safety of the research they allow to be conducted under their auspices. Research governance is an essential component of the responsible conduct of research, as it enhances ethical and scientific quality, promotes good research practice and accountability.        There are approximately 700 research projects currently being conducted across SV&MHS. A breakdown down of the types of research is represented in the above graph.

Research Affiliations Clinical Research Unit for Anxiety & Depression The unit contains the Anxiety Disorders Clinic of St Vincent’s Mental Health Service, the Clinical Research Unit for Anxiety and Depression Clinic (CRUfADclinic) and Virtual Clinic, all of which amalgamate to make a joint University of New South Wales and St Vincent’s Hospital research facility. Clinical Research Unit for Anxiety and Depression is a research unit focused on developing online education and treatment programs for mood and anxiety disorders. Research is trialled through the Virtual Clinic and successful programs are disseminated to clinicians through a world leading service called CRUfADclinic. The Anxiety Disorders Clinic offers evidence based, face-to-face and online therapy for mood and anxiety disorders. Meanwhile, CRUfAD continues to have a primary research interest in the epidemiology and health policy implications of mental disorders associated with old age with the aid of a National Health and Medical Research Council (NHMRC) program grant. Research highlights include: • Fifteen randomised controlled trials examining the efficacy of online treatment programs for mood and anxiety disorders. • 4,000 patients from the community enrolled in effective online programs. • One UNSW Medicine Independent Learning Project, two UNSW Medicine PhD graduates. • Renewal of NHMRC program grant for ‘The prevention, early detection, and effective management of neurocognitive disorders in the elderly.’

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• Clinical Research • Clinical Trial – Device • Clinical Trial – Drug • Low Risk • Data Bank • Tissue Bank • Qualitative Health Research • Population Health • Clinical Interventional

St Vincents & Mater Health Sydney

The academic appointees have developed a program of research and, as a result, the centre is already involved in over 20 active studies. In addition, the centre’s appointees have provided advice on palliative care policy at a state and national level. With a focus on research that addresses symptom management, the end of life experience, educational initiatives and the psychosocial aspects of palliative care, the centre is engaging in multi-site collaborations including involvement with the Palliative Care Clinical Studies Collaborative (PaCCSC), a Commonwealth funded initiative led by Flinders University. Palliative care clinical trials are conducted at both Sacred Heart and Calvary Hospital in collaboration with clinicians at those sites. In addition, the centre’s appointees have assisted healthcare professionals across the Darlinghurst campus, Calvary Hospital and at other sites to engage in palliative care research. Of note, the centre’s administrative, nursing and project research staff contribute greatly to its outcomes. The centre also focuses on how research findings can positively impact care delivery through both practice and policy change. The centre acknowledges and supports the role of health professionals outside of specialist palliative care who are engaged in the care of those with various lifethreatening illnesses through researching, alongside those professionals, what is needed to enable them to optimise the delivery of palliative care in their clinical environments. Examples of such research collaborations include investigations in the areas of bereavement, geriatrics and heart disease, emergency room care towards the end of life, rural nursing education and the effectiveness of professional development in healthcare.


many journeys. one vision. | RESEARCH

Faces in the Street Faces in the Street (FitS) was established in 2008, with the vision to understand the underlying factors that contribute to mental illness in individuals and communities living in urban environments, especially for socially and economically disadvantaged groups. The aim is to determine the most effective ways for services to meet these needs and to promote the mental health of those living in urban areas. In 2011, FitS was incorporated into the Inner City Health Program at St Vincent’s Hospital, where it can complement the program by identifying the needs of vulnerable populations within the inner city, evaluating hospital and community services and supporting the development of innovative programs based on this research and evaluation. In February 2011, FitS hosted ‘Rising to the Challenge: 2nd International Urban Mental Health Conference’ at the Darlinghurst campus. A comprehensive survey of community-based services relating to the Inner City Health Program is being undertaken, in order to identify the functionality of their working relationship with each other and the program; to look for strengths and gaps in services and to ascertain interest in collaborative service provision and research. Later, consumer and carer views will be sought along with needs assessments of vulnerable populations forming the inner city community. A second major project is evaluating the uptake and delivery of an enhanced case management model for consumers within the Inner City Health Program. This model involves the application of personalised packages of care within a strengths-based/recovery-oriented treatment framework. A third project is looking at screening and care pathways for people with mental health problems within the Diabetes Service. It is anticipated that these pathways will later be available electronically and similar pathways will be useful for other groups with physical and mental health co-morbidities. Other projects involve homeless youth or ‘rough sleeper’ patient flows in the Emergency Department, brief psychological interventions for deliberate self-harm and an online intervention for people with type 2 diabetes. The Garvan Institute of Medical Research Founded in 1963 as a research department of St Vincent’s Hospital, the Garvan Institute of Medical Research has evolved into an internationally recognised leader of research into the role of genes in health and diseases. Garvan’s research focuses on diseases including cancer, diabetes and obesity, Alzheimer’s and Parkinson’s Disease, osteoporosis, arthritis and asthma.

Garvan’s mission is to make significant contributions to medical science that will change the direction of science and medicine and have major impacts on human health. Garvan strives to enhance and develop research programs that combine fundamental science with strong clinical interactions. There were many research highlights for Garvan in 2010/2011, a snapshot of these activities include: •D  evelopment of a potential anti-rejection drug for insulin cell transplantation Garvan scientists Drs Helen McGuire and Cecile King developed a reagent with the potential to prevent rejection of transplanted insulin producing cells into people with Type 1 diabetes – one of the most promising immunology developments in recent years. •S  ilencing a deadly conversation in breast cancer While it is already known that breast cancer cells create the conditions for their own survival by communicating their needs to the healthy cells that surround them, Garvan identified a new way of turning off that cellular cross talk. Research has shown that a molecule known as ‘hedgehog’ sits at the centre of the switchboard in breast cancer, transmitting biochemical signals between the cancer cells and healthy cells. When this conversation is blocked – or hedgehog is ‘silenced’ – tumours shrink and their spread is stopped. • An extra five years of life following osteoporosis treatment Garvan clinical researchers Associate Professor Jacqueline Center and Professor John Eisman noted an extraordinary and unexpected benefit of osteoporosis treatment – that people taking bisphosphonates are not only surviving better than people without osteoporosis, they appear to be gaining an extra five years of life.  steoporosis is a serious and disabling condition that O affects around two million Australians. Someone is admitted to hospital with an osteoporotic fracture every five to six minutes, averaging at 262 hospitalisations each day. It has already been shown by Garvan and others that osteoporotic fractures increase a person’s risk of dying, even after relatively minor fractures if that person is elderly.

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• How fatness is forecast in the womb Garvan scientists discovered that children born of mums with gestational diabetes will tend to become fat and the worse the mother’s sugar levels during pregnancy, the fatter they will be. In Australia, roughly 8 to 10 percent of pregnant women develop diabetes in pregnancy. The new finding underlines how important it is for women to try and maintain a healthy weight before and during pregnancy for the sake of generations to come. Garvan Doctors Sue Mei Lau and Jenny Gunton drew their conclusions from a mouse model of gestational diabetes and published their findings in the journal Diabetologia. Existing studies show that diet and exercise decrease the risk of gestational diabetes and of later Type 2 diabetes. Victor Chang Cardiac Research Institute The Victor Chang Cardiac Research Institute (VCCRI) is an internationally renowned biomedical research institute that is committed to excellence in research into heart disease and cardiovascular biology, cardiovascular research training and facilitating the rapid application of research discoveries to patient care. With more than 130 staff, the institute addresses all forms of heart disease and has a major focus on the prevention, diagnosis and treatment of heart muscle diseases. The VCCRI is a leader in adult stem cell technologies and their potential application to the treatment of cardiovascular disease. In Australia the death rate for all major types of cardiovascular disease has fallen by 80 percent since the 1960s, due to advances in medical research. Since its establishment in 1994, the Victor Chang Cardiac Research Institute (VCCRI) has contributed to the world’s knowledge on the causes of cardiovascular disease. In addition to excellence in research, the VCCRI plays an important role in raising awareness in the community of cardiovascular disease, by conducting tours of the institute to give insight into what the institute’s activities are, publishing heart healthy cookbooks, and in 2010 launching the Victor Chang Health Check Booth. The booth is designed to encourage employers to be socially responsible and encourage their employees to have their blood pressure, cholesterol and blood sugar levels tested to increase their awareness of cardiovascular disease risk factors. One of the major fundraising events each year is the traditional ‘Heart-to-Heart’ Ball. The VCCRI was honoured

to have Prime Minister Julia Gillard as the guest of honour at the 2010 ball. The Prime Minister spoke about the lasting impact surgeon Victor Chang has had on the lives of many Australians and her presence also provided an opportunity to raise important issues, like the fundraising challenges faced by Australian medical researchers. On Mothers’ Day the VCCRI urged Australian women to recognise the early warning signs for heart attack by having their risk factors checked regularly. This campaign has special significance for the VCCRI as the institute’s finance manager, Monica O’Loughlin, died suddenly of a heart attack in 2009. A 51-year-old mother of five, Monica delayed seeing a doctor about her condition despite having some classic symptoms of coronary artery disease. A yearly lunch to honour Monica called ‘Women and Heart Disease’ will be launched, aiming to further raise awareness that cardiovascular disease affects not only men but also women. Four times more women die from heart disease than breast cancer. The VCCRI has had a record year in terms of new grant funding. In 2010, a total of $13 million in new National Health and Medical Research Council (NHMRC) grant funding was awarded to the institute over a five year period, which included the renewal of the NHMRC’s program grant (over $9 million) to study how defects in the development and function of heart muscle cells can lead to structural heart malformations. A number of exciting discoveries have recently been made by Victor Chang researchers, published in journals of the highest international excellence. To name a few, Associate Professor Diane Fatkin and her team found that, contrary to accepted dogma, a regular exercise program in addition to treatment with the beta-blocking drug carvedilol, slows down rather than accelerates the development of dilated cardiomyopathy, a serious genetic condition that commonly leads to the need for a heart transplant. In addition to this, Co-Deputy Director of the VCCRI, Professor Jamie Vandenberg, and his laboratory team made a vital discovery about how the rhythm of the heartbeat is controlled, through the precise way in which ions flow in and out of the heart’s ion channels. This could explain why many common drugs, including some antibiotics, antihistamines and anti-psychotics, can cause a potentially fatal abnormal heart rhythm. Early in 2010, the institute’s progress was evaluated by a ‘blue ribbon’ international Scientific Advisory Board which provided a very favourable report on the institute’s progress over the last five years. The institute recently recruited a new faculty member Dr Kazu Kikuchi, an international expert on heart muscle regeneration. Previously based in the USA, Dr Kikuchi relocated to Sydney to start working at the institute in early 2011.

8 to 10% of pregnant women in Australia develop diabetes during pregnancy The new finding underlines how important it is for women to try and maintain A healthy weight before and during pregnancy for the sake of generations to come

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Finally, 2011 commemorated the 20th anniversary of the untimely death of surgeon Dr Victor Chang, in whose name the institute was established. Researchers at the institute continue to honour Dr Chang by their work in understanding and eradicating heart disease. St Vincent’s Centre for Applied Medical Research The St Vincent’s Centre for Applied Medical Research (AMR) has a long and proud tradition of conducting research with the aim of improving outcomes for those with or at risk of disease. In October 2008, the Centre for Immunology and the Clinical Trials Unit from St Vincent’s Hospital merged to form AMR. The Centre for Immunology was established in 1983 and was the first of its kind in New South Wales and the second in Australia. St Vincent’s Centre for Applied Medical Research forms part of St Vincent’s Hospital and is the primary research flagship of the St Vincent’s Group. AMR conducts clinical, applied and translational research with a focus on immunology, HIV and infectious diseases, neurosciences, transplantation biology and cancer. The St Vincent’s BioBank located at AMR was established in 2010 to provide researchers with high quality biological tissues and samples that will translate to better health outcomes for patients. The biorepository is a significant resource that carefully manages many of the issues around ethics and compliance that pertain to the use of human blood and tissues in medical research. St Vincent’s Hospital Sydney has endorsed a policy that recognizes the contribution that is made by those who donate human tissues and samples for medical research. This policy observes the fundamental ethical principle of respect of the donor, including the provision of fully informed consent, professional collection of samples and secure storage of materials and to maintain confidentiality and privacy. St Vincent’s Centre for Applied Medical Research had an exceptional year in 2010/2011, in realising many of the operational efficiencies that were anticipated through collocation and building critical mass with its partners, the Kirby Institute, HIV Immunovirology Program and the Clinical Research Program. Together these groups have implemented a model to efficiently manage their shared essential services. This includes centralising scientific stores and supplies, cryogenic stores, glassware and media preparation services, back-of-house services including waste management, engineering and maintenances, services, medical grade gases and loading dock operations.

many journeys. one vision. | RESEARCH

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HIV Immunovirology Program Professor Anthony Kelleher is head of the HIV Immunovirology program and works closely with colleagues at both AMR and the National Centre in HIV Epidemiology and Clinical Research. He is appointed as a clinical academic at St Vincent’s Hospital and regularly sees patients at the Immunology and Infectious Diseases Unit. The program conducts world class research, presently focussed on the design and development of novel assays and the study of micro RNAs, fine mapping of T-cell function and the transcriptional gene silencing of HIV by siRNA. During 2010/2011 the HIV Immunovirology laboratory continued to provide support to the Clinical Research Program of AMR and programs within the National Centre in HIV Epidemiology and Clinical Research. Clinical Research Program Professor Andrew Carr is Director of the HIV, Immunology and Infectious Diseases Unit, and Head of the Clinical Research Program, Centre for Applied Medical Research, St Vincent’s Hospital. He is also a Professor of Medicine at the University of NSW Wales. He was the first to describe a very common and clinically important side effect of therapy: HIV lipodystrophy, which changes the way body fat is distributed and causes metabolic changes that increase the risk of heart disease. The Clinical Research Program (CRP) provides high quality clinical trial services across the St Vincent’s campus for the clinical implementation of academic, pharmaceutical and investigator-initiated clinical studies. The CRP has clinical trials expertise in multi centred, investigator driven research projects - the major focus of the CRP into the future. The program currently has 80 research projects across clinical specialties including HIV infection, viral hepatitis, anal cancer, neurology and rehabilitation medicine. Innovation and research leadership continued as central themes for the program in 2010/2011 and this was evident with the commencing of clinical studies within the health volunteer patient population looking at the pharmacokinetics of HIV antiretroviral medicine. The program will continue to expand in a number of directions. There is the continued collaboration with the National Centre in HIV Epidemiology and Clinical Research in research treatments for HIV infection. The scope of the clinical research service model for campus investigators will continue to expand into new therapeutic areas such as pain management, rehabilitation medicine and neurology.

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The Kirby Institute The National Centre in HIV Epidemiology and Clinical Research (NCHECR) was established 25 years ago as part of the response by the Australian government to the emerging HIV epidemic. In the intervening years, the NCHECR has leveraged knowledge and research findings into other blood-borne viruses, notably viral hepatitis and sexually transmissible infections. To reflect this broader research base, NCHECR was renamed the Kirby Institute in 2011. While HIV and viral hepatitis remain the core clinical concerns, the scope of the Kirby Institute has expanded to include Indigenous sexual health, justice health and a broad skills-transfer program in the Asia Pacific region, with a particular interest in Papua New Guinea. Now comprising eleven programs and groups, the Kirby Institute is well positioned for further expansion into related research areas. Throughout 25 years of research, NCHECR and the Kirby Institute has valued its close and productive working relationship with St Vincent’s Hospital and St Vincent’s Centre for Applied Medical Research, with whom it is a partner in the Institute of Virology. Nursing Research Institute The Nursing Research Institute has enjoyed two fruitful and productive years due to ongoing support from SV&MHS and the Australian Catholic University (ACU). The scope of nursing-led multidisciplinary research is governed by a vision of generating evidence useful for clinical practice and health services. University-clinical collaborative initiatives such as these and the housing of a nursing-led research team within a clinical institution, is essential for clinically informed research. Grant income to the Nursing Research Institute for 2010 (calendar year) exceeded $460,000, which allowed important research work to continue. Research highlights from the Nursing Research Institute during 2010 include the completion of data collection for the five year National Health and Medical Research Council (NHMRC) funded Quality in Acute Stroke Care (QASC) study. The Nursing Research Institute has completed an important qualitative study on the views and experiences of key stakeholders regarding outcomes, barriers and facilitators to successful clinical networks which was led by A/Professor Elizabeth McInnes. A/Professor McInnes also led an international collaboration to update one of the most highly cited systematic reviews in

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the Cochrane Library, ‘Support Surfaces for Pressure Ulcer Prevention’ and updating the Cochrane review, ‘Support Surfaces for Treating Pressure Ulcers.’ Professor Kim Walker has continued his work, with Jed Duff, Clinical Research Fellow on venous thromboembolism (VTE) prevention and a new project around improving clinical handover. In 2010, the Nursing Research Institute implemented a new model for aspiring nurse researchers, where new nursing graduates were seconded one day a week from their clinical area to work in the Nursing Research Institute as research assistants. The first new nursing graduates to be involved went on to obtain scholarships from ACU to support them to conduct their own research as part of a Bachelor of Nursing (Honours) degree in 2011. The Nursing Research Institute currently has 25 people working on a variety of multi-disciplinary projects which includes 19 clinicians from St Vincent’s, St Vincent’s Private and Mater Hospitals. Sally Sutherland-Fraser, CNC for Perioperative Practice Development and a Nursing Research Institute clinician was awarded the 2010 Australian College of Operating Room Nurses’ (ACORN) Excellence in Perioperative Nursing Award. This award was presented for her research on improving pressure ulcer prevention and treatment in the perioperative setting which was conducted at St Vincent’s and Mater Hospitals. Patricia Ritchie Centre for Cancer Care & Research Based at the Mater Hospital, the centre’s core role is to conduct cancer clinical trials and supportive care research. In 2010/2011 the centre hosted a comprehensive clinical trial programme in collaboration with local academic groups, national and international breast cancer research groups and commercial sponsors. This allowed researchers to involve many Mater breast cancer patients in practice changing research. The support of the Friends of the Mater Foundation, BUPA Foundation and the Cancer Institute NSW has been instrumental in these endeavours. During 2011 the unit moved to a new facility, made possible through the generosity of Mrs Ritchie and The Friends of the Mater Foundation. Claverton, a federation mansion previously owned by the Sisters of Mercy, was renovated to house the outpatient chemotherapy service and provide additional space for research staff and multidisciplinary meetings. The building was officially opened by Her Excellency Marie Bashir in February 2011.


many journeys. one vision. | RESEARCH

Ongoing clinical trials recruiting during 2010/2011 included: • Studies testing new agents in metastatic breast cancer (pertuzumab, T-DM1, lapatinib and ramacirumab) in combination with chemotherapy. • Studies testing the role of extended hormone blocking treatments in early breast cancer to prevent late relapse (SOLE and LATER) and in high risk women to prevent breast cancer (IBIS2). • Meagan Brennan’s PhD project evaluating the role of a survivorship care plan for post treatment care for women with breast cancer*. • A study of the quality of life benefits of meditation and medical Qi Gong for patients with breast cancer. • Evaluation of the efficacy of cold cap therapy in reducing hair loss from chemotherapy*. • Research evaluating management of memory changes after chemotherapy with cognitive training*. • A study following up the pain experiences of women with early breast cancer (ORBT). *Supported by The Friends of the Mater Foundation

Plunkett Centre for Ethics The Plunkett Centre for Ethics maintains a distinguished record in academic research on the ethical, social and religious challenges associated with the provision of healthcare. Staff also provide an ethics consultation service, have teaching and research supervision responsibilities, and contribute to public discussions about ethical issues in healthcare and medical research. A joint centre between the Australian Catholic University and SV&MHS, the centre conducts normative research into philosophical principles and empirical research into actual practices in healthcare. Melanoma Institute Australia Melanoma Institute Australia is a not-for-profit organisation dedicated to preventing and curing melanoma through innovative, world-class research, treatment and education programs. A $40 million donation from Mr Greg Poche AO enabled the construction of the Poche Centre, a purposebuilt, integrated melanoma treatment facility providing the best possible care for patients. This led to the development of a partnership between SV&MHS and Melanoma Institute Australia. The institute has three core research areas. The first is clinical trials, where the institute conducts both investigator driven and sponsored clinical trials. This research focuses on all stages of melanoma. Second is a BioSpecimen Bank, where the institute collects a primary melanoma sample, a blood sample and a sample of a metastatic tumour from consenting melanoma patients. Finally, the Melanoma Research Database has collected information about the diagnosis and progression of melanoma in more than 35,000 patients and is the largest of its kind in the world. This information complements the biospecimen collection.

BioSpecimen Bank The Melanoma Institute Australia BioSpecimen Bank for Melanoma Research is a collection of samples of skin tumour tissue (predominantly melanoma) and blood, donated by people diagnosed with skin tumours. It also contains links to information about the health and treatment of these donors. Samples from the bank are utilised for ethically approved research into melanoma and other skin cancers to find out more about its causes, development, diagnosis and treatment. The Melanoma Institute Australia BioSpecimen Bank is supported by funds from the National Health and Medical Research Council of Australia (NHMRC) and the Cancer Institute NSW. As of the 30th of June 2011, 4,193 patients consented to join the institute’s Bio Specimen Bank. During the 2010/2011 financial year an additional 985 patients consented with some patients contributing multiple blood and tissue samples. The BioSpecimen Bank was a major contributor to the The Cancer Genome Atlas (TCGA project) – a US government funded project to identify the genomic changes involved in more than 20 types of cancer, including melanoma. The bank has contributed 100 samples out of a total of 250 melanoma cases to be analysed and these samples met strict entry criteria.

The institute works with collaborating doctors and key laboratories throughout Australia to use the information developed in these three areas to identify better treatments and hopefully a cure for melanoma.

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As of the 30th of June 2011 The Melanoma Research Database contained clinical research data for Clinical Trials Melanoma Institute Australia is recognised as one of the most active surgical research centres of any type in Australasia, attracting sponsors and collaborative investigator groups from all over the world due to the effective recruitment and retention of patients to clinical trials and production of quality research data, providing treatment options for melanoma patients. Clinical trials are undertaken to examine all aspects of melanoma control including prevention, screening, diagnosis, treatment, health service provision, supportive, palliative care and psychosocial impacts of melanoma. Trial activity is concentrated around four key areas: surgery, radiotherapy, drug/ chemotherapy and immunotherapy treatments. Since 1988 the Institute has participated in more than 70 trials with approximately 3,000 participants. Melanoma Institute Australia has made major contributions to large scale national and international clinical trials. The most significant is the remarkable international contribution to the important NIH funded first multicentre selective lymphadenectomy trial (the institute entered 946 patients, while the other 16 centres worldwide entered just over 1,055 patients). This trial has already established the validity of the sentinel node technique as a highly accurate staging technique and will determine whether or not it improves patient survival. Professor John Thompson was involved in writing the paper in conjunction with the principal investigator Dr D Morton.

33,404 patients

This article was published in the world’s premier clinical medicine journal and has already become a citation classic. It is important because the trial results have had a major impact on melanoma management around the world and the sentinel node biopsy technique is now accepted as standard of care in most countries. It has become a standard requirement for melanoma staging by the American Join Committee on Cancer and the Union for International Cancer Control. The final study report for this trial will be published in 2011/2012. The Treat Excise Analyse Melanoma (TEAM) study is a significant and central operation for the research at Melanoma Institute Australia. No other centre in the world has replicated this success at collecting human melanoma tissue from patients exposed to novel systemic drug therapies before and during treatment with a novel drug and on progression. This study has already been used to examine and validate mechanisms of resistance and has led to real time patient benefits by the design of new combinations of therapies to improve patient outcomes. Melanoma Research Database

during the 2010/2011 financial year, melanoma institute australia saw

1,531 new patients

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The Melanoma Institute Australia clinical research database, now commonly referred to as the Melanoma Research Database (MRD), is central to the academic success of the institute. This unique database was initiated in the mid 1960s by Professor Gerry Milton and Dr Helen Shaw of the University of Sydney. Maintained ever since and migrated through a series of information technology systems, it has captured comprehensive clinical information and histopathology data for over 30,000 melanoma patients. As of the 30th of June 2011, the MRD contained clinical research data for 33,404 patients. During the 2010/2011 financial year, Melanoma Institute Australia saw 1,531 new patients.


many journeys. one vision. | RESEARCH

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Feature Article

Our Stories

Making a difference 01

As he toured the state-of-the-art facilities at St Vincents & Mater Health’s Centre for Applied Medical Research (AMR), visiting laboratory technician Gelinde Narekine was struck by how even the smallest lessons he was learning could make a difference to his country.

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many journeys. one vision. | MAKING A DIFFERENCE

01 Infrastructure, training and support are everyday barriers in the PNG fight against HIV 02 Gelinde Narekine at the Darlinghurst campus 03 & 04 SV&MHS is providing a long term solution built on the skills and capacities of local people

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A specialist in clinical research for mothers and children with HIV, Gelinde, 30, was on an exchange from his home in Papua New Guinea when he was given the opportunity to spend a week at AMR. “There are so many things here that are very advanced, but what I will take away most is how small things can improve how we do things in our developing country,” Gelinde said. “I feel like I can make a real difference in terms of quality management systems and workflow, things which we take for granted back home but which actually contribute a lot to the quality of the results we produce.” As Australia’s foremost HIV reference laboratory, St Vincent’s and AMR has had a long and productive role in the country, through the Papua New Guinea Australia Sexual Health Improvement Program (PASHIP). Program head Phillip Cunningham invited Gelinde to visit AMR and the diagnostic labs in SydPath at the end of a three month exchange Gelinde spent at the National Serology Laboratory in Melbourne.

“The visit was another link to Papua New Guinea and another link in the project, which is all about St Vincents & Mater Health Sydney taking a lead by sharing knowledge, expertise and technology transfer into developing countries,” Mr Cunningham said. Established in 2007, PASHIP works to improve the sexual health of men, women and children. The ongoing project has helped build physical infrastructure in the southern highlands of Papua New Guinea, maintain and improve clinic and laboratory facilities and train a number of local researchers through a clinical and laboratory mentorship program. St Vincent’s involvement in the PASHIP program is in partnership with Australiasian Society of HIV Medicine (ASHM) and Caritas Australia. Recently PASHIP delivered the first four of 10 solar powered microscopes, which Mr Cunningham said have made a vital difference to health services in the most remote regions.

“These new solar powered microscopes work after a short charge to their flat panels, meaning people can do microscopy in areas where there is no power,” Mr Cunningham said. “Their benefit is that they can expand their repertoire of tests, and everyone using the same microscope makes training a lot easier for us, as well as if they need parts or supplies replaced.” Mr Cunningham, Chief Operating Officer of AMR, said the challenges of treating HIV in Papua New Guinea were many. “It’s difficult because it is so underdeveloped and there are not very many well trained people, but they also have very difficult and high rates of sexual health problems,” he said. “But they are just to the north of Queensland, so it is vital that we share our knowledge, experience and training with them.”

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Our Stories

Shot at a cure

Feature Article

A simple injection of a substance formerly used as a food dye is providing new hope to melanoma patients with recurring secondary tumours. Professor John Thompson from Melanoma Institute Australia has led two successful Australian trials of the drug, called PV-10 or Rose Bengal. Treatment involves injecting the drug into recurrent tumours of patients with metastatic melanoma and Prof Thompson hailed its success at not only eliminating tumours, but in some cases even showing signs of halting the growth of tumours in other parts of the patient’s body. “One in 10 melanoma patients suffer from very troublesome recurrences on or under the skin and sometimes they are very difficult to treat with conventional methods,” Prof Thompson explained. “Standard chemotherapy doesn’t work very well and it has all sorts of major side effects. If the problem is just one or two little areas they can be dealt with surgically, but when they are multiple areas of recurrence then they are a real problem to deal with. “This treatment is very simple. It can usually be done as an outpatient and in most of the patients treated this way the tumour just melts away, with the advantage of the patient suffering very little collateral damage to the surrounding tissue.” Sydney mother of three Cheryl Bickham said the injections appear to have put an end to almost nine years of gruelling treatments for the 17 tumours she has suffered since a second recurrence of melanoma in 2002. “At this stage I think I am on the road to being tumour free, which is great,” said 60-year-old Cheryl, from Ingleburn.

01 On the road to being tumour free, Cheryl Bickham is back on the tennis court.

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Prof Thompson treated Cheryl with PV-10 in September, 2010. “My experience has been pretty hard at times in that the tumours have kept coming at me,” Cheryl says. “But at the stage where I had three tumours left, we injected the three and I had a very good reaction to the last treatment. One tumour disappeared, it just fell out and the other two have been stunted, they are just not growing anymore. This feels like it is the light at the end of the tunnel.” Prof Thompson, who is based at Melanoma Institute Australia, in the Poche Centre at the Mater Hospital, recently completed a Phase 2 Australian trial, which showed that there were very few side effects of PV10 injection and a high success rate. “Another interesting thing is that in about a third of patients, when you inject a tumour, nearby tumours that haven’t been injected also go away. There is clearly an immunological effect produced by injecting one tumour that has an effect on other tumours,” Prof Thompson said. Called the “bystander effect” this occurrence will be further researched in Phase 3 trials, which are to be commenced shortly and are likely to lead to registration of PV-10 in the US and Australia.

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Patient Cheryl Bickham

Annual Review 2010/11

many journeys. one vision. | SHOT AT A CURE

“This feels like the light at the end of the tunnel.”

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Our Stories

Chance of a lifetime 01

“We collect their blood and stem cells and transplant them back after a course of chemotherapy. The theory is it suppresses the immune attack on their skin to such an extent that the skin eventually starts to repair.” Dr Moore

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03

Pelting towards the try-line, Kristin Atkinson heard something she wasn’t used to. With the loud breath of an opposing team member on her shoulder, the representative touch football player knew something was seriously wrong. What started as a rash on her hands and face had developed over a few months into an exhausting, painful condition that mystified her doctors and saw her try a series of fruitless alternative therapies. “It was a social game and I was breaking away for a try and the fact that they were able to catch me was a real shock,” Kristin says.

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“I had always been very fit but by that point I couldn’t even finish a training session. I just knew something was not right. It was going to be bad.” Sure enough, nine months after those first spots appeared, came a devastating diagnosis. At 32, Kristin had scleroderma, a rare and often fatal disease in which the body’s immune system creates an excess of collagen. “It was like my body was breaking down,” she explains. “With the condition your skin gets incredibly tight and you get really stiff. It’s like you have concrete poured into your body and the joints ache.” “It’s very painful and when you knock into something, it’s like a knife is cutting into you.” Kristin was devastated. Already no stranger to hospitals, with her husband Adam having been diagnosed with cystic fibrosis as a child, she had always assumed she may need to become the main breadwinner within the family so that he could concentrate on his health. (Adam is currently on the lung transplant waiting list at St Vincent’s Hospital and continues to work full time).

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Although there is no cure for scleroderma, a trial at St Vincent’s Hospital led by Dr John Moore since

2001 has had marked success in halting the progress of the condition, through an autologous stem cell transplant. Dr Moore, a clinical haemoatologist, has performed 14 of the transplants, whilst around the world 200 of the procedures have been performed. “The patients have to be young and like Kristin they have tried and failed every treatment available. Like any transplant, it is also a risky procedure, so the patients need to weigh that up as well,” Dr Moore said.

many journeys. one vision. | CHANCE OF A LIFETIME

01 Kristin Atkinson is one of 14 patients at St Vincent’s Hospital to have had an autologous stem cell transplant 02 Dr John Moore’s trial is awaiting review with the medical journal Bone Marrow Transplantation 03 Kristin with her husband Adam 04 Before her illness, Kristin was extremely fit 05 Kristin as a representative touch football player

“We collect their blood and stem cells and transplant them back after a course of chemotherapy. The theory is it suppresses the immune attack on their skin to such an extent that the skin eventually starts to repair.” The procedure has worked with every one of Dr Moore’s patients. “This is unlikely to be a cure, but it has halted the progress. For three of our patients the disease has come back and sadly two of those patients have died of their disease. “But for the others, several of them were on disability pensions and have now gone back to work or are studying and we think it’s very successful.” Dr Moore’s trial is awaiting review with the medical journal Bone Marrow Transplantation, but he said, “It’s likely this will become standard treatment for this condition and if that’s the case it will be the first time that something has been shown to be effective in treating this devastating illness.” For Kristin, there is no question that her transplant in 2004 saved her life. “A lot has changed for me, my hands are permanently clawed and I can’t play sport anymore. But I am back now at work as a HR operations project manager in a business and technology solutions company, and I consider myself incredibly fortunate to be in remission,” she says. “My illness is in the background for us. Now it’s time to focus on getting a lung transplant for Adam.”

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“Things I took for granted, I just don’t any more. I try to be grateful for everything in my life instead.” Angelo Tigano See his story on page 64

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Our Stories

Feature Article

“My position didn’t look too good. I’ve been a pretty keen golfer and I could see me playing my next 18 holes up in the sky, but it all seems to have turned out really well now.”

many journeys. one vision. | a life saving trial

A life saving trial

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Herb Harris

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When Herb Harris learned he was showing dangerous signs of developing cancer, his age counted against him. The usual treatment for his condition, Barrett’s oesophagus with intraepithelial cancer, was extensive surgery, but this just wasn’t an option for the elderly Sydney man. “It wasn’t looking too flash for me at first,” says Herb, an 85-year-old grandfather of four from the north shore. Fortunately, Herb’s doctor referred him to Professor Reg Lord, who went on to include him in a trial in which surgery was replaced with endoscopic radiofrequency ablation.

Herb was one of the first patients in Australia to receive the therapy, which was delivered every six months for three years on an outpatient basis by endoscopy at St Vincent’s Clinic. “The difference in invasiveness of endoscopic procedure compared to oesophagectomy is vast,” says Prof Lord.

“The advantage offered by endoscopic treatment in this scenario has provided a spectacular advance in clinical management. In fact, I would say that surgery is now the second line treatment for patients with this problem and its role is to salvage patients who suffer treatment failure with endoscopic treatment.”

As for Herb – who is happy to report he “And in his case, and in the case of all the Prof Lord explains that with patients doesn’t need any follow up treatment for such as Herb, who was showing several patients who were in the preliminary trial, another two years - he couldn’t be more the Barrett’s oesophagus was, as far we focuses of cancer cells, the risk of grateful to have been included in the trial. can tell, completely cured.” developing invasive cancer is as high as 40 percent. “My position didn’t look too good. I’ve Prof Lord has received National Health been a pretty keen golfer and I could see and Medical Research Council funding “Until recently the treatment to remove me playing my next 18 holes up in the to focus on laboratory studies to these cells has been oesophagectomy, sky, but it all seems to have turned out investigate the long-term likelihood but as an elderly patient, Herb was not really well now.” that the patients are definitely cured. fit from an anaesthetic point of view to under go such a major procedure,” says The initial Australian trial was held at St Vincent’s and Prof Lord said there ProfLord, Program Head at St Vincent’s were plans of a larger trial with centres Centre for Applied Medical Research. 01 Herb & Brenda Harris at home in northern Sydney 02 Professor Reg Lord in several states. Annual Review 2010/11

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Nature’s

Secrets

Sydney scientist Lawrence Lee remembers well the moment he realised the secret behind one of nature’s most extraordinary biological machines. As he was falling asleep one night, the researcher at the Victor Chang Cardiac Research Institute was struck not only by the solution, but also surprised by just how simple it was.

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“One of the things that I really enjoy about scientific discovery is seeing the simplicity and elegance of nature’s engineering.” Dr Lawrence Lee

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many journeys. one vision. | unlocking nature’s secrets

In 2010 Dr Lee was a post doctoral graduate working with Dr Daniela Stock, and their team was able to map the three-dimensional arrangement of hundreds of thousands of atoms that assemble into tiny motors in bacteria. These miniscule flagellar motors allow them to swim rapidly towards nutrients and away from toxins and they are crucial to the spread of bacterial infection. They can rotate at up to 100,000 revolutions per minute, yet can switch directions in milliseconds. Scientists from around the world have been piecing together their discoveries on the flagellar motor since the 1970s. Dr Stock brought the research with her to the Victor Chang Cardiac Research Institute from Cambridge University and the group’s breakthrough came after about a year’s work. “One of the things that I really enjoy about scientific discovery is seeing the simplicity and elegance of nature’s engineering,” Dr Lee says. What made progress so difficult was the size of the motors. “If you look at your fingernails and watch them for one minute, they would have grown the diameter of these motors, which are only 45 nanometers in size and impossible to visualise with even the most powerful microscope in the world,” Dr Lee explains.

“What we did was reveal the molecular structure of a small part of the motor, so it was akin to discovering the gearbox in a car. Following on from decades of work before us we were able to work out how the car operated and also how it switched directions.” Responsible for many serious diseases, including hospital acquired pneumonia and gastric ulcers, bacteria use their propellers to move through bodily fluids to attack their target tissues. Discovering the mechanisms that regulate their movements could have significant implications for the treatment of these potentially life threatening diseases, by allowing the design of new anti-bacterial drugs to combat the spread of infection. The discovery also has important ramifications for the growing field of nanotechnology. “From an engineering standpoint it is very interesting,” Dr Lee said. “The way in which they work is a big question for research in nanotechnology. It is really a result of four billion years of evolution and probably represents a pinnacle of sophisticated nanoscale motor design.” He concludes, “The discovery opens avenues to use nature’s design for our own technological advance.”

01 Eyes on the prize... Dr Daniela Stock 02 Dr Daniela Stock & Lawrence Lee at the Victor Chang Cardiac Research Institute Annual Review 2010/11

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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.

Cunningham Centre for Palliative Care

Don Harrison Patient Simulation Centre

The Cunningham Centre for Palliative Care has been extensively involved in education in 2010/2011. Embracing education and research, and physically based at Sacred Heart Darlinghurst and Calvary Hospital Kogarah, the centre was officially opened in August 2008 and is a collaboration between Sacred Heart Hospice, the University of New South Wales (UNSW), The University of Notre Dame Australia (UNDA) and Calvary Healthcare Sydney.

Serving as an invaluable education resource on the St Vincent’s campus, the Don Harrison Patient Simulation Centre (DHPSSC) provides staff the opportunity to practice team performance skills that are crucial in practicing safe patient care. Training focuses on teamwork, task management, decision-making and communication.

Each of these institutions has contributed significantly to the development of the centre, as has the Cancer Institute of New South Wales through their Academic Chairs Program. Sacred Heart’s support has been made possible through the generous philanthropic contributions of many individuals and organisations over the years. Aiming to achieve a measurable growth in the range, quality and availability of NSW’s palliative care educational options, the centre is establishing a program that focuses on building the palliative care capabilities of health professionals. To date this has involved teaching medical students at UNSW and UNDA and students of nursing at UNDA, post-graduate students and health professionals in hospitals in both urban and rural settings. With the vision of reaching out to rural NSW, the centre has delivered an array of educational activities, delivered both directly and via-video conferencing, to rural sites. It is also exploring the effectiveness of ‘spaced education’ a novel form of online education that consists of a series of case-based questions and answers delivered via email.

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With 39 different programs ranging from one-hour sessions to all day workshops and six-week courses, activity in 2010/2011 continued at a fast pace. The bulk of attendees were SV&MHS staff, but also included external medical and nursing professionals, medical and nursing students and community organisations. Community involvement continued in association with the Cruising Yacht Club of Australia, with two Medical Management for Mariners courses held in the past year. In August 2010 the DHPSSC was delighted to have a visit from Darlinghurst Public School students, who practiced bandaging and were involved in a brief scenario. The emphasis on education and training in recognising the deteriorating patient led to a 70 percent increase in the number of inter-professional deteriorating patient workshops. There was also positive feedback to the early introduction of simulation education to undergraduate medical students.


many journeys. one vision. | EDUCATION

Postgraduate Medical Education St Vincent’s Hospital provides recognised and college accredited postgraduate education programs in a range of specialty areas including emergency, physician, anaesthetics, pathology, surgical and orthopaedic training. Vocational training is also provided for senior residents and registrars in most specialities. The unit designs and implements a syllabus for postgraduate year one and two doctors, with an emphasis on clinical related education. Initiatives included medical and surgical simulation training, problem solving workshops and a broad based clinical lecture series for medical and surgical education. University of New South Wales St Vincent’s Clinical School In 2010/2011 the school facilitated training of approximately 269 medical students in all years of the undergraduate course, 104 postgraduate students and more than 30 elective students from other countries and states. Students performed particularly well in their assessments. The school continued to provide administrative and other support to educational activities for the St Vincent’s campus, such as the weekly Medical Grand Rounds. Much attention was paid to implementing the school’s strategic plan, with multiple successful initiatives in the key areas of improving the student experience, research, community engagement and optimising capabilities and resources. The clinical school produces the largest number of publications (286) on campus and together with its campus partners, the National Centre for HIV Epidemiology and Clinical Research (181), the Garvan Institute for Medical Research (145), the Victor Chang Cardiac Research Institute (29) and

the St Vincent’s Centre for Applied Medical Research (23), amounted to 37 percent of the publication output of the UNSW Faculty of Medicine. The school’s relationship with the Garvan Institute of Medical Research is already strong by virtue of research collaboration and conjoint appointments to its faculty. This will be further enhanced by the establishment of the Kinghorn Cancer Centre, which is currently under construction and expected to open in mid 2012. The centre will provide a new venue for student teaching and research and was made possible by the generosity of many donors, in particular the Kinghorn Foundation and the Federal Government. It is planned that the centre will become a paradigm for translational research, with the early introduction of new research findings into clinical practice and improved communication with regard to ongoing clinical problems, from clinicians and patients to researchers. Competitive funding was also obtained from Health Workforce Australia, via a joint bid with St Vincent’s Hospital, St Vincent’s Private Hospitals and St Vincent’s Clinic. This funding targets the upgrading of facilities to ensure capacity for an expected growth in student numbers, in order to produce the promised increase in doctor numbers. University of Notre Dame – Medicine The School of Medicine, University of Notre Dame (UNDA) Sydney continued to send students to undertake clinical placements at SV&MHS facilities. The graduating class of 2011 will be the first of medical students from UNDA Sydney and the partnership with SV&MHS has been an invaluable part of the training for this group.

There are 20 students from UNDA Sydney placed annually in St Vincent’s Hospital, Sacred Heart Hospice and St Vincent’s Private Hospital. The ties between SV&MHS and UNDA Sydney continue to strengthen, with successful collaborations in education across a range of areas including anaesthetics and palliative care. University of Notre Dame – Nursing Students from the School of Nursing, University of Notre Dame Sydney are placed throughout SV&MHS. During their 33 weeks of clinical practicum, students maximise their learning through access to a variety of settings, including surgical services, mental health and critical care. University staff work in partnership with their workplace clinical colleagues to help students bridge the theory practice gap. This is essential to developing efficient, caring registered nurses. University of Tasmania Bachelor of Nursing Degree The University of Tasmania (UTAS) is a partner organisation with SV&MHS, with a nursing campus located at the Darlinghurst campus that offers a two year fast track Bachelor of Nursing degree program. In 2010 there were 132 students and 50 graduates while in 2011 there were 133 students with 54 expected to graduate. St Vincents & Mater Health Sydney staff work closely with UTAS and act as clinical facilitators for students whilst undertaking clinical experience within SV&MHS facilities. Graduates are encouraged to seek ongoing employment as Registered Nurses within SV&MHS and in 2012 some 32 applied for employment at St Vincent’s, St Vincent’s Private and Mater Hospitals.

Annual Review 2010/11

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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.

Annual Review 2010/11

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A year in review 01

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Since its inception St Vincent’s has had as its primary mission the care of the sick, the poor and the marginalised, while at all times being mindful of the need to adapt and change to meet community demands. The hospital’s mission remains the same while constantly striving for improvement, and this is reflected in the many initiatives undertaken over the past year, the highlights of which are outlined below.

As part of National Health Reform, the NSW government recognised St Vincent’s Hospital, Sacred Heart Hospice and St Joseph’s Hospital, Auburn as a Local Health Network (LHN) in January, 2011. The establishment of the St Vincent’s Health Network compliments the national governance changes within St Vincent’s Health Australia (SVHA). This will provide tremendous opportunities to present as a united group with a focussed goal of becoming a leader of mission-based, innovative, quality and compassionate healthcare. It will also increase potential for greater synergies between the organisation’s public hospitals, private hospitals and aged care services at a group level. During 2010/2011, a vast amount of construction has taken place on the St Vincent’s campus. In many ways these physical changes reflect the dynamic nature of the organisation’s endeavours. Construction of the $120 million Kinghorn Cancer Centre – a partnership between St Vincent’s and the Garvan

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Institute of Medical Research – is progressing well, with the centre scheduled to open on time in the middle of 2012. The centre will integrate world-class cancer research with best practices, rapidly translating research findings to patient care. In 2010, St Vincent’s opened the O’Brien Centre; Australia’s first facility to integrate community and mental health with drug and alcohol services. The O’Brien Centre is proving a wonderful physical environment for creating new paradigms of healthcare, with the physicality of the centre ensuring the patient is the focal point of care, and a co-ordinated effort to maximise patient outcomes. Operationally, St Vincent’s has focussed heavily in the past twelve months on improving patient access and patient flow through the hospital. Both bed access and treatment times have improved, mainly through the endeavours of the St Vincent’s Patient Flow and Sustainable Access Committee.

Clinically, the St Vincent’s campus continues to make major inroads in pioneering new treatments to further improve patient outcomes. One major area where St Vincent’s has become an international leader is in the development of heart and lung mechanical assist devices. In the past, up to one-quarter of patients awaiting heart transplants died before receiving a new heart. Today, thanks to the mechanical devices that St Vincent’s has helped pioneer, the number has dropped to five percent of patients. In August 2010, the hospital performed the southern hemisphere’s first Total Artificial Heart transplant. This device completely replaces the diseased heart and allows the recipient to improve in health and strength while they await a transplant. The device also has the advantage of being portable so that the person can return home and it represents an important bridging option for those who would not likely survive the wait for a transplant


01 St Vincent’s clinicians using innovative electronic medical record systems 02 A physiotherapy student from the University of Sydney works with patient Sigmund Bordacs at St Vincent’s Hospital 03 St Vincent’s Hospital by dusk

We have continued to try and find new ways to deliver services that meet the needs of our clients and patients. A range of e-health initiatives have been developed or are in development. An example is www.crufadclinic.org, now in its second year of the operation. CRUfAD clinic provides therapy for anxiety and depression via a web based interactive program. At the heart of St Vincent’s Hospital is a mission to care for the sick, the poor and the marginalised. A case in point is our commitment to homeless health. We have developed a framework whereby several units work in unison to provide an integrated and cohesive model of care. In 2011, the hospital intensified its efforts to address homeless health issues and provide a more holistic and cohesive service. Located in an area characterised by a population with Australia’s highest concentration of homelessness, St Vincent’s provides community outreach in streets, parks and general community settings. The traditional

design of health services tends to support a fragmented approach to care, with limited integration between specialities. Homeless individuals frequently present with a range of cooccurring health conditions along with housing and other psychosocial issues. St Vincent’s has identified key opportunities for improving access to a wider range of services as well as strategies for the delivery of cohesive, multi-speciality care-coordination, resulting in a range of outreach and campus-based services designed to meet each individual’s health needs. These initiatives have coincided with new funding, with St Vincent’s recently being allocated responsibility for two projects arising from the NSW and Federal Governments’ National Partnership Agreement on Homelessness.

many journeys. one vision. | st vincent’s hospital | sacred heart | st vincent’s private hospital | mater hospital | st joseph’s hospital | st joseph’s village

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A multi-speciality assessment and coordination team has also been developed, with a single telephone number for all homeless health referrals, streamlining access to services.

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01

The final initiative is the planned establishment of a Homeless Healthcare Centre, or “medicottage.” Services will include sub-acute medical care, including post-surgical recovery and convalescence following an inpatient admission; stabilisation on treatment programs and sub-acute care for individuals with mental health problems. By facilitating collaboration in care planning between health specialties and other community agencies, medicottage will offer an assertive and holistic approach aiming to generate more sustainable change to help break the cycle of homelessness. Another example of our commitment to mission is a range of programs to foster and support equity and access to healthcare in Aboriginal and Torres Strait Islander communities. These program are guided by the St Vincent’s Health Australia Reconciliation Action Plan. Examples include, a collaboration with Redfern Aboriginal Medical Service to provide a fortnightly orthopaedic specialist clinic and an association with

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Pius X Aboriginal Corporation, where the St Vincent’s Ear, Nose and Throat team has operated an outreach clinic in Moree for the past eight years. Planned new initiatives include executive shadowing for students in senior school years and a mentor program for the first 12 months of employment. New building and equipment are exciting and tangible reflections of the service’s mission. In essence though, kind and compassionate care should always be the hallmark of what the service does. This is why the SVHN was particularly delighted when Paul Esplin, a Registered Nurse with the St Vincent’s Hospital Homeless Health Outreach team, was recently awarded Nurse of the Year at the 2011 HESTA Australian Nursing Awards in Melbourne. Paul has spent the last four years looking after the homeless of Sydney. His clients are rough sleepers in the inner city, many living with severe mental illness, developmental delay, intellectual disability, drug and alcohol addiction or social isolation.


In 2010/2011 St Vincent’s Hospital was one of 20 in NSW to implement Improving the Patient & Staff Experience (IPSE) in the Emergency Department & select inpatient units

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With our research partners including the Garvan Insitute of Medical Research, Victor Chang Research Institute, University of NSW, Notre Dame and Australian Catholic University, we are creating one of the country’s largest research hubs. This hub will be the catalyst for translational research and facilitate world leading innovations in diagnostic, treatment and prevention strategies to improve the prevention and management of diseases. One of a number of major recent research breakthroughs on the campus includes the identification of a key pathway that contributes to the inability of specific brain cells to proliferate and differentiate appropriately, leading to compromised repair in multiple sclerosis and possibly other brain diseases.

The quality of our services also continues to be a priority. In 2010/2011 St Vincent’s Hospital was one of 20 in NSW to implement Improving the Patient and Staff Experience (IPSE) in

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the Emergency Department and select inpatient units. Putting the patient at the centre of care, IPSE enables managers and staff to create a culture of better practice through the implementation of evidence-based tools, tactics and resources. Historically, the care of heart and lung patients has been a focus for St Vincent’s Hospital. In 1968, St Vincent’s performed Australia’s first heart transplant. Since then, the hospital has claimed a number of Australian firsts including the replacement an aortic valve, reducing the risk of stroke by closing the left arterial appendage and clipping of the mitral valve as an alternative heart surgery. With a vision to continue its pioneering efforts and to meet need, St Vincent’s Hospital is collaborating with St Vincent’s Private Hospital to establish a proposed St Vincent’s Heart Lung Vascular Institute on the Darlinghurst campus. This exciting

new development will increase capacity in terms of public and private beds for heart, lung and vascular patients and will further capacity for heart lung vascular interventional laboratories, shared diagnostic imaging facilities as well as additional clinics and rehabilitation services. Lastly, a primary goal is respect for the skills and talents of employees. Core to the 2011-2015 St Vincent’s Public Health Services Strategic Intent is the creation of a supportive and inspiring environment that promotes excellence. Program Engage affirms the organisation’s commitment to employees and encompasses a range of initiatives that will, between now and 2015, help to achieve the organisation’s aspirations. A response to the organisation’s Best Practice Australia Employee Survey conducted in 2010, Program Engage articulates the steps needed to ensure a strongly supported workforce and an organisation that continues to excel.

Annual Review 2010/11

many journeys. one vision. | st vincent’s hospital | sacred heart | st vincent’s private hospital | mater hospital | st joseph’s hospital | st joseph’s village

01 Federal Health Minister Tanya Plibersek with Sr Jacinta Fong during a visit to St Vincent’s on her first day in the new portfolio 02 Nurses working in HOAC, the hospital’s haematology, oncology & ambulatory care ward

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Kinghorn “Not everyone will need everything we are going to offer, but the difference is that we will always be able to offer it.”  Prof Spigelman Director of SV&MHS Cancer Services and Head of the UNSW St Vincent’s Clinical School

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Every step of the patient journey will be improved when the Kinghorn Cancer Centre opens in 2012. From a dedicated cancer patient car park to a day-spa style consulting area for complementary therapists, the Kinghorn Cancer Centre’s design is a response to extensive patient and staff consultation.

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The Kinghorn Cancer Centre is a joint venture which will align the internationally recognised research strengths of the Garvan Institute of Medical Research with the acclaimed best practice cancer services of St Vincents & Mater Health Sydney (SV&MHS). Housed in a new custom-built $110 million building on the Darlinghurst campus, designed by BVN Architecture, the Kinghorn Cancer Centre will be complete by mid 2012.

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Professor Allan Spigelman, Director of SV&MHS Cancer Services and Head of the UNSW St Vincent’s Clinical School, said although the current cancer services at St Vincent’s Hospital attain a consistent high level of patient satisfaction, the new facility will improve every facet of the experience. Key to this is the provision of separate physical areas for differing types of consultation, including those with nutritionists, social workers, genetic counsellors and allied care providers such as acupuncturists.

“We have found that when these members of staff see patients in our current physical set up, they see them in the same room in which they may have been given their diagnosis and then the same physical area where they went on to have their chemotherapy,” Prof Spigelman explains. “Patients sometimes reported to us that they felt anticipatory nausea when they were coming in just to see their doctors. They walk into that environment and they start to feel queasy.” In the new centre, dedicated purposebuilt space will be provided for each separate consultation, including a Wellness Centre which aims to provide access to and clear information about complementary therapies. Level four of the Centre will house Haematology Oncology Ambulatory Care (HOAC), which will be known as the NELUNE Centre in recognition of the $2.5 million support of the NELUNE Foundation. The floor will also house the separate Wellness Centre with treatment rooms. Level five will accommodate the clinical consultation rooms, interview rooms, pharmacy and multidisciplinary rooms with audiovisual equipment. “Not everyone will need everything we are going to offer, but the difference is that we will always be able to offer it,” Prof Spigelman says.

many journeys. one vision. | st vincent’s hospital | sacred heart | st vincent’s private hospital | mater hospital | st joseph’s hospital | st joseph’s village

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01-03 Designed from the patient’s perspective, a major focus of the centre is sunlight and surrounding landscaping. Patient treatment areas on the lower floors can see research activities on the upper levels as seen in the artist’s impression of the atrium 04 An artist’s impression of a treatment area within the Kinghorn Cancer Centre Annual Review 2010/11

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Home at last 01

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W hen he lived on the streets, Les Gordon had a broom that he would use to keep the area clean. He would say to anyone who littered “Would you do that in your home? Don’t do it in mine.” Today, settling back for a chinwag in the tidy living room of his inner city unit, Les continues to be houseproud. The walls are hung with a mix of Aboriginal designs and prints of old Australian artworks, and there’s a growing stack of country music tapes and CDs beside an old stereo. The cosy scene seems odd given our conversation: Les is talking about spending decades of his life living on the street, his measured tone all the more incongruous when he describes the desperation of his day-to-day existence. “When you are on the street, you haven’t got a minute. In the day-time you are worrying about your gear. At night you don’t know if you are going to wake up in the morning, whether you’re going to die out there from cold or some idiot is going to cut your throat,” he says. Such was the life Les was living, until July 2010, when a collaboration between the St Vincent’s Hospital Homeless Health Service, Neami Way2Home and several other organisations set him on the path to finding a home.

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Paul Esplin, a Registered Nurse who works in partnership with the Homeless Health Service at St Vincent’s Hospital and Mission Australia’s Missionbeat Service, says it was only through the strong collaboration of a large team that Les, a 66 year old former horse racing track rider, is living so well today. “All the service providers involved came together to try to look at ways to improve Les’s health and homelessness as quickly as possible,” Paul says. This collaboration included NSW Health, the City of Sydney Homeless Unit, NSW Housing, non-governmental organisations including Neami Way2Home, the Mathew Talbot Hostel, and Mission Australia. The St Vincent’s Hospital team was made up of Social Work, the Homeless Health Service, the Heart and Lung Clinic and an Aboriginal Liaison Worker. “We meet Les on the street after we received requests to assist him as soon as possible, due to his complex health condition, which was being worsened by him sleeping rough on the streets and the very cold and wet 2010 winter Sydney was experiencing,” Paul says.

Paul said the team soon realised Les was very proud and did not want to be told what to do. “So we asked Les how we could try to assist him and this attitude shift then improved the situation rapidly. Les was agreeable, things took off from there and started to improve. As we can see today, Les is a gentleman living a much happier and more contented life in his own home.” Les explains that on his 65th birthday, in October 2010, he was “cleared and finally kicked tuberculosis.” Grateful to the many people behind helping him and for finding the peace he didn’t think he would ever have, Les hopes that “from his bad luck someone else will benefit.” “Every day I wanted to get out of there,” he says. “I was never actually asked what I wanted though, I was always told what to do. I’m a stubborn bugger, so it wasn’t until they came and asked me that I was ready to listen.”

Les has lost track of just how long he spent on the streets, but those last months were definitely his worst. Suffering from tuberculosis and living under a bridge behind the Matthew Talbot Hostel in Woolloomooloo, Les was photographed by the Sydney Morning Herald to illustrate how Sydney’s bitterly cold winter was hurting the city’s homeless. “That’s me there,” he says, pointing at a photo of a clearly broken man in the folder in which he keeps his paperwork. “I’ve come a long way since then though. Now you wouldn’t get me out of here with a bulldozer. It’s God’s waiting room out there. Believe it.”

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many journeys. one vision. | st vincent’s hospital | sacred heart | st vincent’s private hospital | mater hospital | st joseph’s hospital | st joseph’s village

01 Nurse Paul Esplin is one of 16 people who are part of the hospital’s expanding Homeless Health Service. Paul stands next to Les Gordon who is now at home in an inner city unit 02 July 2010, Les Gordon was photographed as he prepares for another night on the streets of Sydney

In August 2011 in the City of Sydney local government area, there were rough sleepers

(people sleeping outside/ in public space)

people in crisis accommodation or hostels

(up to three months accommodation) Source: City of Sydney

Annual Review 2010/11

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The

waiting game

When Angelo Tigano finds himself getting frustrated with waiting, he takes a deep breath and remembers to be grateful.

“The year is an achievement, but what It’s not too hard to find perspective we would like to do is to be able to when each day is an unexpected gift, transplant him as soon as possible.” and Angelo knows this better than most. The first person in the Southern The device is powered by a pneumatic Hemisphere to receive a Total Artificial driver and replaces the left and right Heart, Angelo celebrated a year with the ventricles to pump up to 9.5 litres of device in August, 2011. blood each minute. Two cables lead from the heart through the abdominal “It’s been a year, and it’s a year of life wall and are attached to the machine, that I wouldn’t have had, so I am very which sits outside the body on a trolley thankful to everyone involved,” Angelo or in a backpack. says of the milestone. “Things I took for granted, I just don’t any more. I try to be grateful for everything in my life instead.” Having suffered from cardiomyopathy since he was in his 30s, Angelo, 51, wasn’t expected to survive more than a few weeks with his own failing heart when St Vincent’s Hospital Cardiothoracic Surgeon Paul Jansz offered him the opportunity to receive the Total Artificial Heart. Designed to keep patients alive until a donor heart becomes available, the devices have been introduced to a limited number of Northern Hemisphere transplant centres in recent years. One man overseas survived four years until a transplant, but Angelo and his doctors are hopeful he won’t need to challenge that record. “Angelo is going really well, considering it has been a year for him,” Dr Jansz says.

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“There hasn’t been a suitable donor yet for Angelo, but with his blood group and his size he would be the priority,” Dr Jansz says.

“The Total Artificial Heart has a pretty major impact on patient outcomes. Those four people who are waiting for hearts now would not be alive today without it.

Angelo says although he is looking forward to the day he can travel to places he has long wished to visit, such as Alaska and Canada, or a return to see family in Italy, he is also mindful of not wanting to rush.

That’s the problem with transplants, you can’t just pull a heart off the shelf.”

Dr Jansz says there are currently four Australian Total Artificial Heart recipients awaiting transplants, with another potential patient being treated at St Vincent’s Hospital.

“There’s a part of me that is waiting for a phone call, but it’s about enjoying my life now. It’s most important to me to get a reasonable match and I am glad to wait as long as I have to in order to have a match that will last.”

Dr Paul Jansz Cardiothoracic Surgeon St Vincent’s Hospital.


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In 2011,

337 ORGAN DONORS

gave 1001 Australians a new chance in life. The number of organ donors and transplant recipients in 2011 was the highest since national records began.

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01 The southern hemisphere’s first person to receive a Total Artificial Heart transplant, Angelo Tigano pulls a trolley with two cables that lead from the machine through the abdominal wall and to the Total Artificial Heart 02 Angelo at home with his sister, father and nephew 03 Dr Paul Jansz holds the Total Artificial Heart

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A new voice 02

They were the words Audrey Hodge thought she’d never hear again. Looking into her eyes, the big bear of a husband who she thought she’d lose so many times worked to form a sentence. It had been months since John had spoken, after an uncommonly fast throat cancer diagnosis and full laryngectomy robbed him of his voice. “I’ll never forget the moment he spoke again. None of us thought it would ever happen, but he looked in my eyes and he said: “Oh, I love you,” Audrey says of that moment in early 2011. When John was diagnosed with advanced throat cancer, he and Audrey were spun into a whirlwind of treatment: surgery, chemotherapy and radiotherapy. So advanced was his tumour that there was no option other than to perform a pharyngolaryngectomy. John’s specialist at Dubbo transferred him to St Vincent’s Hospital, where he underwent surgery in December 2009.

01 John Hodge is back on the bowling green 02 John at home in his beloved tool shed 03 John and Audrey Hodge at home in Dubbo 04 Therese Dodds, the Speech Pathologist who helped John to communicate again, and Helen Brake, Manager of Speech Pathology 66

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total laryngectomies are performed at St Vincent’s Hospital for cancer patients each year

8,950

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408

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occasions of service were provided to 1,049 patients in 2010/2011.

occasions of service were provided by the head and neck speech pathologists to patients referred from 96 cancer services.

speech pathologists work in the St Vincent’s Hospital Speech pathology Department

“To lose the ability to communicate can be devastating. The fact that he can achieve voice and communicate with his family is a real success story.” Helen Brake – Manager Speech Pathology Department St Vincent’s Hospital.

won’t be able to communicate once And while the immediate challenge of their recovery starts, it can be very saving John’s life was met by a team challenging. at St Vincent’s Hospital consisting of the ear nose and throat surgeon, the “There is a period of grief they go multi-disciplinary team on 8 South and through, and recovery is very important. radiation oncology. It was the help from If a patient has their voicebox removed speech pathologist, Therese Dodds, which they need to find an effective form of enabled John to communicate again. communication.” Helen Brake, Manager of Speech After some challenging months, Pathology at St Vincent’s Hospital, said John was able to master the use of the Hodges were offered counselling a voice prosthesis, which was fitted before and after his surgery and cancer in early 2011, after he completed treatment, as well as intensive speech radiotherapy. therapy afterwards. At 62, John not only had to learn to “We get involved right at the beginning swallow again, but as Audrey and he when a patient is diagnosed offering live in Dubbo, in the west of NSW, the counselling and education to the patient end aim was for him to be able to and to their families,” Helen says. maintain his voice prosthesis on his “It can be very difficult for people to cope own. John has been home for several initially. A cancer diagnosis is frightening months, and while he’s facing a new challenge in his cancer battle, he enough but then to think that they

has immersed himself in their local community and even gone on to represent Dubbo in the recent state bowls championship. “He just lives for his bowls. He’d have a bed there if he could,” Audrey says with a smile. “It changed us a terrible lot, but we are living a good life now.” For John, the fact that he is able to spend his days between his vegetable patch and his beloved bowling club means only one thing.

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“There were times we didn’t think we would get our lives back, and we really thought I’d die back then. But they worked a miracle for me at St Vincent’s and I’m very thankful.”

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Our Stories

Song of hope Until recently Ayla Sutherland could only dream about singing, running and swimming. Trapped inside an unwilling body, the 14-year-old had come to accept she would never be able to join her friends performing the everyday miracles of just being kids. Having fought cystic fibrosis since she was a baby, a good day for Ayla would involve just a few hours on a nebuliser, and maybe managing not to cough so much on the school bus home that people turned and stared. A bad day could be one of many spent in hospital, often for months at a time, as her lungs continued their steady degeneration. It was during one of her regular stays at The Children’s Hospital at Westmead in October 2010 that Ayla’s health took a dramatic turn. With the onset of a gastro bug, her frail, 32 kilogram body collapsed. “It was incredibly fast,” Ayla’s mum Tina says.

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“She became so critical in just a month, and all of a sudden she was on life support and on the active donor list for a lung transplant.” Ayla was transferred from The Children’s Hospital at Westmead to St Vincent’s Hospital under the care of her Cardiothoracic Surgeon, Associate Professor David Winlaw. “Ayla is in the transitional age range between pure paediatric practice and adult practice, where the combined strength of a paediatric hospital and an adult hospital are required to get the best result,” A/Prof Winlaw explains. Dr Brett Gardner, Director of Clinical Governance at St Vincent’s Hospital, adds “Well before Ayla became unwell, teams from St Vincent’s and The Children’s Hospital at Westmead were already working together to provide care for children and adolescents before and after lung transplantation – a service that is ordinarily not available in NSW.” Once transferred to St Vincent’s Hospital for the next 57 days, Ayla was kept alive by extracorporeal membrane oxygenation (ECMO), a bedside life support system that


“I am so grateful to be able to breathe normally now, since it was such a struggle before. I hope you can find some comfort in knowing I couldn’t be more grateful to have a second chance to live and I will never forget this gift that you have given me.” Ayla Sutherland’s letter to her donor’s family

03 01 Today Ayla Sutherland is at home with her mother Tina 02 Ayla has rejoined her friends in Year Eight at her local high school 03 A/Prof David Winlaw, Dr Phillip Spratt and Dr Paul Jansz

does the work of the heart and lungs. St Vincent’s Hospital is the statewide referring hospital for ECMO, and Ayla’s time on the device is thought to be an Australian record. In that time, as they waited for donor lungs, Tina rarely left her daughter’s bedside and Ayla’s weight plummeted to 25 kilograms. “I think what got Ayla through was firstly her mother, who was incredibly committed and sensible and dedicated, and helped her find what it took for Ayla to stay on track and remain focused on getting better,” A/Prof Winlaw says. “And Ayla herself is very tenacious; she fought very hard the whole time.” But even when Ayla’s new lungs were ready, her battle wasn’t over. Tina describes her sense of disbelief when doctors told her, 10 hours into Ayla’s double lung transplant in January 2011, that she was unlikely to survive: “I would not accept it. I just kept thinking not all of this and then she dies, it’s not possible.” A/Prof Winlaw says Ayla’s transplant was among the most difficult he’s been involved with.

“There were several times along the course of her treatment where we felt she was more likely to not survive. The lung transplant was technically very difficult. It involved multiple re-operations for bleeding and other things and it was an enormous team exercise between the Children’s Hospital and St Vincent’s,” A/Prof Winlaw says. “But once she had her new lungs sorted out, her recovery continued quite well, considering that her body was very debilitated. Ayla had been sedated and lying still with her muscles relaxed for so long that she needed extensive rehabilitation to regain strength, and this happened mainly at the Children’s Hospital.” Having been sent home from hospital in late May 2011, Ayla recently re-joined her friends in Year Eight at her local high school. One of the most-welcome surprises of her new life is that now Ayla can sing, and as she lets out a voice that is pure and strong, her smile is beautiful and her joy infectious.

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“I can walk around now and I don’t get puffed at all. I’m going to be able to swim soon and do all the things that before I couldn’t. Soon I should even be able to run.”

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success Sweet sound of

“We got to know her so well as she worked here and you could see day-to-day how much she needed the implant, and how for an intelligent person, she was so limited in what she could do” Sarah Platt Hepworth Audiologist at the Hearing and Balance Centre, St Vincent’s Hospital

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in Australia have a hearing loss

Hearing loss costs Australia almost

02

For 12 long years Karen Baker filed and typed and smiled, moving from one junior administration role to another in search of stimulation. Having suddenly lost her hearing at the age of eight, Karen found her disability led her to suffer at school and later was unable to find an employer willing to promote her beyond entry-level. “There’s sometimes a misconception that deaf people must be ‘dumb,’ however, in my case it was anything but, and I felt this inability to move forward in my working life quite severely,” Karen, now 36, says of that time.

$12 Bil/ Yr

“From the moment she came here, I started working on her because I knew the implant was exactly what she needed, but it took that entire time to convince her to do it,” Sarah says. “We got to know her so well as she worked here and you could see day-to-day how much she needed the implant, and how for an intelligent person she was so limited in what she could do.” It wasn’t until Karen decided to study teaching at university that she relented to Sarah’s prodding. “I didn’t like the idea of having my hair shaved and then having to undergo such a big operation,” Karen says now.

It wasn’t until Karen started work at the Hearing and Balance Centre at St Vincent’s Hospital that she saw first-hand how different things could be with a cochlear implant.

“It was a vanity thing, the stitches. I was scared really, but the thing that pushed me over to having it done was the fact I was going to uni, and it was probably a very sensible thing to do in terms of helping me to become a teacher.

But Karen’s journey from admin worker to the happily employed country primary school teacher she is today wasn’t as clear cut as you might suppose.

“I put up a fight for three years, insisting I was fine just the way I was, and I was fine, in a way, but now I’m great!”

Despite spending each day seeing the difference a cochlear implant made to the lives of the patients at St Vincent’s Hospital, Karen spent quite some time refusing to have the same surgery. Audiologist Sarah Platt-Hepworth, who first employed Karen at the Hearing and Balance Centre and went on to switch-on the implant after her surgery, said it took three solid years to convince Karen to go ahead with it.

An audiologist for 30 years, Sarah describes Karen’s journey as one of the more dramatic she has witnessed. “She put it off for a long time because she was scared of the surgery, but these days the surgery is such a small thing - they stay overnight at most generally, and the scar is particularly small,” Sarah says. “I’m just pleased she went ahead with it, because she has a whole life now where she was so limited before.”

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01 & 02 Karen Baker and Sarah Platt-Hepworth Annual Review 2010/11

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A message of

LOVE

Adam Freney had just about given up hoping he would have his own family, so when his baby daughter Rose was born after a whirlwind romance with his wife Banita, he knew he was the luckiest man alive.

Those first few weeks of June 2010 were the happiest of Adam and Banita’s life, as they fell “in love at first sight’’ with their longed-for little girl. “The birth of my baby was the most wonderful day of my life,” said Adam, a 41-year-old security guard. “Nobody can tell you the feeling that you have when you hold your little baby for the first time, it’s absolutely beautiful.” However, within a month the family’s life was to take another dramatic turn, when doctors told Adam the nagging pain in his hip and back was due to the fact he had Acute Lymphoblastic Leukaemia. Months of chemotherapy and a bone marrow transplant at St Vincent’s Hospital made the next year a blur, and in July 2011, he learned that his chances of survival had narrowed,

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when Adam relapsed and his doctors gave only a 20 percent success rate for the proposed treatment. Supporting Adam and Banita throughout his treatment were Senior Social Workers Annette Polizois and Rosemary Arias, who work in the haematology department. As Annette spent time with Adam, he spoke about his family and his fear that Rose may not remember him. “Adam was at the stage where he had been advised to get his affairs in order, and so we talked through some of the things he wanted to pass on to Rose, should he not be there to share them with her,” says Annette. Aware of the magnitude of the situation and the effect it would have on Rose in years to come, Annette started to think about how Adam could pass


04 01 Social worker Annette Polizois with Adam Freney, daughter Rose and wife Banita 02 Annette Polizois and Adam Freney 03 Adam Freney with daughter Rose 04 Adam Freney and wife Banita

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on ideas, values, information and a sense of himself – how a permanent record could be made. Annette wanted to assist Adam in leaving something unique for his family. In close collaboration with the hospital’s audio-visual department, Medici Graphics, Adam jumped at the chance to film a message during an outpatient visit. “I just felt it was important that Rose had something from her father. She’s very young, so she is probably going to have zero memories of me,” Adam said. “I wanted to put something down for her that would maybe give her an idea of what her father was about, just to offer her some advice throughout her life.”

In Adam’s video, he spoke about his childhood and his wish that Rose takes the right path, always treating her mother with love and support. He also talked about how he met Banita and how they fell in love, before describing what his little girl meant to him and how he would like her to remember him.

“I had a sense that there were some really important things that Adam might need to leave behind for both his wife and his daughter.”

“It’s my intention to last as long as I can. Annette Polizois It could be months, it could be years,” Social Worker St Vincent’s Hospital he said at the end of his message. “I just hope that mum can explain that I was just a normal loving dad. I am a big man, with a tough exterior, but a big marshmallow inside. I have a big soft heart and you melted it the day you were born. I love you very much and I always will. I love Banita very much and always will.”

Annual Review 2010/11

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“There were flowers, French champagne, they decked out the ward like a chapel, it was really quite amazing and lovely.� Michael Aaron See his story on page 112

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Our Stories

Feature Article

Bronwyn Crosby Deputy Director of the Alcohol & Drug Service at St Vincent’s Hospital and co-creator of the new website Your Room www.yourroom.com.au

“Alcohol & drug education is a vital public health issue, and as basic in many cases as getting access to clean water.” Bronwyn Crosby, Deputy Director of the Alcohol & Drug Service at St Vincent’s Hospital.

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What is www.yourroom.com.au? Your Room is a one-stop website incorporating more than 100 pages of drug and alcohol education, information on prevention of drug use, support for individuals and their family or supporters, as well as treatment service options. The site provides information on the harms associated with drug and alcohol use. The part of the site that is supported by NSW Health provides information on community action teams and community resources.

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Is it only for young people? It’s not geared at any particular age group, instead we hope all groups would at least have a look. It’s a little bit of fun. For older people there are tools that are engaging, because we wanted to try to encourage people who don’t necessarily spend a lot of time at the computer to visit us. What sort of information will I find there? We try not to use too many professional terms and instead talk more about the impacts of mood altering substances on your body, health and life. The ADIS also has a huge database of alcohol and drug services, more than 2,000 entries from around the state, so we have a lot of information for people about where else they can go for help.

Will there be changes to the website? We have been working out the bugs and are going to modify and start to broaden our information base. Our amazing team have fantastic specific alcohol and drug knowledge, but we would love ideas from anyone else about how we can make our message more approachable and relevant.

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How important is being educated and informed? Education is important in so many ways. It helps people recognise that they may be getting into bad habits, and if you look at legal drugs they tend to cause problems when bad habits have been well entrenched into lifestyles. The other important thing is that it’s vital for parents to have the right answers – or know where to go if their children ask them questions about drugs.

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How has alcohol and drug use changed since appointment to your role in 1995? Drug use hasn’t really changed, the types of drugs used might be slightly different but mood altering substances have been used by humankind for thousands of years. People are now living longer so the effects of bad lifestyle choices are more evident than before.

How was the website created? Yourroom.com.au is a joint venture between the ADIS at St Vincent’s Hospital and the NSW Department of Health. We worked together on the look and how to get our messages across.

What are the most popular parts of the website? Illicit drugs are the most commonly researched items. Cocaine and heroin are the most popular groups still, but methamphetamine has experienced a fast growth in use and interest.

Why was the website created? Your Room is a private place for people to ask questions without any fear. It’s an extension of the Alcohol and Drug Information Services (ADIS) call centre. With technology being what it is, phone calls are becoming an increasingly small part of how we communicate. The advantage of the call centre is that people can ring up when they are alone and nobody need know that they need a little help. So after 28 years of operating public support and information in one medium, we expanded into new technologies. The first natural step to increase our reach was the website.

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What is the number one challenge for ADIS? To spread the messages of awareness of the potential impacts of drug use on our bodies, on our lifestyles. Often people are unaware of whether or not their drug and alcohol use is problematic, until it really is. We want to get people to know that earlier and prevent problems arising.

Over 70%

of people with drug and alcohol problems will not see a clinician in the next 12 months, yet many of these people will get better without treatment.

Annual Review 2010/11

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Acute Program The Acute Program is the largest program at St Vincent’s Hospital with strategic and operational responsibility for the Emergency Department, Perioperative Services, Medical/Surgical and Anaesthetic Services, Intensive Care and High Dependency Units, Acute Wards, Interventional Services, Day Procedure Centre, Renal Services, Trauma Services and Medical Surgical Transit Unit. Emergency Department A major centre of activity, throughout 2010/2011 the Emergency Department treated an increased number of patients from a multitude of Sydney events. Continuing to engage with the community, in 2010/2011 the department continued its services to the City2Surf, providing a multidisciplinary team to treat participants at Bondi Pavilion at the conclusion of the run. In 2011 the department received its first final year medical student from the University of Notre Dame. Having always had a strong commitment to teaching, early feedback has been exceptionally positive. The department also takes students from the University of NSW and overseas elective medical students. Medical staff and nursing staff have generously given training and supervision, which has led to a significant number of students choosing St Vincent’s as a preferred choice for internship in 2012. The department remains heavily supported by the generosity of SIRENS. Intensive Care Unit The Intensive Care Unit (ICU) treats acutely-ill patients with general, neuro, trauma and cardiothoracic complaints as well as being the sole provider of heart lung transplantation in NSW. The ICU is extremely busy with close to 100 percent occupancy (97 percent) most of the time. Currently 17.5 of the 20 acute available beds are funded. These are now being flexed to accommodate High Dependency Unit patients at various ratios, depending on demand and availability. 2010/2011 was a very busy year with 1,419 admissions to the ICU, with an average length of stay of 100.5 hours and long-stay patients averaging 16.4 days per month. Some 65 percent of admitted patients were male and patients had an average age of 59 years. Almost half the department’s admissions were

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emergency admissions and almost two thirds of admissions came to ICU via theatre. As a NSW state referral centre for Extracorporeal Membrane Oxygenation (ECMO), the ICU provides approximately 37 episodes of ECMO support each year. There are approximately 65 heart and/or lung transplants each year and following introduction of the total artificial heart device in 2010, four patients have now been implanted with the device. Education has been provided to all ICU ECMO accredited nurses and doctors for the implementation of the new Cardiohelp ECMO console, which should assist patient transfer and retrievals from other centres and ongoing management. Extracorporeal Membrane Oxygenation workshops are conducted twice a year and are well attended by ICU clinicians from NSW and beyond. The use of Citrate to provide regional anti coagulation of CRRT circuits has exposed patients to less changes of dialysis circuits. Working groups have focussed upon medication safety in ICU, handover, communication, hand hygiene and occupational health and safety. The postgraduate ICU course continues to contribute strongly to the success of students and development of advanced practice ICU nurses and the ICU is involved in a number of Australia-wide ICU trials. Interventional Services Providing a patient focussed model of care, Interventional Services comprises Interventional Radiology and Procedure Suites including Endoscopy, Day Procedure Centre and the Medical Surgical Transit Unit (MSTU). Interventional Services continues to undertake innovative practices under the direction of the Acute Program in close liaison with gastroenterologists, radiologists and researchers. Patient flow has improved and bed block decreased in the hospital following inclusion in the department of the MSTU in 2010, which facilitated the movement of medical and surgical patients from the Emergency Department to theatre.

Medical Sub-Specialities Gastroenterology The Gastroenterology Department offers a comprehensive

gastroenterology and hepatology clinical service, which delivers therapeutic endoscopy, endoscopic ultrasound and capsule endoscopy. The department also services outpatient clinics for patients with gastroenterology complaints, inflammatory bowel disease (IBD) and viral hepatitis. Among the highlights for 2010/2011 was establishment of a new dedicated IBD service, which incorporates the appointment of a care coordinator, multidisciplinary clinics and participation in multi-centre clinical research. There was also the establishment of a study examining screening of patients at high risk of developing pancreatic cancer. The study is supported by a grant from Cancer Institute NSW in collaboration with the Australian Pancreas Cancer Genomic Initiative. There was an upgrade to endoscopic ultrasound (EUS) equipment to enable new techniques, such as EUS-guided pancreaticobiliary access and contrast enhanced harmonic EUS. 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, neuro oncology, 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.


Vascular Medicine at St Vincent’s Hospital provides inpatient and outpatient services for patients with a variety of vascular disorders including venous, arterial and lymphatic disease. These services are undertaken with the support of vascular surgery, interventional and diagnostic radiology and allied health services. The department in collaboration with St Vincent’s Private Hospital has been involved in the development and implementation of campus policies for the prevention of venous thromboembolism (VTE). Recognition of the importance of VTE among hospitalised patients has led to the appointment of a VTE Clinical Nurse Consultant (CNC) at St Vincent’s Hospital. The department manages VTE such as lower limb deep vein thrombosis and pulmonary embolism providing up to date therapies, including systemic thrombolysis for the management of massive pulmonary embolism and, in collaboration with vascular surgical and interventional radiology colleagues, endovenous techniques for the treatment of extensive deep venous thrombosis. The Vascular Wound Care Clinic at St Vincent’s Hospital provides a multidisciplinary approach to the management of lower limb ulceration. This is supported by the department’s vascular physicians, outpatient nursing staff and the hospital’s Wound CNC. In collaboration with local researchers and those from other institutions, research is currently underway in the areas of deep vein thrombosis and peripheral arterial disease. This has been supported by funding that has been successfully obtained to further vascular research.

Perioperative Services

Perioperative Services comprises Anaesthetics, the Recovery Unit, Sterile Processing Centre and Support Services, in order to provide optimal care to patients undergoing elective and emergency surgery. The Sterile Processing Centre also provides a variety of sterilisation services to all departments at a hospital wide level. All surgical specialties, including trauma but with the exception of obstetrics and paediatrics, are catered for within Perioperative Services. A variety of postgraduate courses are run each year to assist with professional development and upskilling of nursing staff to maintain a highly skilled nursing workforce within the service.

Renal Ambulatory Care The Renal Ambulatory Care unit provides haemodialysis and peritoneal dialysis for patients with acute and end stage renal failure, across St Vincent’s and St Vincent’s Private Hospitals. The unit also provides clinical support to other units such as the Intensive and Coronary Care Units. The unit has a 24-hour on call service for urgent dialysis needs. The education and assessment of patients with chronic renal impairment, hypertension and renal transplantation are managed in three outpatient clinics as well as in the Renal Ambulatory Care unit. An in-home training program with extensive follow-up is also in place for community-based peritoneal dialysis patients, including an around-the-clock telephone counselling service. Activity has remained steady throughout the year with more than 10,000 haemodialysis treatments performed and up to 23 patients being managed at-home on peritoneal dialysis. A generous donation from a patient in 2011 saw the purchase of new dialysis chairs, which has significantly improved the comfort of all patients. In 2011 the unit also implemented the use of a database for dialysis called Smarthealth, which has enhanced data collection and storage.

Surgery Sub-Specialities 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. Colorectal Surgery The Colorectal Surgery team treats all aspects of colorectal surgery, with a particular focus on colorectal cancer, anal cancer and inflammatory bowel disease. There has been an increase in the number of laparoscopic procedures required in 2010/2011 and the department has also increased its expertise in colonoscopic removal of large polyps. While the department’s research interests include the value of multidisciplinary meetings, the genetics of colorectal cancer, the treatment of anal intra-epithelial cancer and solitary rectal ulcer syndrome, there is also an ongoing commitment to student teaching.

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. Ophthalmology With a solid presence in ophthalmic care, the department offers virtually all ophthalmic sub-specialties 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. The department continues its focus on education and routinely teaches registrars in the area of phacoemulsification surgery. Orthopaedics More than 5,000 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 and ankle surgery and shoulder surgery. The area of musculoskeletal oncology also continues to grow. Otolaryngology, Head and Neck and Skull Base Surgery One of the country’s leading units in the discipline of skull base surgery, the department also provides expertise in otology, neuro-otology, head and neck cancer surgery and advanced endoscopic sinus surgery. Working in close collaboration with neurosurgical and plastic surgery colleagues, the department provides multidisciplinary care and undertakes a large number of procedures including surgery for acoustic neuroma, Cochlear and brainstem implants as well as major head and neck surgical oncology cases. Additional facilities have been provided to the Microsurgical Skills Laboratory, which is involved in the teaching of otologic and rhinologic surgery. There is ongoing active research in rhinology and hearing disorders in collaboration with the Garvan Institute of Medical Research. The department maintains its teaching of two advanced surgical trainees, as well as providing fellowships in otology, neuro-otology, head and neck cancer surgery and Annual Review 2010/11

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rhinology. Teaching is also provided for both the University of New South Wales and Notre Dame medical students. Plastics and Reconstructive Surgery The Department of Plastic, Reconstructive and Maxillofacial Surgery at St Vincent’s Hospital is involved in the provision of a comprehensive service for patients with a multitude of conditions. A multidisciplinary approach to treatment results in the highest level of reconstructive surgical care for patients with a variety of conditions including skin cancer, head and neck cancer, breast cancer, sarcoma, complex traumatic wounds and soft tissue deficiencies (abdominal wall, chest wall, orthopaedics). Microsurgical reconstruction is of great benefit in the management of these conditions and serves to offer the patient the full range of treatment options. An integrated maxillofacial trauma service is provided for patients with facial injury and post-traumatic deformities. The clinical research of the department has resulted in a number of innovative publications. The planning and establishment of a telemedicine consultative service, for remote patient access and follow-up, should offer better access and better care. 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. Urology The department consists of seven urologists covering the breadth of urological endeavours including oncology, reconstructive urology and urinary calculi. Benign prostatic hyperplasia treatments are performed, with expertise in laser therapy, infertility and impotence work. Outpatient investigations include urodynamics, cystoscopy, transrectal and transperineal biopsies and outpatient chemotherapy. Complex kidney work includes partial nephrectomy and laparoscopic renal work. With particular expertise in robotics and laparoscopic surgery, the department has close collaborations with the radiotherapy, medical oncology, and x-ray departments, 78

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as well as a strong research collaboration with the Garvan Institute of Medical Research.

services at St Vincent’s Hospital with the Garvan Institute’s internationally acclaimed cancer research.

Trauma Service

The major funding source for the KCC is the Commonwealth Government, with other funds coming from a variety of sources, the most significant of whom is reflected in the name of the Centre. The Australian Cancer Research Foundation’s (ACRF’s) funding was an important recognition of the place of the KCC in research landscape, while the ambulatory chemotherapy area, much expanded and purpose built, will benefit from a generous donation from the NELUNE Foundation and its supporters. The KCC is still hoping to secure sponsorship for its innovative Wellness Centre.

Operating in a consultative capacity, the Trauma Service reviews all major trauma patients on the day of admission, or next working day, and co-ordinates their care through the stages of admission. In 2010 the St Vincent’s Hospital Trauma Service received re-designation from NSW Health as a Major Trauma Centre for the local community. The service has subsequently received approximately 1,000 patient presentations, with approximately 120 of those with a moderate or severe injury. The service provides excellent support to all staff involved in the provision of trauma care, with regular, clinical focused education and training, including in-services on all wards. Conducted fortnightly and open to all staff, Trauma Grand Rounds provide a clinical meeting which reviews an interesting trauma presentation.

Dental The main goal of the Dental service is to optimise oral health, particularly in the elderly. Addressing the oral health needs of the elderly is essential, as oral health deficits impact on all branches of medicine and can complicate medical management and extend stays in hospital.

To ensure optimal patient flow, the service has worked with nursing and allied health to implement and educate staff on the Westmead Post Traumatic Amnesia Score, ensuring best practice head injury care.

The hospital’s strategy of providing appropriate oral and dental care for the aged is aimed at understanding an older person’s functional needs and addressing oral health education for the aged.

The service maintains a close working and referral relationship with the South Eastern Health Network and St George Hospital.

Another group with a focus on optimising oral health is the head and neck cancer cohort. These patients require a multidisciplinary approach for effective oral health management.

Cancer and Immunology Program The vision of the Cancer and Immunology Program is to provide excellence in holistic healthcare, incorporating prevention, treatment, innovation, education and research, through the optimal use of available resources. Such care needs to continue to be developed in keeping with all of the values of the organisation, which are of particular importance in the context of cancer. At a time of consolidation and strategic planning, the program continued to scope the future move of much of its services to the new Kinghorn Cancer Centre (KCC). The focus of planning has been on the translational aspects of the new centre, developing novel models of care that can quickly reflect research breakthroughs. The KCC will align the best practice cancer

The strategy of St Vincent’s Hospital to reduce the impact of potential complications of radiation therapy will be to ensure that all patients with head and neck cancer are assessed by a dentist as early as possible, an oral health baseline established and a preventive dental program initiated. It is also essential that routine monitoring of the oral cavity take place throughout treatment. Finally, as dental services play a major role in some trauma cases, the goal is to ensure timely assessment and treatment of these patients.

Haematology/Bone Marrow Transplantation The Bone Marrow Transplantation service, providing care for patients from across the state, has struggled to keep up with demand and to work within available resources. The amount of work referred to the service is testimony to its success and to the


Hereditary Cancer Clinic The cancer genetic service has noted year on year increases in utilisation by consumers wanting to increase their knowledge of their cancer risk, so as to employ preventative and/or early detection strategies. The service provides outreach advice to rural and regional NSW.

HIV, Clinical Immunology and Infectious Diseases HIV, Clinical Immunology and Infectious Diseases continued its superb clinical and research work in these challenging areas. Provision of comprehensive HIV, clinical immunology, viral hepatitis and infectious diseases care is a key goal of this unit, with a co-existing aim to maintain its place as a nationally and internationally recognised centre of excellence. Beginning in the 1970s as a clinical immunology service, with particular expertise in auto-immune disease, this was where the first case of HIV in Australia was identified in 1983. It remains the largest HIV unit in Australia, caring for more than 1,500 HIV patients. HIV is now a chronic, manageable disease and care has largely shifted to the ambulatory setting, with care relating to prevention of chronic complications of HIV and of HIV therapy. The multidisciplinary care of these patients is served by specialist expertise in immunology, infectious diseases, neurology, haematology, anal cancer, dental care, liaison psychiatry, and ophthalmology. The unit will continue to provide infectious disease services to the hospital, in particular to heart, lung and bone marrow transplant services, as well as intensive care, geriatrics and surgery. More recently, a substantial viral hepatitis service has developed for patients requiring management of chronic viral hepatitis B and C, including those co-infected with HIV. It is one of the largest such services in Australia. Internationally recognised, the unit is a leader in the research of HIV and infection and viral hepatitis and well-

established research collaborations locally, nationally (particularly via the University of NSW’s Kirby Institute) and internationally. The unit’s key proposals for improved care are the creation of a new advanced training position and new ambulatory clinics in allergy, primary immunodeficiency, HIV complications, advanced liver disease and alcohol and drug problems.

Medical Oncology Medical Oncology continued to provide leadership for multidisciplinary care for most tumour groups, such care being the cornerstone of modern cancer treatment. Particular advances were made in the area of the multidisciplinary team working in lung cancer. Strategic planning for future appointments of staff was also a focus of activity. In collaboration with Social Work, a new program of patient information seminars and a breast cancer support group were established. A magnificently situated house in Avoca on the Central Coast was donated to the program by the late Diane Wishart, a grateful former medical oncology patient, for respite care for patients with cancer and their families. There were numerous other donations by patients who wished to support the program at St Vincent’s, including $100,000 from a donor for research efforts.

Radiation Oncology Radiation Oncology at the Darlinghurst campus provides radiotherapy services for all adult malignancies. Specialised services include 3D conformal radiotherapy, image guided radiotherapy, highly focused external beam techniques such as Intensity Modulated Radiotherapy (IMRT) and an internationally recognised brachytherapy program. Total Body Irradiation (TBI) is also provided for haematology high dose chemotherapy transplantation patients. Radiation Oncology also provides a leadership role for relevant multidisciplinary team meetings. A major strategic review of this service is underway at the time of writing.

Clinical Governance Decision Support Unit A Decision Support Manager was recruited in November 2010 to be responsible for performing research and analysis of financial and productivity data, preparing detailed

reports and recommending strategies and operational procedures to ensure St Vincent’s Hospital is able to meet and improve organisational objectives. A number of major achievements have resulted from the commencement of the Manager including the operating theatre redesign, the stranded patient initiative and the establishment of scorecard reporting and non-financial reports in Qlikview.

Infection Control The Infection Control Department and Employee Counselling and Treatment Program provide information to staff, volunteers, visitors and patients on infection control related topics. The department is also responsible for providing vaccination and exposure management to staff and volunteers. Infection Control undertakes a range of surveillance activities to monitor healthcare associated infections and ensure all relevant policies and guidelines are in place to improve patient safety. A comprehensive review of environmental cleaning within the hospital was commenced in 2010, with a focus to further improve the standard of environmental hygiene within the hospital. The department participated in the Clinical Excellence Commission Quality System Assessment on-site visit for the first time in 2010, with healthcare associated infection a particular area of focus for assessment. The hospital continues to participate in the national hand hygiene initiative, co-ordinated through Hand Hygiene Australia in Melbourne. Many staff across the campus have undertaken training to be hand hygiene auditors and hand hygiene stations are located throughout St Vincents & Mater Health Sydney. The first St Vincent’s Hospital mass staff seasonal influenza vaccination day took place in May 2010, with hundreds of staff given the seasonal influenza vaccine in the mobile clinic.

Medical Workforce Unit Medical Workforce is responsible for the recruitment, retention, budget and workforce planning needs for over 700 Medical Officers (both senior and junior) across St Vincent’s Hospital.

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quality of care provided. In 2011 the service celebrated its 35th anniversary at St Vincent’s with a commemorative service attended by more than 300 people. The generic haematology oncology service (cancers of the blood) continued to conduct major clinics in rural NSW.

A review of the Medical Workforce Unit identified that the existing staff profile did not permit adequate support to Annual Review 2010/11

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JMO administration especially with regards to planning of the workforce, recruitment and rostering, nor flexibility with leave cover or succession planning. There was limited leadership for the management, support and co-ordination of trainees and junior medical staff, in areas such as the promulgation of clinical governance accountabilities and the clinical management of services with respect to patient flow and clinical redesign. A number of new positions were established in the Medical Workforce Unit in 2010/2011. These included the positions of Executive Manager Medical Workforce; Senior Medical Officer (SMO) Manager; Administration Officer to Director Clinical Governance; Clinical Superintendent Medicine and Surgery positions and site Director Physician Training. These new positions have helped consolidate the Medical Workforce Unit to provide the necessary frontline human resource support to medical practitioners; in the delivery of major improvements to patient safety and quality and providing great assistance to improve education and training standards for junior medical staff and in the accreditation of positions.

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.

Patient Safety & Quality Unit The Patient Safety and Quality Unit plays a key role in assisting St Vincent’s Hospital to deliver the highest quality of care, ensuring the right treatment is provided in the right place at the right time for each individual. The unit co-ordinates a number of key systems and process to assist clinicians and managers with their daily work and plays a large supportive role to the Patient Safety & Quality Committee 80

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(PSQC). The PSQC is responsible for the hospital’s clinical governance systems. The PSQC has developed a Quality and Safety Governance Strategic Plan 2011-2015, which incorporates the best ideas from international and national improvement frameworks, as well as current safety and quality initiatives. Many of the initiatives included in the plan are currently led by senior clinicians, some of whom are internationally recognised as experts in their field. During 2010/2011, representatives of the Clinical Excellence Commission (CEC) attended St Vincent’s Hospital to verify the Quality Systems Assessment (QSA) survey. The QSA program focuses on the systems in organisations that assist staff to maintain a high level of safe quality care. Overall, the hospital was found to have very effective systems and plans for continuous improvement in place. Preliminary results from the most recent NSW Health patient satisfaction survey indicate that St Vincent’s Hospital is providing a high level of patient satisfaction when it comes to healthcare. Likewise, the Improving Patient & Staff Experience (IPSE) project, supported by NSW Health is directed at improving both patient and staff satisfaction and the results were very competitive against other hospitals across NSW. Other initiatives include improving hand hygiene compliance, aimed at preventing hospital acquired infection in patients and the venous thromboembolism (VTE) prevention program, aimed at preventing patients from developing blood clots when they are less mobile or after surgery. Effective communication amongst staff is an important component of patient safety and the clinical handover program aims to standardise the handover of information about the care of patients across professional groups and settings. It also aims to ensure that patients and their family/carers are included in discussions about their care.

Radiation Safety Radiation Safety protects staff, patients and the public from the harmful effects of radiation. One of the key activities for the department is to ensure the hospital’s compliance with national and international radiation safety standards. In 2010/2011, Radiation Safety

increased targeted audit and inspection activities to ensure compliance with radiation safety regulations. Staff radiation exposure records were reviewed and performance was benchmarked against national radiation monitoring results for selected workgroups. Additional security measures were implemented for radioactive sources used within the hospital and a full-time radiation safety officer was appointed in January 2010.

Heart Lung Program Cardiology Cardiology delivers an extensive range of non-invasive and invasive cardiac services, with a particular focus on the sickest and most complex patients due to the capacity to provide heart transplantation and mechanical circulatory support within the Heart Lung Program. Cardiology has a strong clinical and basic research focus, with many of the senior clinicians holding research appointments also in the Victor Chang Cardiac Research Institute.

Cardiology – Interventional 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. In 2010/2011 the laboratories introduced a procedure known as left atrial appendage occlusion with a self-expanding prosthesis that allows patients to come off anticoagulant drugs whilst being protected from the thromboembolic complications of atrial fibrillation. In more than of 90 percent of stroke patients with atrial fibrillation, the blood clot originates from the left atrial appendage. This particular cohort of ischaemic stroke has a high mortality rate and high rate of significant permanent disability. Left atrial appendage occlusion is equivalent to long term anticoagulation in the prevention of these strokes. Also in the past 12 months, the laboratories conducted the first-inmantrial of the Coherex device and, to date, is the only institution in the world to have used each of the three available devices.


The laboratories are working to introduce the MitraClip device, a percutaneous treatment for a leaky mitral valve, in the coming 12 months, and to engage in a first-in-man study of a novel bioabsorbable stent. The Cardiac Reperfusion Initiative (CRI) was implemented in July 2010 as part of a state wide program to improve access to pre-hospital assessment for patients with suspected myocardial infarction. When patients are transported to the Emergency Department with chest pain, an ECG is remotely sent to the cardiologist while the patient is still in the ambulance. This early warning system has helped to improve timely access to treatment for patients who are referred via life net. Interventional cardiologists continue to provide outreach services to cardiac catheterisation laboratories in Tamworth and Wagga Wagga and an assessment clinic in Armidale. Interventional cardiologists at St Vincent’s also have close ties with hospitals in Wollongong, Gosford and Coffs Harbour. Cardiac Electrophysiology Service The Cardiac Electrophysiology Service provides treatment and ongoing management for patients living with cardiac arrhythmias (abnormal heart beats). Diagnostic tests on the heart rhythm (electrophysiology studies) and potentially curative procedures (catheter ablation) are performed, in addition to implantation of cardiac devices such as pacemakers and defibrillators. Working in conjunction with the St Vincent’s Hospital Heart Transplant Unit, the Cardiac Electrophysiology Service specialises in treatment of arrhythmias in patients with severe heart failure, with coexisting left ventricular assist devices and post-cardiac transplantation. In 2010 the Cardiac Electrophysiology Service continued at the forefront of complex ablation and cardiac pacing therapies. The year was highlighted by several key publications in leading cardiac journals based on research conducted in the electrophysiology unit. Several members of the department were invited to present at the prestigious Heart Rhythm Society in the United States and national Cardiac Society meetings.

The unit has now integrated rotational angiography, cardiac MRI and cardiac CT into electro-anatomical mapping systems for optimising ablation strategies. A great advance in 2010 was the installation of a new threedimensional imaging system (CARTO 3) to enhance mapping and ablation of complex arrhythmias such as atrial fibrillation and atrial and ventricular tachycardias. The Cardiac Electrophysiology service continues to be one of the leading centres in implantation of cardiac resynchronisation devices, which are used specifically in the treatment of severe heart failure. In view of increasing demand, the Service also developed an advanced nursing role to enhance management of patients living with cardiac devices.

Cardiology – Non-Invasive Non-invasive Cardiology includes electrocardiography (ECG), ambulatory ECG (Holter) monitoring, stress ECG testing, event recording and imaging the heart with ultrasound, or echocardiography. Echocardiographic services include transthoracic, transoesophageal and stress echocardiography. Transoesophageal echocardiography is used extensively to guide procedures in the cardiac catheterisation and electrophysiology laboratories and in the cardiac operating rooms and intensive care. Advanced Cardiac Imaging Program The Advanced Cardiac Imaging program at St Vincent’s Hospital, a service developed and run conjointly with the Medical Imaging Department, includes a state-of-the-art Toshiba Acquilion One 320 slice Cardiac CT scanner, the only CT scanner which is able to image the heart and coronary arteries in a single heartbeat. This allows for superior image quality with low radiation exposure. The single beat imaging allows measurement of blood flow to the heart and imaging of the coronary arteries. This is an ideal solution that often avoids the need for additional testing. Advanced cardiac imaging is also provided on a 3.0T magnetic resonance imaging (MRI) scanner, with plans afoot to add a 1.5T MRI scanner to provide a comprehensive cardiac MRI service. Cardiology also has an active cardiac CT and MRI research program. A recent publication on a unique form

of measuring calcium in the coronary arteries was awarded the best research article from Australia and New Zealand at an international cardiac conference.

Cardiac Rehabilitation The Cardiac Rehabilitation Service (CRS) comprises a multidisciplinary team and offers a comprehensive service commencing from hospital admission to outpatient recovery. The program develops and manages individualised services for all patients who have had a heart attack, stent procedure, heart surgery, implantable defibrillator or any other acute cardiac conditions. In 2010, 237 new patients commenced the St Vincent’s Hospital Phase 2 outpatient cardiac rehabilitation program, which was an increase in attendance from previous years. In addition, 839 patients were referred to regional cardiac rehabilitation programs. With an increase in the incidence of cardiac patients with Type 2 Diabetes, the CRS and Diabetes Centre worked together to provide monthly diabetes education sessions for all diabetic patients attending the program. Implantable Cardiac Defibrillator (ICD) support groups continue to be held quarterly. During 2010, the service was incorporated into the hospital’s cardiopulmonary patient database. All patients who have been consulted by the service, across both St Vincent’s and St Vincent’s Private Hospitals are entered on the database, giving nurses, occupational therapists and physiotherapists access to a multidisciplinary resource to document and assess patient outcomes.

Cardiothoracic Surgery Cardiothoracic Surgery delivers a complete range of adult cardiac and thoracic surgical services, working in conjunction with St Vincent’s Private Hospital and performing approximately 900 procedures across the Darlinghurst campus each year. Internationally recognised activities relate to the management of heart and lung failure, and transplantation of these failed organs is a core activity of the department. Also, there is a full range of mechanical assistance for the failing heart and lung, including extracorporeal membrane oxygenation (ECMO) and continuous flow ventricular assist devices. The implantation of a total artificial heart Annual Review 2010/11

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The transcatheter aortic valve implantation (TAVI) program for aortic stenosis remains active and an increase in demand is anticipated in the coming 12 months.

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was a ground-breaking achievement in 2010/2011. Another key procedure has been the introduction of pulmonary thromboendarterectomy for recurrent pulmonary emboli. With these innovations the department remains at the forefront of provision of surgical relief for the most complicated cardiothoracic problems.

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 patients from South Australia and other states. Continuing to attract worldwide recognition, the unit’s patient outcomes are significantly superior to international standards. 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 been used successfully as a bridge to lung transplantation in nine young patients with cystic fibrosis and pulmonary fibrosis. Extracorporeal membrane oxygenation has also been used successfully post transplant in eight patients with primary graft dysfunction, all of whom have fully recovered. In response to NSW Health guidelines, the unit developed the policy on lung transplantation and donation after circulatory death (DCD). Over the past three years introduction of the guidelines has resulted in a 20 percent growth in the service delivery of lung transplantation, with 23 recipients of DCD lungs contributing to more than 40 lung transplants each year. As an adjunct to the DCD program the unit is developing the ability to support donor lungs for prolonged periods in the laboratory prior to transplantation using ex-vivo lung perfusion (EVLP) to improve the function of the donor lungs. Implementation of the new total artificial heart program has provided a service to a group of patients who previously would have been unlikely to survive heart transplantation, and in August 2011 the first recipient celebrated a year with his total artificial heart.

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Fostering an environment of excellence, the unit maintains an active research program. An increased ability to provide artificial heart, ECMO and EVLP support will bring additional activity to the unit in coming years and ensure best possible results. Heart Lung Clinic The Heart Lung Clinic provides cardiopulmonary ambulatory care for transplant patients as well as those with heart and lung failure, tuberculosis and chronic obstructive pulmonary diseases. The clinic’s activities include pacemaker checks; tuberculosis screening; pre- and post-heart and lung transplant check-ups, dressings and infusions. The clinic is also responsible for supporting patients on the heart and lung transplant waiting list and those waiting to be listed. Transplant Co-ordinators work with Donate Life and a 24-hour telephone counseling and support service is available to transplant recipients. The activity in the Heart Lung Clinic is ever increasing with the growing transplant population and the introduction of new innovations such as the total artificial heart in 2010. In May 2011, a Transplant Rehabilitation Program commenced supporting the needs of transplant patients, many of whom have chronic diseases. Behavioural interventions are imperative to self management, best practice and survival outcomes. In recognition of the fact the transplant journey is a lifelong journey, education and exercise in this patient population is paramount to holistic care.

Pulmonary Hypertension Clinical Trials Since 1999 the Heart Lung Program has engaged in trials to improve clinical outcomes for those with pulmonary arterial hypertension. 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 significantly improved – from 50 percent chance of two-year survival to 85 percent. With some of the highest patient participation numbers, the hospital is a world leader in several clinical trials, including a Pfizer examination of sildenafil and a VITAL study of bosentan.

More than 300 patients with pulmonary hypertension are now managed by the unit and as part of the cardio pulmonary record, a comprehensive database of their progress is being developed. This will feed into a national registry of pulmonary hypertension patients that will significantly enhance understanding of this disease and its management in Australia and New Zealand.

Thoracic Medicine The Respiratory Chronic Care Service (RCCS) is a multidisciplinary service catering for patients with chronic respiratory illness. The service aims to enhance primary care, education, healthcare co-ordination, best practice and self-management skills and offers inpatient, outpatient and community review, intervention and consultation. The RCCS also offers evidence-based pulmonary rehabilitation - an eight week, bi-weekly program that has been developed specifically for people with chronic obstructive pulmonary disease (COPD). New evidence indicates other types of chronic respiratory illnesses may benefit from the pulmonary rehabilitation program, which is designed to improve exercise tolerance, provide patient education, provide psychosocial support for patients and their families and develop self-management skills. The service works closely with Cardiac Rehabilitation, the Heart Failure Service and Community Health to provide coordinated care. This also extends to coordination and referrals to local, state and interstate facilities and services. Quality improvement projects were commenced to look at palliative care education and inspiratory muscle training in pulmonary rehabilitation and there was a continuation of the Goal Attainment Scales (GAS) in pulmonary rehabilitation. The GAS pilot study was the winner of the St Vincent’s Hospital Quality Award - Novice in 2010. The impact of the GAS in the pulmonary rehabilitation pilot study has seen the GAS concept being implemented in other departments throughout the hospital. Sleep Unit The Sleep Unit provides a comprehensive diagnostic and treatment service for a broad range of respiratory and non-respiratory sleep disorders. These include snoring, sleep disordered breathing, obstructive sleep apnoea, respiratory failure,


Each year the two-bed unit conducts approximately 390 overnight sleep studies (diagnostic and treatment studies using CPAP and BIPAP). Tests of excessive daytime sleepiness, such as multiple sleep latency test and maintenance of wakefulness test, are also performed. 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 in association with the Heart Lung Program at St Vincent’s Hospital, the unit provides pretransplant work-up sleep studies and ongoing treatment and/or management of sleep disordered breathing and respiratory failure in pre-transplant patients.

Inner City Health Program The Inner City Health Program (ICHP) at St Vincent’s Hospital provides comprehensive inpatient and outpatient services for people with mental illnesses and/or addictions and vulnerable populations residing in inner city Sydney such as the homeless and those with HIV and Hepatitis C. The service is driven by the mission of the Sisters of Charity and aims in collaboration with community and primary healthcare agencies to deliver recovery oriented, integrated care to its consumers and their families. Specific areas of focus, in addition to service delivery, include, ongoing training for mental health, alcohol and drug professionals, health promotion about alcohol and drug use, analysis and advocacy for health policy, homeless healthcare and clinical research. The program maintains strong academic and research links with the University of New South Wales, University of Notre Dame, Australian Catholic University, University of Tasmania and others.

Alcohol and Drug Service The service is renowned for taking innovative, harm reduction approaches to the treatment of those experiencing problems related to alcohol and/or drug use. Help is not confined to alcohol- and drug-dependent individuals, but is

freely offered to their families and friends. Health professionals who are working with the individuals and community agencies are also offered specialist assistance and support. The Alcohol and Drug Service provides two distinct types of service. Firstly, face-to-face treatment units deal with individuals who are dependent on an array of mood altering substances. In addition, the service provides a specialist call centre, covering alcohol and drug issues as well as smoking cessation services across NSW and beyond – the Alcohol and Drug Information Service and the NSW and ACT Quitline. It also promotes the development of community and prison based self help SMART groups. These provide effective options for those who are less impaired by their addictions but who still need practical ways of overcoming them. Alcohol and Drug Information Service The Alcohol and Drug Information Service (ADIS) is a 24-hour anonymous, confidential specialist telephone helpline and call-centre for NSW. The service provides advice, crisis counselling, information and referrals for assistance on most issues regarding alcohol and other mood altering substances. Callers include people dependent on alcohol and drugs, family members, concerned others and health professionals. Having been in continuous operation for more than 32 years, ADIS manages approximately 40,000 calls each year. Additional niche services target priority populations. These include health professionals, through the Drug and Alcohol Specialist Advisory Service; opiate-dependent individuals, treatment clinics and consumer groups, through the Methadone Advise Conciliation Service (MACS); and methamphetamine using and dependent individuals through the Stimulant Treatment Counselling Line. In April 2010, ADIS moved into the new O’Brien Centre to a purposebuilt contact centre. This move was much anticipated and saw the ADIS team work more closely with the wider Alcohol and Drug Service. The ADIS database has been extended to include information on over 2,000 agencies and services that provide treatment and social welfare solutions across NSW.

Gorman House Gorman House is a long-standing speciality unit which operates around the clock to support those with severe drug and alcohol dependency. With a short term, non-medical harm minimisation program, staff at the 20bed residential withdrawal unit, offer support, respect and compassion to all clients. To upgrade services and comply with campus-wide non-smoking workplace legislation, Gorman House introduced nicotine replacement therapy to assist residents manage their tobacco smoking. There has been a high level of collaboration to integrate service delivery to homeless people referred via the new Homeless Health Service and joint-case management has commenced. The ongoing generosity of the Order of Malta has ensured funding for the 24/7 operation of Gorman House. NSW/ACT Quitline Funded by and working closely with the NSW Cancer Institute and ACT Health, the NSW and ACT Quitline is a confidential, specialist, telephone counselling and information service, primarily designed to help smokers quit smoking tobacco. These services moved into the O’Brien Centre in April 2010 and are collocated with ADIS in the new state-of-the-art contact centre. Also in 2010, the NSW Quitline received tender extensions of four and three years from their funding bodies. This was due to the success of the operational model selected and the skills of the team. Ongoing partnership with the Multicultural Health Communication Service has resulted in the employment of bilingual Arabic, Vietnamese and Chinese speakers, extending the reach of the service. Working closely with ADIS, the Quitline call centre is able to manage incoming calls for help and information, as well as outbound calls for customised health management strategies and interventions. The NSW Cancer Institute website – www.icanquit. com.au – has extended the range of modalities offered into the online realm.

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parasomnias, narcolepsy, idiopathic hypersomnolence and circadian rhythm disorders. Both inpatient and outpatient services are offered.

Another important service offered by Quitline is the Quit Prison service, which was commissioned to assist the many inmates in NSW and ACT prisons to stop smoking. In 2010 these services managed approximately 50,000 inmates.

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Rankin Court Treatment Centre In 1984, Rankin Court Treatment Centre (RCTC) commenced providing opiate pharmacotherapy and support with a focus on harm minimisation to individuals with opiate dependency. Continuing its high quality service Rankin Court provides assessment, referrals and case management. Treatment concentrates on individuals’ drug, physical and mental health, as patients have a very high rate of health problems spanning all three areas. Working with a vulnerable and volatile population, RCTC cares for and interacts with approximately 325 opiate-dependent outpatients every day of the week. In 2010 RCTC moved to a purpose-built clinic within the new O’Brien Centre. Patients have formed a consumer committee and work with staff to maintain a welcoming environment within the new RCTC. Providing high quality, specific, customised appropriate care in a modern and welcoming setting is helping to improve patient health outcomes. Stimulant Treatment Program The Stimulant Treatment Program (STP) was designed and established in 2006 as a pilot program with Hunter New England Area Health Service to provide a specialised treatment option for stimulant users. From a framework of harm reduction, the STP works to help clients develop safer ways of using and/or attaining or maintaining abstinence. The program uses a strengths-based, stepped-care approach with individual counselling as the core treatment provided. In June 2010, the STP completed its four-year pilot phase and in partnership with NSW Health and the National Drug and Alcohol Research Centre conducted a comprehensive evaluation of the service. The report is scheduled to be presented to the Health Minister in 2011. Throughout 2010, the STP’s work included counselling services to 195 patients and dexamphetamine substitution therapy for a small number of those with extreme problematic methamphetamine use. In collaboration with ACON, STP developed an outpatient strengths-based, relapse prevention group, to service the needs of more individuals with issues around substance use.

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Homeless Health Service With considerable growth in 2010, St Vincent’s Homeless Health Service provides homeless individuals with multi-specialty assessment, treatment, care co-ordination and referral. The service facilitates clients’ transition into mainstream health services by employing a consumer focused biopsycho-social model. Homeless Health uses a collaborative approach, working with local services to co-ordinate care and maintain a support network for clients. Throughout 2010 the Health Outreach Team continued to provide outreach primary healthcare through medical, nursing and podiatry clinics and individual follow up at a variety of locations appropriate to individual client needs. This team includes the Medibeat nurse, in partnership with Mission Australia. The Assessment and Co-ordination Team commenced in 2010. This multispecialty team is the single point of entry to the Homeless Health Service. The team provides intake and total healthcare assessment, referral, brief intervention and care co-ordination. Recruitment planned for 2011 will see increased capacity and service provision. In 2010, the Way2Home Health Team began providing care co-ordination, assessment, treatment and referral on an outreach basis to chronic rough sleepers. The team works in partnership with the Way2Home Support Team to provide holistic support for clients’ health and housing needs. The Way2Home Assertive Outreach Service is jointly funded by NSW and the Commonwealth Governments under the National Partnership Agreement on Homelessness. Also commencing in 2010, the Homeless Health Co-ordinated Exit Planner is based in the hospital’s Emergency Department and is also is jointly funded by the NSW and Commonwealth Governments under the National Partnership Agreement on Homelessness. The Co-ordinated Exit Planner’s role is to try ‘break the cycle’ of homelessness, by providing comprehensive assessment and care co-ordination to individuals with complex needs, in collaboration with local services. In 2011, the service hopes to secure capital and operational funding for the old Gorman House site on Ice Street, Darlinghurst. The plan is to

establish a 10-bed medi-cottage where homeless clients who do not require an acute inpatient admission may be provided with accommodation for up to two weeks. It is then envisaged that hospital-based services, including social work, medical, mental health and alcohol and drug services, may provide co-ordination and interventions to assist in breaking the cycle of homelessness and improve health outcomes.

Mental Health Service Aboriginal Mental Health Service The 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. The service establishes contact with individuals whilst they are in hospital and once discharged, follows up with the patient and their family in the community. As is the case with other Indigenous mental health service providers, the aim is to address the needs of clients across generational and geographical boundaries. For the past five years through the endeavours of Aboriginal Mental Health Professional, Kaylene Simons, the service has established Connections – Aboriginal Women’s Art Therapy Group as well as hospital and community links with the Aboriginal Medical Service, non-governmental organisations and and other agencies who provide referrals. The service has received a significant boost with the recent appointment of a male co-worker to share the work load and address the particular needs of men in a culturally appropriate way. Anxiety Disorders The Clinical Research Unit for Anxiety and Depression (CRUfAD) is a joint University of NSW and St Vincent’s Hospital facility. It receives research support from National Health and Medical Research Council and the Department of Health. The Anxiety Disorders Clinic sees 14 new patients each week and, with the addition of people referred for online treatment, currently treats 1,000 new patients a year. Crufadclinic.org provides online courses, which rural and other clinicians can use with their patients. There are now 1,100 clinicians actively using the courses. To date, 4,000 patients have been prescribed a course for panic disorder, social


Caritas Mental Health Inpatient Unit 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. In May 2010, Caritas moved into the O’Brien Centre. The O’Brien Centre is an integrated mental health, alcohol and drug and community health facility. Strongly embodying the mission and values of St Vincent’s, the O’Brien Centre aims to improve interventions for at-risk individuals and groups. The sharing of skills, resources, knowledge and priorities results in better access to services that are tailored to the individuals’ needs. Activities in 2010 included the implementation of the Star Wards program, a review of the care and management provided to consumers in the acute and sub-acute wards of Caritas. In addition, a consumer information booklet in direct response to consumer feedback was also produced. The activity program at Caritas continues to evolve and has been adapted to the new environment. The program has a broad range of therapeutic and diversional activities and groups and is delivered by a multidisciplinary team. The mural project continued in 2010. This long-term project involves consumers and members of Connections, a Redfern based women’s Aboriginal art therapy group, in the development and construction of Caritas murals. Consumer participation is an essential focus of the Caritas recovery and strengths. The nurse-initiated intervention of therapeutic mealtimes continues to enhance the relationship between staff and consumers, and results in positive feedback from consumers and staff. Caritas staff presented at the 2010 Australian College of Mental Health Nursing on therapeutic mealtimes and seclusion reduction. In 2010, as 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, and to

97 in 2010. This continued reduction in seclusion and restraint highlights Caritas’ commitment to national mental health strategies, as well as the caring attitude of the team, which pushes the boundaries for excellence in patientcentred care. Community Mental Health In late 2010, the Mental Health Executive supported a researchbased pilot project to implement a personalised strengths assessment and packages of care model for the provision of case management. The pilot will examine the delivery of case management using evidence-based, recovery-focussed and strengthsbased approaches in Community Mental Health (CMH). This exciting endeavour will provide staff with new clinical skills and enhance existing skills, as well as providing an opportunity to improve the quality of life and functioning of people accessing community mental healthcare. A major undertaking has been the relocation of CMH into an integrated space in the O’Brien Centre. From an operational perspective the integrated environment has led to improved communication between departments, while future partnership opportunities have been recognised and formalised. Clients are now welcomed into a space that is discreet, light and airy. The waiting area is spacious and calming and interactions with reception do not occur through perspex protective screens as was the case in the past. Community Mental Health Rehabilitation St Vincent’s Community Mental Health Rehabilitation Service is a multidisciplinary team that provides psychosocial interventions. The focus is to help people re-establish meaning and improved quality of life, which may contribute to their recovery. The team adopts a strengths- and wellnessbased approach to their work with consumers. The Community Mental Health Rehabilitation works closely with other teams within the service, as well as external organisations and local nongovernment organisations to explore a range of options that help to minimise the disconnection and isolation that can result as a consequence of mental illness. Support is also provided to help people re-establish connections with their local community and, where possible, connections with family.

This work is supported through access to a family consultant. Rehabfocused options to regain stable and secure accommodation are available in conjunction with the services’ partnership with Neami. The service supports an ongoing focus on people’s right to access mainstream employment or study opportunities. This work is supported through a dedicated vocational education, training and employment role and an established partnership with a local employment agency. During 2010 there was an increased focus on addressing the physical health needs of clients within the service, resulting in the development of new partnerships between Community Mental Health, Homeless Health, Diabetes Service and health promotion. All of these relationships were enhanced as a result of the relocation to the new O’Brien Centre. Consultation-Liaison Psychiatry Consultation-Liaison Psychiatry delivers mental health services to patients of St Vincent’s Hospital who have a primary medical condition associated with a mental disorder, or those with a mental disorder associated with, or complicated by, a medical problem. The service plays a crucial role in helping a range of patients to cope with their conditions and also provides in-service education, support and advice to local general practitioners. The service also works closely with patients who self-harm and/or who have made suicide attempts and through the Green Card Clinic, it produced a patient workbook and clinician manual for use with these patients. The workbook is also being introduced as the first step in a new program in the Southeast Sydney Local Health Network for people with personality disorders. The team has been working closely with the Heart/Lung Program, providing pre-transplant psychosocial assessments and mental health interventions pre- and post-transplant. The service is actively involved in the transplant rehabilitation group program, continues its strong association with the Sacred Heart Hospice and the Diabetes Service and is involved in joint projects with both.

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phobia, generalised anxiety disorder or major depression. The average level of improvement is excellent and adherence is now 51 percent.

HIV and Hepatitis C Mental Health Services The service is placed at the nexus of transmissible blood borne viruses, Annual Review 2010/11

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drug and alcohol use and primary care. The service consists of a clinical nurse consultant, clinical psychologist and psychiatrist, with the main objective of assisting general practitioners and HIV/ HCV clinicians in the treatment and management of individuals at risk of and infected with HIV and/or HCV. Towards the end of 2010 the service had assessed and treated more than 1,200 unique individuals and provided consultative input for many more. Each individual clinician presented at various conferences throughout the year to raise awareness of HIV/HCV and the risks to mental health consumers. Program for Early Intervention and Prevention of Disability (PEIPOD) The program works with young people between 16 and 25 years of age who have experienced the recent onset of a major mental illness, such as psychosis or a mood disorder. The multidisciplinary team provides assessment, mental health treatment, intensive case management and a range of psychosocial and psychological interventions for young people. The Program for Early Intervention and Prevention of Disability works collaboratively with families/ carers and local non-government organisations to identify emerging mental health problems as early as possible. This is done in order to facilitate access to health services and to support the young person and their carers throughout their recovery. In 2010/2011, PEIPOD operated a weekly outreach mental health clinic for young people at Oasis Youth Support Network, a local youth crisis accommodation service. The clinic has provided an opportunity for young people who are homeless to access a ‘youth friendly’ mental health assessment and support, in engaging with various counselling or treatment services as required. This pilot project was evaluated by Faces in the Street (Urban Mental Health Research Institute) and its success was recognised as a finalist in the St Vincent’s Health Australia Quality Awards. Psychiatric Emergency Care Centre The Psychiatric Emergency Care Centre (PECC) receives patients from across the Sydney metropolitan area. The centre accounts for half the patients seen at St Vincent’s Hospital and is delivering on outcomes as well as rapid high quality patient care. Patient satisfaction surveys highlighted the very

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high to excellent levels of care being delivered by this specialist team of doctors, social workers and nurses. The staffing profile was further enhanced in 2011 and PECC now employs endorsed enrolled nurses to compliment the nursing team profile of clinical nurse consultants, nurse specialists and registered nurses. The high level of academic achievement continues to be maintained with another four nurses graduating from masters programs. The PECC has consolidated its position in emergency psychiatric services and is frequently referenced by state, national and international health providers as a gold standard in mental health emergency patient care. Psychogeriatric Service

and carer views will be sought on these services along with needs assessments of vulnerable populations forming the inner city community. In parallel with the latter is a project to evaluate the uptake and delivery of an enhanced case management model for people who have severe persistent mental illnesses. This service will formalise the application of the “strengths model” of recovery-oriented treatment and personalised packages of care for these individuals.

Operations Commenced in 2009 and extended in 2011, Operations encompasses Nursing, Allied Health, Diagnostics, Patient Flow, Emergency Response and Clinical Information Systems. It also holds day-to-day operational responsibility for St Vincent’s Hospital.

A multidisciplinary team made up of medical, nursing, psychology and social work clinicians, the service works closely with patients, families, general practitioners and other health professionals across the hospital and wider community. A major development for the service in 2010/2011 was securing funding for two dedicated psychogeriatric inpatient beds in the geriatric medical ward. A second major development was securing funding for a social worker to join the team, for the first time since the service began in 2003. These resources have significantly enhanced the team’s ability to provide seamless integrated multidisciplinary psychogeriatric care to older people with mental health problems and mental illness. The team also spent time in planning initiatives in community education and rural outreach, for implementation in late 2011.

Allied Health

St Vincent’s Urban Mental Health Institute – Faces in the Street

Nutrition Services

Faces in the Street was established in 2008 with the aim of supporting the development of the ICHP and the services it delivers through identifying the needs of vulnerable populations within the inner city, it works by researching hospital and community services and supporting the development of innovative programs based on this research and evaluation. There are a variety of research projects currently underway. The top priority projects involve a comprehensive survey of community based nongovernmental services that will in the first instance identify the functionality of their working relationship with each other and the ICHP. Later, consumer

Operations was extended in 2011 to incorporate the critical clinical function of Patient Flow – the right patient in the right place at the right time, which is an ongoing multidisciplinary challenge with a limited acute inpatient bed base, high emergency and elective patient demand as well as changes in community and ambulatory services.

Audiology The Hearing and Balance Centre provides a full range of audiological and vestibular assessment and rehabilitative services for all patients. This includes pre- and post-operative specialised services for patients with cochlear and brainstem implants. The centre is also accredited to provide hearing aids to patients via the Office of Hearing Services scheme.

Nutrition Services provides a dietetic service and nutritional counselling for inpatients and outpatients from clinical areas including aged care, emergency, HIV, haematology, oncology, radiation oncology, renal, heart and lung transplantation, cardiology, palliative care, rehabilitation and the Diabetes Centre. Improvements to clinical care included introduction of a weekend dietetic service in October 2010, providing timely attendance to urgent nutritional matters and any new referrals. At the same time, the dietetic service to the Intensive Care Unit was strengthened with the appointment of a dedicated member of staff.


Members of the department were also involved in presenting sessions on nutrition during the ‘Living with Cancer’ program and for the Cardiac Rehabilitation Program. Occupational Therapy Occupational Therapy supports both inpatients and outpatients across a number of disciplines including neurology, neurosurgery, cardiac surgery, stroke treatment, rehabilitation and palliative care. With the expansion of the occupational therapy role into the new mobile rehabilitation service, many patients were able to leave hospital early and given acute intensive rehabilitation for up to two weeks. The department joined the multidisciplinary team taking part in the transplant outpatient program, which provides comprehensive support for patients and their families post transplant. Areas covered included psychological adjustment, physical exercise and the return to work, which had not previously been targeted. During 2010/2011 the department conducted a number of educational seminars and courses including an education forum aimed at improving chronic respiratory care and cardiac disease management. Pharmacy The Pharmacy Department provides a comprehensive range of pharmaceutical services to patients and staff at St Vincent’s Hospital. The Inpatient Pharmacy is responsible for procurement and dispensing of medications and provision of clinical pharmacy services, including drug information and patient counselling. Each year the busy Outpatient Pharmacy supplies more than $36 million of specialised medications not available from community pharmacies. In 2010/2011 improvements in pharmaceutical care and access to medications were achieved with the introduction of a Sunday pharmacy

service and the creation of an oncology pharmacist position. Ongoing training of the pharmacy workforce remained a focus for the department in line with the recommendations of the Caring Together Report. Three pharmacy assistants and technicians enrolled in certificate courses, in preparation for future requirements of all dispensing technicians to have a Certificate III qualification. Four pharmacists were also enrolled in postgraduate programs. The pharmacy team maintained an active practice-based research program. As a result 12 projects and presentations were made at national conferences, with five publications in peer-reviewed journals. Physiotherapy The Physiotherapy Department provides in- and outpatient physiotherapy services to patients and clients throughout the hospital and community. Areas of service provision include all the ward areas in the acute hospital, the Emergency Department, Fracture Clinic and Sacred Heart. There is also service for musculoskeletal outpatients, rehabilitation outpatients, cardiothoracic outpatients, cardiopulmonary transplant outpatients, palliative care community physiotherapy, pulmonary rehabilitation, cardiac rehabilitation and immunology and HIV outpatients. The department was very productive in 2010/2011, with a number of clinical developments including establishment of a weekend physiotherapy service in the Emergency Department. The department has also played an integral role in the establishment of the Orthopaedic Clinic at the Aboriginal Medical Service in Redfern, where every second week specialist orthopaedic consults and treatment is offered. The Musculoskeletal Physiotherapy Department was one of the areas chosen in the hospital to pilot the Improving Patient and Staff Experience (IPSE) program from the Ministry of Health and was involved in establishing IPSE strategies, with excellent results in the patient satisfaction survey. The Physiotherapy Department was also involved with the establishment of the transplant rehabilitation program, a formal program of education and exercise provided to patients before and after they receive their heart or lung transplant.

Psychology Psychologists, clinical psychologists and clinical neuropsychologists work across various programs at St Vincent’s Hospital to provide evidence based psychological treatments for a range of mental health problems and assist patients in managing the significant impact of acute or chronic illness on their lives. In 2011, clinical psychologists in the Psychogeriatrics Service developed and evaluated an innovative group therapy program for older adults with mental health concerns living in residential care and hosted their first community education forum on depression and older adults. Clinical psychologists in CRUfAD/ Anxiety Clinic introduced online cognitive behaviour therapy programs as a part of routine care for patients with generalised anxiety disorder, panic disorder, social phobia and depression. They continued to conduct clinical research into anxiety and depressive disorders and their treatment, with several papers published on topics such as health anxiety and the role of uncertainty in anxiety and depressive disorders. They also provide ongoing support and training for the Anxiety Disorders Support and Information Service (ADIS). Clinical psychologists in the mental health service established a new mindfulness group therapy program and are conducting an ongoing research project to evaluate its effectiveness. They were also involved in establishing a multidisciplinary mental health outreach clinic for young homeless people with mental health issues, a program which was acknowledged as a finalist in the 2011 St Vincent’s Health Australia Quality Awards. The clinical psychology service in Consultation/Liaison Psychiatry contributed to the development of resources and a group program providing psycho-education and support for heart/lung transplant patients and they continue to participate in providing palliative care workshops at Sacred Heart. They are currently working on developing a psychosocial needs screening tool for use in community palliative care.

many journeys. one vision. | st vincent’s hospital | sacred heart | st vincent’s private hospital | mater hospital | st joseph’s hospital | st joseph’s village

In recognition of the importance of education, there were clinical placements of nutrition and dietetic students from Newcastle and Wollongong Universities as well as lectures to students at Charles Sturt University. Nutrition assistants were trained in various aspects of special diets and the department has taken part in a new outpatient education program for transplant recipients and their carers.

Psychology services at the Sacred Heart Rehabilitation Service have continued to expand over the past year with the establishment of the Mobile Rehabilitation Team (MRT) and the expansion of the Pain Clinic providing Annual Review 2010/11

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individual and group therapy programs for patients with chronic pain. Social Work The Social Work Department is a comprehensive specialised service providing psychosocial assessment and intervention for patients and families, both locally and from across the state regarding the impact of illness and injury. Its work covers all key service areas and provides short- and long-term follow up and the provision of counselling, psychosocial and practical support. This includes Samaritan fund assistance and the provision of patient, relative and carer’s accommodation. In May 2011 the Social Work Department marked its 75th anniversary, honouring its founder Norma Parker and celebrated innovative practice past, present and future. During 2010/2011, a new clinical care model was developed to ensure all social work services in the acute hospital were aligned with specified clinical units, while the services were enhanced with the provision of weekend cover across the acute hospital. In addition to a new fund for cancer patients and their families being established, there was an expansion of cancer services with increased staffing to develop a new cancer group program. The department also continues to facilitate a highly regarded student training program. Speech Pathology Speech Pathology provides services to patients with communication, voice and swallowing problems related to stroke, head and neck cancer, neurological problems and other medical conditions across acute care and rehabilitation units. The department offers a state-wide service for voice disorders, including a combined Speech Pathology and ENT Voice and Swallowing Clinic which works closely with the Botox Clinic in Neurophysiology. A weekly Modified Barium Swallow Clinic run with the Medical Imaging Department enables the department to provide detailed assessment of swallowing disorders. The department also provides clinical education to speech pathology students through lecturing at universities and providing clinical placements in the rehabilitation student unit and Voice and Swallowing Clinic. 88

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New acoustic analysis equipment was purchased for the Voice Laboratory following a fundraising appeal which raised over $44,000. The department also received a $22,000 grant from the Curran Foundation to purchase the Phonatory Airflow System. Speech pathology staff will be able to offer instrumental assessments to patients with voice disorders, which will improve their ability to diagnose voice disorders and measure the outcome of voice treatment.

Clinical Services The Clinical Information Systems (CIS) department leads planning, development, implementation, training and user support of the hospital’s computerised patient information management systems. In 2010/2011, the MedChart electronic medication management system was rolled-out to two additional areas: the Intensive Care Unit and theatres. As of January 2011, all inpatient wards at the hospital, with the exception of Emergency Department, were using MedChart. In 2011, a new and improved version of MedChart was released which included the long awaited variable dose order module. This allowed clinicians to prescribe labdependant variable dose medications, including Warfarin, on MedChart and for the wards to finally remove paper medication charts. Members of the department have presented at a number of local and national e-health events about the MedChart implementation at St Vincent’s Hospital as the hospital is considered an e-health leader in Australia. Pre- and postimplementation studies conducted at the hospital have shown that the use of MedChart has more than halved prescribing errors. The Web deLacy inpatient electronic medical record system continues to go from strength-to-strength, with additional functionality, alerts and referrals added during the year. Clinical Information Systems is preparing for the release of the next version with requirements and functionality requests received from clinicians being incorporated to ensure that the system meets the needs of its users. One of the awaited features includes the electronic discharge summary. CHIME, the community health electronic medical record, which is used by the Community Health,

Mental Health, Alcohol and Drug, and Homeless Health services, was upgraded in January 2011. The new version provides enhanced functionality in many areas as well as several bug fixes. Other services registering their clients in CHIME include Community Palliative Care, Diabetes Centre and Community Respiratory Chronic Care. The year was ended with preparation for the next version of CHIME which will include a change to the messaging interface to increase client and staff safety. The revamped version of the application is planned for release in early 2012. The Inner City Health Program continues to move towards its goal of a paperless service with scanning implemented across the board to move the last of the paper records into CHIME. The CIS department has expanded to provide support for information systems used by cancer services, including radiation oncology and medical oncology. Clinical Information Systems has been in the process of trialling the Smart Clinic outpatient clinic management system in the Diabetes Centre and Renal Ambulatory Care, with a view to roll-out to additional outpatient clinics. The department has also been involved in the development and testing of the Smart Health Solutions electronic medical record for non-inpatients, which forms part of the national Personally Controlled Electronic Health Records Project.

Diagnostic Services Department The Diagnostics Services Department formed in mid 2010 amalgamates the Medical Imaging and Nuclear Medicine services. The department provides state-of-the-art diagnostics services to in- and out patients and supports several national and international research activities. Medical Imaging Service Medical Imaging provides diagnostic medical imaging services including digital x-ray, multi slice computed tomography (CT) (320, 64, and 16 slice), three dimensional magnetic resonance imaging (MRI), state-of-theart ultrasound and orthopantomogram as well as therapeutic and diagnostic interventional procedures. In 2011 more than 86,000 examinations were performed.


The service also performs CT brain and body perfusions, CT and MRI angiograms and is a leading site for ultrasound guided radio frequency and laser treatments for varicose vein ablations. Other strengths of the service include being a leading site for selective internal radiation therapy for extensive colorectal liver metastases and also for insertion of ports for chemotherapy. Nuclear Medicine Service Nuclear Medicine provides St Vincent’s Hospital with diagnostic and therapeutic nuclear medicine including positron emission tomography (PET) and computed tomography (CT). In December 2010, the service moved out of the St Vincent’s Clinic site and relocated all its patient services to within the hospital on Level 2. The service improved its equipment in 2010 by replacing the MG gamma camera with a new Hawkeye 4 slice SPECT CT and a new GE Discovery 16 slice SPECT CT. There were approximately 14,000 examinations performed for the 2011 year and in March 2010 the Medical Imaging Radiology Information System Patient Archiving Communication System (RIS PACS) was rolled out into the service. The service specialises in the care of those with cancers of the ovaries, head and neck, colorectal cancers as well as melanomas. It also works in collaboration with Medical Imaging in supporting the use of selective internal radiotherapy (SIRT) for hepatic metastases. Research has focussed on the areas of metastatic breast cancer, melanoma, lymphoma and the ongoing effectiveness of SIRT.

Emergency Response Following the release of updated Australian standards relating to emergency planning, St Vincent’s Hospital undertook a complete revision of its emergency operations plans to not only ensure full compliance, but to ensure the safety and security of patients, staff and the local community, in the event of emergencies and disasters. With a commitment to safety, the hospital received an ‘A’ score for emergency response in the Occupational Health Safety and Injury Management (OHS&IM) Profile audit in 2011, which is a hospital wide audit for assessing performance in essential aspects of OHS&IM. All public health organisations are required to be audited every two years. The hospital continues to provide comprehensive emergency response and disaster training. The Major Incident Medical Management and Support (MIMMS) team member course is offered to both internal and external staff throughout the year and is a pre-requisite for those who wish to be deployed to a disaster site as part of a health response team. There are now more than 50 suitably qualified staff from a variety of specialities including emergency, intensive care, mental health, allied health and surgical services. During the devastating events in Queensland, Christchurch and Japan in 2011, an overwhelming number of staff volunteered to assist. St Vincent’s Hospital staff led a combined South Eastern Sydney Illawarra mental health team deployed to Queensland to assist with their recovery efforts.

Medical Records The department operates a seven day a week service in the provision of medical records and health information services and has recently expanded its operations to 24-hours a day. The department’s core focus is the commitment to the continuum of patient care and safety, protection of patient privacy and quality health information, as well as accurate and efficient health record management. Services include the timely retrieval of medical records in order to assist clinicians, allied health professionals and other hospital staff in the provision of quality care to patients, as well as to support research.

The department is also responsible for transcription of outpatient letters, processing medico-legal requests for records and patient information, clinical coding of patient admissions and collection of statistics to track the hospital’s activity and report to the Department of Health. Recent achievements include reducing and maintaining the coding backlog, from six- to eight-weeks, to two- to three-weeks in preparation of activity based funding. The department also commenced integrating records for the haematology and radiation oncology departments.

Patient Flow The Patient Flow unit manages admissions, bookings, surgical waiting lists and bed allocations, with an emphasis on ensuring each patient is in the right place at the right time. The unit attempts to ensure the patient journey is as smooth and efficient as possible by developing and reviewing policies and business rules, overseeing and supporting patient flow projects and through constant engagement with clinical staff. The unit’s collaborative partnerships with all of the hospital’s programs and services are key in order to minimise delays in the admission and discharge of patients. Surgical waitlists and emergency department activity continue to be a challenge, however a number of projects are occurring to meet these challenges and further improve patient care by making significant inroads into reducing delays for patient care and treatment. Through a great deal of hard work and the collaborative efforts of admissions, theatre staff and medical staff, St Vincent’s Hospital met its monthly surgical waitlist key performance indicators (KPIs) for most of 2010. The Emergency Department access KPI continues to be a challenge for the hospital and it is anticipated that the hospital will bear the benefits of a number of innovations and projects that have been introduced in the past year.

Switchboard

many journeys. one vision. | st vincent’s hospital | sacred heart | st vincent’s private hospital | mater hospital | st joseph’s hospital | st joseph’s village

In August 2011, voice recognition software was installed on the Radiology Information System to further improve the turnaround time in providing diagnostic reports. Further, with the installation of Illuminate software within Patient Archiving Communication System, staff now have access to a Google-like free text search engine which automatically displays all relevant prior patient examinations when reading a new examination. The system can create a library for teaching and research and it also provides alerts for tracking patients through subsequent treatments.

Switchboard provides an around the clock telecommunications service to St Vincent’s Hospital. The telephonists provide assistance to staff, patients and the general public, which includes maintaining a considerable knowledge of the hospital facilities, daily rosters Annual Review 2010/11

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and the on-call rosters for staffing and departments. During 2010/2011 an SMS system was enabled to allow text messaging to groups of mobiles for high priority contact in emergency situations. A process was also developed to contact the on-call staff from the Cardiac Catheterisation Unit. Providing estimated times of arrival and data for reporting purposes, the information ensures the unit meets strict time lines for procedures.

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 at the Darlinghurst campus. The library maintains a collection to support specialty areas across the campus and its services include document delivery, literature searches, training, online databases and other resources. With the implementation of Athens Authentication, users need only a single login and password to access the library’s online resources, including e-journals and EBSCOhost databases (including CINAHL). MyAthens enables staff to view these resources from home. As part of the library’s strategic plan to increase online content, archives of specialist journals, which can be accessed via any hospital computer at any time, were purchased. This archive content is available via a MyAthens account. In addition a number of packaged e-journals were purchased in specialist areas of management, research and clinical care. The library’s open source library management system, Koha, was recently upgraded. The upgrade provides further web 2.0 enhancements, as well as updates to the online catalogue, including highlighting new purchases via a banner on the front page.

Population Health Program The Population Health Program consists of General Ambulatory Care, 36 outpatient clinics, Diabetes Centre, Dermatology, Aged Care, Xavier 9 North and the Medical Assessment Unit (MAU), Community Health Services including Home and Community Care (HACC) programs, the Chronic Care Heart Failure Team, Transitional Aged

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Care Packages, Clinical Pharmacology, Transport and Fleet Management and Podiatry. Many of these services focus on keeping patients healthy and in their own environment. The program’s success in 2010/2011 can be accounted to its attention to high quality care and patient safety. Insulin infusions, clinical handover, the ‘Home for Brunch’ project for the aged care ward and transport analysis were a few of the projects undertaken that improved patient care throughout the year.

Aged Care There has continued to be a high level of activity in the Acute Geriatric Unit, Aged Care Services in Emergency Team (ASET) and the Medical Assessment Unit (MAU). The MAU has continued to work closely with the Emergency Department in order to divert or minimise the time spent by patients in the department.

Ambulatory Care In March 2011, General Ambulatory Care opened its multi-purpose room for eight hours each weekday and four hours on weekends, for patients requiring medication administration and wound dressings. Patients from the Emergency Department can now be referred electronically via the Web deLacy system, enabling referral transmission at any time of day and ensuring better access. The 36 outpatient clinics have continued to be areas of high activity within the hospital. A new initiative with the St Vincents & Mater Health Sydney Information Technology Service Centre to replace the old booking system with Smart Clinic is proceeding well. The weekend clinic, in collaboration with the Primary Care Team in the Community Health Service, continues to provide an alternative to inpatient care.

Community Health Service The Community Health Service continued to service the Local Government Areas of Waverley, Woollahra and City of Sydney, in collaboration with the mental health and alcohol and drug teams. These services are now well settled in the new O’Brien Centre and have better integrated their care for clients, including people who are homeless.

In 2010/2011 the Transition Aged Care Packages (TACP) service increased packages of care, for people returning to their own home from hospital, from 26 to 32. To date, almost half of the people engaged in the service are self caring at the completion of their episode of care.

Endocrine and Diabetes Centre The Diabetes Centre continued to provide education, management and support to people with diabetes and their carers. In 2010/2011, the centre piloted Smart Clinic for a more efficient way of booking and tracking patient services. The centre also implemented a general practitioner liaison helpline, to allow quicker access to specialised support and management advice for diabetic patients of general practitioners. This has provided more timely, appropriate and better care for patients. A new referral template was introduced for general practitioners to specifically select the service types required for their patients.

Transport The non-emergency patient transport service offers patients transport to and from St Vincent’s Hospital as well as providing a fleet car service to other hospital departments. Trips to regional NSW and across Sydney have assisted expedient discharges from the Hospital and reduced costs of other transport forms for the Hospital at the same time as enhancing patient comfort.

SydPath SydPath provides 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.


The Division of Anatomical Pathology provides core diagnostic services to the Darlinghurst campus and various other clinics in metropolitan Sydney and regional NSW. The department’s expertise in in-situ molecular diagnosis is being complemented by the creation of a molecular tumour biology unit: a molecular pathologist has been appointed and assays are currently being validated. It is the department’s aim to offer comprehensive biomarker analysis in a variety of solid tumours, as well as haematological malignancies. The Division of Chemical Pathology has continued to develop an automation project aimed at returning results to doctors in the shortest possible time. There are clear benefits to acute care areas such as the Emergency Department and the Intensive Care Unit to be able to have results as soon as possible for urgent clinical decision making. Also within the general wards, the return of results within the same doctor’s shift in which the test was requested improves interpretation of the results. During the year the division also introduced a new high-sensitivity troponin assay for assessment of cardiac damage. This test can identify considerably smaller amounts of heart muscle damage than previous tests, allowing the more reliable exclusion of heart damage. As this was also moved to the automated system, the testing process was accompanied by an average reduction of the time to result for the Emergency Department of about 10 to 15 minutes, allowing earlier response to the testing. The division was again active in research and presentations in the field of chemical pathology. 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 Haematology Laboratories provides a comprehensive service which includes blood transfusion, coagulation and general haematology diagnostics. The Haemostasis Laboratory, in conjunction with the Blood, Stem Cells and Cancer Research Program and St Vincent’s Centre for Applied Medical Research, was successful in gaining funding and equipment to work on a

project assessing the clinical response to anti-platelet therapy in patients undergoing percutaneous coronary intervention, to see if it can help predict which patients are more likely to experience ongoing ischaemic events. In addition, it is planned that response to anti-platelet agents will also be assessed in patients undergoing cardiac surgery in an attempt to identify those who may be at a greater risk of surgical bleeding. The Haemostasis Laboratory has also collaborated with external investigators to study the effects of detergent sclerosants on the coagulation system, and is currently working with researchers at Royal North Shore Hospital in a multi centre study looking at improving testing for heparininduced thrombocytopenia. Some of this work has resulted in publications with further publications planned. The Contract Pathology Unit operates a specialist clinical trial business, which has been in operation since 1995, during which time it has established an international reputation for the provision of quality, central-laboratory services, locally and internationally. The Division of Immunopathology Laboratories provides diagnostic laboratory and contract services that span an extensive range of immunochemistry, autoimmune serology, and flow cytometry. The introduction of the FACS Canto II eight-colour flow cytometer has helped facilitate the diagnosis and monitoring of cancers and HIV. The Division of Microbiology provides a high quality comprehensive clinical microbiology diagnostic laboratory service to the Darlinghurst campus and to general practitioners in Sydney, Narrabri and Moree. A new diagnostic PCR test for respiratory viruses has significantly improved the detection rate of viruses in patients with respiratory illnesses, which has important therapeutic implications. An improved algorithm for diagnosis of Clostridium difficile infections is under development. With increasing numbers of multi-antibiotic resistant organisms being seen in the hospital, a review of the antibiotic stewardship program is taking place. A number of research projects continue, including prevalence of candida infections in the Intensive Care Unit at St Vincent’s Hospital and Malaysia, therapeutic drug monitoring

of antifungal drugs and parasitology research, including further work on Dientamoeba fragilis, which has led to the publication of a significant number of papers. SydPath follows all relevant principles of the International Conference on Harmonisation on Good Clinical Practice (GCP), Organisation for Economic Co-operation and Development (OECD) on Good Laboratory Practice and is National Association of Testing Authorities, Australia (NATA) accredited and Therapeutic Goods Administration licensed. And through the specialist clinical trial business unit, provides a comprehensive range of clinical trial laboratory services across local, central and global laboratory operations. SydPath provides comprehensive trial services covering phase I to IV research programs, to international and domestic companies across North America, Europe, Asia, and Australasia. The trials range from company sponsored drug trials, blood and tissue banks, and investigator initiated research.

Volunteers The volunteers who dedicate themselves to St Vincent’s Hospital are an energetic group ranging in age from 18- to 93-years, with some travelling from as far as the Southern Highlands and Central Coast for their roles. The 160 volunteers at St Vincent’s Hospital are proud to be part of the volunteer team of 450 who work across all St Vincents & Mater Health Sydney (SV&MHS) facilities and each volunteer gives an average of six hours per week. Their roles are varied but all make a difference: from serving red frogs and freckles to grateful staff in the Little Shop, to walking with patients in the aged care ward to help keep them mobile and engaged, or helping with administration support in departments. In 2010/2011, the Darlinghurst campus volunteers contributed 23,000 working hours, extending and enhancing the work of the staff, caring for patients, and helping to achieve the SV&MHS mission.

Annual Review 2010/11

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SydPath is comprised of several divisions:

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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.

Under the management of St Vincent’s Hospital, Sacred Heart provides palliative care, rehabilitation and houses radiotherapy services for cancer treatment. Palliative care 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 rehabilitation service provides complete patient rehabilitation following an illness, injury or surgery with the aim of helping patients and their carers to achieve maximum potential through a multi-disciplinary approach. The Unit offers sevenday rehabilitation – the first public rehabilitation service in NSW to offer weekend therapy.

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01 Sacred Heart 02 Nurses at Sacred Heart prepare to administer medication 03 A patient poses for Mark Tedeschi, QC and professional photographer Annual Review 2010/11

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“There was a really caring vibe among staff, not just care staff but the admin staff as well. We are very fortunate to have Sacred Heart and other places like it in Australia.� Mark Tedeschi QC and professional photographer

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A place of peace

The inspiring work of Sacred Heart Hospice has come under the spotlight in recent times with two groundbreaking documentaries and the commissioning of a comprehensive photograpghic essay. One of Sydney’s most prominent lawyers was responsible for the photos, while both SBS and the ABC were granted access to the hospice for their reports on how patients and staff managed the end of life journey.

“These types of observational documentaries can fill a compelling need for both the human story as well as deliver some rare insight and wisdom about the work of Sacred Heart.” he said.

Crown prosecutor Mark Tedeschi, QC, who is also an accomplished photographer, said he approached the project with the aim of providing a photographic record for the NSW State Library.

“It’s interesting, one area where we hadn’t traditionally been able to generate a lot of media interest had been palliative care. Ironically, this is an area where the public have often held the most misconceptions about what we actually do.

“I have done various day-in-the-life projects, but it came to me that there probably wasn’t very much in the way of a photographic record of Scared Heart or any other palliative care hospice,” he said of the photos (which appear in this publication). Having found the process very moving, Mark says “It is a place of solemnity and respect, but for an outsider it was also surprisingly positive.” “It’s a completely different pace to St Vincent’s. It is a lot more sedate and it doesn’t have that rush.” David Faktor, Manager of Public Affairs and Communication at St Vincents & Mater Health Sydney, said access was given to Mark and to the documentary makers in order to highlight the true nature of the work of Sacred Heart. 01 Mark Tedeschi QC 02 & 03 Some of Mark’s photographic essay shots

“It was important for us to work closely with Mark, SBS and the ABC to provide as much access as appropriate to try and dispel some of these misconceptions. The participating patients and staff really opened themselves up. The net result in all three cases is a truly intimate insight for the viewer, many of whom expressed a sense of privilege to be afforded this insight,” David says. First screened in February 2010, the ABC’s 4 Corners report ‘A Good Death’ followed the journeys of patients at the end of their lives, while staff shared their experiences caring for them. The SBS documentary ‘Living the End’ focussed on two patients, following them from treatment of their disease to exploring end of life issues. Both series attracted major critical acclaim, positive viewer feedback and extensive on-line forum discussion. Annual Review 2010/11

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For Madeline High, the half-hour stop with Dot and Julie is a welcome break from her quiet contemplation of the leafy view from her corner room of the palliative care wing. The 95-year-old’s face creases into a lovely smile as she sees Julie and Dot approach with their trusty stainless steel manicure trolley. “I feel like Cleopatra. It is bliss to be primped and pampered and have everything done for me,” Madeleine says with a chuckle. “And it’s so nice to look down at my hands with a pretty colour. Today I have chosen violet because it matches my gown, but next week I will have my new vibrant blue gown and my nails can match that one too.”

Dot has been volunteering at Sacred Heart for 20 years and insists she gets a lot more out of her visits there than the patients do. “We like to give them a break from the clinical care, to give them something that’s just for themselves,” Dot says. “As we get to know them we find that some of these women have never really had anything done for them their whole lives. We want to be able to make them feel better.” As Julie approaches one patient after another, she offers a warm smile, a gentle stroke of the cheek and the occasional sweet kiss on the brow. Murmuring close to those who may be feeling too unwell for a manicure, she asks about their families and their stories, picking up on details remembered from their last visit. “We get to know the patients and we become quite attached, so yes, it can be very sad as they become more unwell. We do find it hard,” says Julie of her 14 years as a volunteer. “But we also like to make it fun,” she says, smiling as she chooses a bright pink shade for another patient.

“When Dot and I go out to buy the polishes we tend to chose them for their names: I think this one, Aphrodite’s Pink Nightie, is perfect, don’t you?” It is this sense of fun and whimsy which makes the volunteer’s visits to Sacred Heart so special, according to Chris Harvey, who is the Volunteer Coordinator for Sacred and St Vincent’s Hospital. “It lifts their spirits and we want the patients to feel good about themselves. Even though they can’t control the other physical things that are happening to them, they can at least have some control over how they look,” Chris says. “It’s a gentle touch and I find the patients really respond to the volunteers because the clinical staff are in and out of their rooms a lot. They are talking about medication and about their disease and exercise, all those important things that are part of their job. But when a volunteer comes to see a patient they are there to listen, and they are not dwelling on the longevity of their illness.”

“We like to give them a break from the clinical care, to give them something that’s just for themselves.” Dot Hunt

01 Volunteer Dot Hunt combs the hair of 95-year-old Madeline High as Julie Goold paints Madeline’s nails. 02 The two volunteers lift the spirits of patients.

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It may not seem much, a gentle hand massage and a couple of coats of nail-polish, but when volunteers Dot Hunt and Julie Goold visit patients each Friday at Sacred Heart, they offer more than a manicure.

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Sacred Heart The Cunningham Centre for Palliative Care The Cunningham Centre for Palliative Care has continued to contribute to palliative care throughout NSW and beyond during 2010/2011. Embracing education and research, the Centre was officially opened in August 2008 as a collaboration between Sacred Heart Hospice, the University of New South Wales, The University of Notre Dame Australia and Calvary Healthcare Sydney. Each institution has contributed significantly to the development of the Centre, as has the Cancer Institute of New South Wales through its Academic Chairs Program. Sacred Heart’s support has been made possible through the generous philanthropic contributions of many individuals and organisations over the years.

All the ageing mattresses in the two palliative care wards were replaced with memory foam, pressure-relieving mattresses, which have significantly improved the comfort of patients. The money to replace the mattresses was raised by the Rainbows for Kate Foundation. The Sacred Heart Palliative Care Service was the subject of two documentaries in 2010/2011. The ABC’s 4 Corners A Good Death and the SBS documentary Living The End. Sacred Heart Community Palliative Care and Day Centre Serving the northern sector of South Eastern Sydney and Illawarra Area Health Service, Sacred Heart Community Palliative Care Service is an around the clock consultative, multi-disciplinary service that receives approximately 500 new referrals each year.

Guided by a multi-disciplinary academic team and based at Sacred Heart, Darlinghurst, and Calvary Hospital at Kogarah, the Centre reinforces the role of these facilities in contributing to the palliative care evidence base, and to the translation of evidence into palliative care practice. This is achieved through research, education and the dissemination of information about evidence-based practice in palliative care.

The service supports people with a life-limiting illness in their own home or residential aged care facility and at any time there are on average 230 patients registered with the service.

The Centre has conducted various seminars and workshops throughout 2010/2011, including presentations by internationally renowned experts in palliative care. The Centre aims to prioritise the consumer perspective in palliative care, and engages in research that engages both consumers of palliative care and healthcare providers, while also searching for factors that can improve the way in which organisations deliver palliative care.

In addition to the community service, Sacred Heart operates a Day Centre five days each week, which can be used by palliative care in-patients and community patients. The Day Centre gives patients the opportunity to partake in activities facilitated by a diversional therapist and nurse, with offerings such as music therapy, massage therapy and barbecues, while also providing an opportunity to meet people in similar situations.

Palliative Care Services

Over the past two years patients have been offered a client biography service, where an occupational therapist and volunteers record their story, transcribe it and compile a biography for them.

Sacred Heart provides inpatient and outpatient palliative care and is one of Australia’s largest and leading palliative care providers. There are 39 inpatient palliative care beds and a specialist community palliative care team. The two inpatient wards provide palliative care and supportive care for patients who are receiving radiotherapy and/ or chemotherapy. The community palliative care service incorporates a Day Centre for community patients and inpatients. The Cunningham Centre is the academic centre for palliative care. In 2011, the staff of 4 South began a major quality improvement project,

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Operation Medsafe, which is exploring interruptions to nurses while they are administering medications. This project aims to significantly improve medication administration safety.

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The Day Centre has also assisted palliative care patients to achieve their dream or complete a project that they may not have otherwise. Patients and staff from the palliative care Day Centre collaborated to produce a cookbook. Recipes from the Heart recognises how recipes that have been passed on through generations become living legacies of loved ones, symbolic of shared love and nurture. Patients and staff shared their family recipes and the stories behind them.

Rehabilitation Service The Sacred Heart Rehabilitation Service provides a comprehensive rehabilitation program to assist people to achieve their maximum potential when recovering from an injury, illness or surgery. A diverse mix of patients with orthopaedic and neurological conditions, Left Ventricular Assist Devices (LVAD), artificial hearts, transplant patients, and aged care are rehabilitated at Sacred Heart. The team is comprised of a large group of multi-disciplinary professionals including medical, nursing, occupational therapy, physiotherapy, speech pathology, social work, dietitian, pharmacology, administration, clinical and neuropsychology. The rehabilitation goal aims to restore function to the individual, maximising their potential following hospitalisation and facilitating an appropriate transfer into the community with resources and support. The department consists of a 27 bed inpatient unit and provides outpatient services. In May 2010, rehabilitation celebrated 10 years of service and held an afternoon tea. The Mobile Rehabilitation Team (MRT) was introduced in late 2010, with the aid of Commonwealth funding. The MRT is a multi-disciplinary approach to patients within the acute phase of their hospital stay, which has the capacity to enrol 10 patients at a time and provide rehabilitation parallel to the acute treating team. The goal of MRT is to introduce the rehabilitation philosophy to the patient, endeavouring to enhance the transition to an inpatient rehabilitation unit, or to be discharged home after their acute inpatient admission. A future study of the MRT will be commenced later this year while three other studies are nearing completion. The first looks at the effectiveness of rehabilitation and education for those with mild strokes. A second stroke study investigates the effectiveness of virtual reality in hand function (Wii), and another is in an innovative pain program for chronic pain patients. Through generous donations the Sacred Heart Rehabilitation Service has been able to purchase two new patient hoists, which have assisted staff and patients from a clinical, safety and uniformed perspective. All mattresses within the unit were replaced by static pressure prevention mattresses.


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A year in review With an Australian-first, a private young adult mental health unit poised to open and international recognition of its nursing excellence, St Vincent’s Private Hospital continues its proud tradition.

Following a busy year marking St Vincent’s Private Hospital’s centenary, the hospital celebrated several milestones, which will cement its reputation into the next century. Over the past 18 months the St Vincent’s Campus Capital Master Planning Project has moved ahead, building on the recommendations from the Campus Clinical Plan. Consultation took place with clinicians, and data analysis and activity projections were undertaken. Architects were engaged to commence the capital master planning process and a business case for the redevelopment and expansion of St Vincent’s Private Hospital is expected in mid 2012. Meanwhile, to maintain St Vincent’s Private’s current high standard of care, a bed replacement program commenced in June 2011. Set to replace the existing 250 beds in St Vincent’s Private Hospital, the program was completed in August 2011. All televisions are in the process of being replaced with flat LCD panels and this program will conclude in 2012-2013. Some upgrade of furniture and furnishings in patient’s rooms is also occurring and all of these items are easily transferrable to any new built form. Among the major achievements was the awarding of Magnet designation to the hospital’s nursing staff. Highly sought after, Magnet designation is granted by the American Nurses Credentialing Centre and recognises St Vincent’s Private Hospital’s commitment to maintaining the highest standards in the provision of nursing excellence. St Vincent’s Private Hospital is the first private hospital in Australia and the second private hospital to receive this prestigious award outside of the United States. The Magnet recognition summary report, of May 2011, stated that St Vincent’s Private Hospital met all Magnet criteria with no recommendations.

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The feedback from the appraisers particularly commended the work of St Vincent’s Private staff in reaching out to the community, as well as the ways in which the hospital recognises and rewards its nursing staff and empowers them through their involvement in decision making. St Vincent’s Private Hospital is Magnet designated until 2015. Yearly reports are to be submitted to the Magnet Recognition office, with re-application in 2014 and re-submission of the documentary evidence in 2015 for re-designation. St Vincent’s Private Hospital is set to open a state-wide psychiatric service for young adults, aged 16 to 30 years, with early psychosis or mood disorder. The 20 bed sub-acute unit will be the first such dedicated private facility in Australia and is due to be opened in early 2012. In addition to accommodating a 20-bed in-patient service, the unit will focus significantly on after-care planning prior to admission with the unit working closely with Headspace services as well as other non-governmental organisations. Mental illness is a significant health issue facing young Australians, yet the current mental health system is not adequately resourced to deal with those aged between 16 and 30. Only a quarter of those in need have access to any type of support and this population is recognised as the most in need of appropriate, age-specific mental health care. In June 2011, Friends of St Vincent’s Private Hospital was established as the hospital’s new fundraising arm. Building on the traditions of the former Ladies Committee, Friends of St Vincent’s Private Hospital’s initial focus will be the capital cost associated with the young adult mental health project. An Executive Officer was appointed and one of the first fundraising functions was held in August. Mrs Roslyn Packer AO was appointed to be Patron of Friends of St Vincent’s Private Hospital.


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01 Nurse Unit Manager Carol Ann Hayes and colleague on the Sister Bernice Wing at St Vincent’s Private Hospital 02 Nurse Tracey Owen speaks with patient Patricia Campbell 03 Assistant in Nursing, Carlos Moura de Lemos Junior, at St Vincent’s Private Hospital

Friends of St Vincent’s Private Hospital has also committed to continue support of the Sister Mary Bernice Research Grant of $100,000. In 2011 the grant was awarded to Dr David Brown for his work on Macrophage inhibitory cytokine-1: a potential screening test for colonic polyps and their impact in predicting bowel cancer behavior, which was undertaken at St Vincent’s. In a key technological advance, the hospital’s new Da Vinci Robot arrived in May, with training commencing soon after. The robot is predominately used in the treatment of prostate cancer and cardiovascular disease and features some key enhancements. These include improved dexterity and range of motion and tactile feel, while its smaller size makes it more manoeuvrable between theatres eliminating several occupational health and safety issues. Easier and faster to set up, it also features enhanced high definition 3D vision to greatly enhance the operative field. The robot also supports teaching with dual console capability and a simulation package. During the Christmas and New Year break in 2010, theatres 1 and 2 and pre op within the Day Surgery Unit were also refurbished. With the length of stay project commencing in August 2010, the hospital was able to free up 2677 patient days – or the equivalent of seven beds each day. While this is a positive result, the hospital will make further efforts to focus on reducing average length of stay in some specialties. The new clinical governance arrangements continued to be refined, with all medical departments meeting twice yearly for the purpose of peer clinical review. Following the commencement of third year medical students from the new Notre Dame Medical School in 2010, fourth year students commenced at the beginning of 2011. Integration of these new students into the hospital’s activities has been well received.

A significant process of improvement was undertaken to address the assembling and coding turnaround of medical records. The billing review continues and has already generated a number of significant process improvements, while the proportion of patients admitted with financial consent is 99.9 percent, a great credit to all staff within patient services. There were several major clinical achievements and highlights during 2010-2011. The overall experience of patients with nursing care as indicated through Press Ganey was at the 96 percentile of the benchmarking peer group. The nurse-sensitive indicators, such as hospital acquired MRSA, pressure ulcers, medication adverse events and patient falls were all well below the Australian Council on Healthcare Standards benchmarks. The hospital also continued to lead the industry in the percentage of patients admitted on the day of surgery (84 percent), and also the percentage of patients risk-assessed for falls, venous thromboembolism, pressure ulcers and skin tears. St Vincent’s Private Hospital continued to invest in research and practice development as a driver to improve patient-focused outcomes, such as venous thromboembolism, care of the deteriorating patient, clinical handover, medication safety and falls prevention and management.

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And finally, with no current job vacancies at the hospital at the time of publication, St Vincent’s Private Hospital has reached the lowest staff turnover rate in the industry; less than two percent.

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Our Stories 01 John and Nerida Irvine with Nurse Johanna Gale in the Day Surgery Unit at St Vincent’s Private Hospital

For John & Nerida Irvine, St Vincent’s has been a reassuring, lifelong presence. Born and raised in Sydney’s eastern suburbs, the retired couple were treated at the Darlinghurst campus throughout their young lives, while both John’s father & Nerida’s parents passed away there.

“My parents, my wife’s parents and my wife and I and our offspring have all been involved with surgery and treatment at St Vincent’s,” says John, a former senior manager who now lives north of Wollongong. John paid tribute to the professionals who have supported his family through their long history with the hospital, from the Sisters who cared for John when he underwent major surgery in his 20s for duodenal ulcers, to the ophthalmology team at St Vincent’s Private Hospital who recently treated Nerida, 79, for a basal cell carcinoma near her eye. “A lot has changed in that 50 years, but we have found them marvellous at every turn, and I have no doubt they saved my life in that first year of our marriage,” John, 80, says.

Keeping it in the family

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St Vincent’s Private Hospital? Together with many other ‘friends’, I will be looking to continue and expand on the work of the Ladies Committee – upholding the fundraising legacy of the remarkable Sister Bernice and supporting the Private Hospital’s mission of excellence in patient care.

 2 You have done so much for the Hospital, what drives this passion for you? The historical traditions of the Sisters of Charity, the Hospital’s culture of compassionate care, its spirit of pioneering and innovation, and the dedication of the wonderful staff (past and present) all continue to inspire me.

 3 Your family has a long and proud tradition of

involvement with the Hospital; can you tell us of some of your more notable experiences here? My association and that of my family goes back over 45 years and includes so many notable and memorable experiences. The Hospital has been a reassuring presence all of my adult life.

 4 Mr Packer was also a great friend of St Vincent’s,

“The hospital has been a reassuring presence all of my adult life”

in particular of Sister Mary Bernice Elphick, what can you tell us about their relationship? Kerry and Sister Bernice shared a long and warm friendship based on mutual affection and respect. Sister Bernice was much admired by Kerry and he loved her for her spirit and reassuring ways.

 5 What is the number one focus for your new role?

To encourage as many people as possible to join Friends of St Vincent’s Private Hospital and support the wonderful work of the Private Hospital.

 6 How can other people help and become friend of

St Vincent’s Private Hospital? Contact or visit the office at St Vincent’s Clinic – there are so many ways to become involved with the St Vincent’s community and participate in the rewarding work of the Hospital.

 7 How will Friends of St Vincent’s Private Hospital

expand on the role of the Ladies Committee? Friends of St Vincent’s Private Hospital aims to forge and maintain closer and broader based connections between the community, the mission of St Vincent’s Private Hospital, and exciting new initiatives such as the Young Adults Mental Health Unit.

10 Questions with

Mrs Roslyn Packer AO

Patron of Friends of St Vincent Private Hospital

 8 How important is fundraising in supporting the work

of St Vincent’s Private Hospital? Fundraising is crucial. So much of the exceptional work carried out by the Hospital would just not be possible without the support of the very community they serve and care for. It is a vital partnership.

 9 What would your message be to anyone looking to

support the Hospital and becoming a Friend of St Vincent’s Private Hospital? Please join us as a supporter or friend of St Vincent’s Private Hospital. It is the best way to ensure that the Hospital retains its position at the forefront of medical research, innovation and patient care – and that benefits everyone across the whole community.

many journeys. one vision. | st vincent’s hospital | sacred heart | st vincent’s private hospital | mater hospital | st joseph’s hospital | st joseph’s village

 1 Tell us about your new role as Patron of Friends of

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 10 What makes St Vincent’s Private Hospital special? Put simply – the extraordinary quality of patient care.

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Nothing to fear 02

For most of his adult life, Rodney Eirth has been keenly aware of his high risk of prostate cancer. Having lost his father and watched two uncles fight the disease, Rod knew the importance of yearly physical checks and a blood test known as prostate specific antigen (PSA).

“My cancer was completely removed. I had 65 percent sexual function return about a week and a half after surgery with expected full recovery, full continence within four weeks.” Rodney Eirth

So it came as little shock when in 2011, following a PSA test at the age of 39, Rod was indeed diagnosed with an aggressive prostate cancer. But what did surprise Rod was that rather than being the terrifying and painful ordeal he had expected, the father of two was back at work as a horticulturalist – and cancer free – within weeks of his diagnosis. Rod’s urologist and prostate specialist, Dr Raji Kooner from St Vincent’s Private Hospital, attributed much of the success of Rod’s treatment to early screening and the hospital’s newly updated daVinci robotic surgical system. “Rodney benefited quite markedly from having his procedure done with the robotic system, as it allowed us to do the operation much more accurately and precisely than we would otherwise have been able to,” Dr Kooner said. “Rod was a good candidate for surgical treatment of his cancer.

01 Dr Raji Kooner stands in front of the da Vinci surgical system as painted for the 2011 Archibald Prize by 2011 Sulman Prize winner and former GP Peter Smeeth 02 & 03 Rodney Eirth was back at work within weeks of his prostate cancer diagnosis 106

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Given how young he was, he wanted a cure that was going to last him the rest of his life and hence following consideration of all the treatment options, he chose surgery.” Dr Kooner, who has performed over 600 robotic cases to date, explained that when treating prostate cancer the aim is for the holy trinity of recovery – cancer cure, continence and restoration of erectile function. “We have been very pleased with how well Rod has fared. He spent the usual 48 hours in hospital and has recovered very well.” St Vincent’s Private Hospital recently installed an updated version of the daVinci system. One of the few Australian hospitals to use the system, the first daVinci was installed in 2005. Since then daVinci has been instrumental in the progression of surgical procedures and has been successful in delivering a number of Australian firsts. Of enormous benefit to patients, daVinci can reduce length of stay, decrease blood loss, results in less scarring due to a decrease in incision size and can speed up recovery time.

Predominately used for urological procedures such as prostatectomy and partial nephrectomy for kidney cancers, the daVinci system also has a role in cardiothoracic, gynaecology, upper gastrointestinal, colorectal and otolaryngology surgery. Rod said his recovery was a pleasant surprise, “I was worried because with prostate surgery continence and sexual function can be an issue.” “My cancer was completely removed. I had 65 percent sexual function return about a week and a half after surgery with expected full recovery, full continence within four weeks. That is an important part of your recovery, because although your general health is your main concern, things like continence and sexual function can really affect your mental recovery.”

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Rod’s recovery is attributed to early detection allowing a full nerve sparing procedure to be performed with the latest daVinci system at St Vincent’s.

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“This is a more individually tailored treatment, and that is where medicine is going now. Whatever treatment you are having, we try to change it in any way to suit your needs.” Lyndy Carolan Clinical Nurse Specialist St Vincent’s Private Hospital 01

Home sweet home When Greg Stone was told he needed a hip replacement he tried all possible avenues to avoid surgery. Now, as he strolls comfortably through the harbour-side park near his home, he is pain free.

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01 Greg Stone at home in Double Bay 02 Greg Stone is back on the golf course 02 Greg walking on the beach 04 Nurse Lyndy Carolan is part of the St Vincent’s Private Hospital home rehabilitation program 05 Dr Craig Waller performed Greg’s left hip replacement

“Although I knew hip replacement surgery was the most successful of all orthopaedic procedures, I thought if I could avoid it I would. I did a lot of work with physiotherapy, exercise physiology and massage therapy but in the end there was no avoiding the surgery,” he recalls. After plenty of research Greg, a 60-year-old careers consultant from Double Bay, asked Dr Craig Waller, from St Vincent’s Private Hospital, to perform his left hip replacement. “It was a very pleasant surprise. I was up and walking the next day, and I could not believe how pain free I was because of the operation,” Greg says of the surgery in April last year. Even better, after being selected for St Vincent’s Private Hospital in home rehabilitation program, Greg found himself at home within the week. “Originally I was going to do some rehabilitation at one of the outpatient centres but when Dr Waller and the physiotherapists saw I was recovering quickly, they offered to make me part of the in home rehab program,” he says.

“I was a bit wary at first because I wasn’t sure how I’d go with the stairs and things like that, but it turned out to be fine.” Greg received visits each weekday from a St Vincent’s Private Hospital nurse and physiotherapist. Before he was sent home, his treatment plan was set by his surgeon, rehabilitation doctor, occupational therapist, nurse and physiotherapist. “It worked incredibly well,” a grateful Greg says. “The exercises they gave me were really good and they dressed the wound a number of times.” Clinical Nurse Specialist Lyndy Carolan says Greg’s case is typical of those who take part in the home-based program. “The program is proving particularly popular with our younger patients, the type who can’t bear the thought of a long stay in hospital,” Lyndy says.

And the benefits are not limited to the patients, who relish the opportunity of recovering in their own bed with home cooked meals. “It’s also a win-win for the hospital because it frees up beds as much as 10 days earlier, and it also reduces the exposure of patients to the risk of infection.” Now, as he plans a return to golf after two years off the course, Greg says he couldn’t be more pleased with his experience. “I felt no inconvenience at all, and you can’t ask for more than that,” Greg says. “You get used to living with pain. It wasn’t until it was gone that I realised how significant it had been. Also, the in home rehab program was fantastic. I can’t speak highly enough of the program and would encourage others, if offered the opportunity be become involved.”

“The idea of going home early, knowing they have the coverage of nurses, an occupational therapist, physiotherapist and the rehabilitation doctor if they need pain management, it makes them very confident as they are not on their own.”

Annual Review 2010/11

many journeys. one vision. | st vincent’s hospital | sacred heart | st vincent’s private hospital | mater hospital | st joseph’s hospital | st joseph’s village

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Our Stories

The

sweetest thing

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“They were such a lovely and loving couple that we were glad to do what we could to make it special for them. To share that lovely experience with them is something that we will never forget.” Jennifer Millhouse Clinical Nurse Specialist St Vincent’s Private Hospital

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When Michael Aaron was told he had just days to live, he knew not to waste time railing at fate. After months in hospital fighting a very rare cancer-like condition that would not respond to treatment, he wasn’t going to start complaining. Instead, he pledged the last of his energy to the woman who wouldn’t leave his side, and asked Anna Bernardi to marry him. And even though they are concerned very much with the practical, and know better than to believe in such notions, some of the staff at St Vincent’s Private Hospital came to think that the achingly sweet Intensive Care Unit (ICU) wedding that Mike and Anna shared with them in November 2010, was, in fact, what saved him. “It was a turning point, quite simply. The doctors told me, and I had come to accept, that I would be dead within the week,” says Mike, a special needs teacher who has been home since January, having been declared free of his rare illness Castleman’s Disease after a bout of chemotherapy following the wedding last year. It started off quite small. Anna would wear a simple white dress to the bedside ceremony, with two friends as witnesses and the St Vincent’s Chaplain, Father Laurie Christie, officiating. “It’s funny, because I don’t remember telling anyone, but the nurses found out about it and they just took it over,” says Mike. “There were flowers, French champagne, they decked out the ward like a chapel, it was really quite amazing and lovely.”

Radiographer Roz Sharp, who is also a professional photographer, had x-rayed Mike countless times during his treatment, and she happily volunteered to shoot the wedding. Clinical Nurse Specialists Gabby Mathen and Jennifer Millhouse, who were part of Mike’s primary care team in ICU, organised the ceremony. And all of it was a surprise to the bride and the groom, who have been together since 1988. “It had its own momentum,” says Anna, a 51-year-old jewellery store worker. “I rocked up thinking I was going to the bedside and getting married, and then I arrive and there was all this amazing preparation.” Having recently been married herself, Gabby was in charge of details. “We wanted to take the ICU-ness out of it as much as we could, so we covered all the machinery, covered the chairs, got rose petals, borrowed the chapel’s pedestals. There was music, wine glasses, French champagne,” she says. Jennifer says once Mike, 58, realised what was unfolding, he insisted on leaving his bed to sit in a wheelchair for the ceremony, whose guests included a small band of the couple’s friends, Mike’s son Tom and some rather teary ICU staff.

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“It was exhausting for him to sit up for the ceremony but he wanted to do it. He was very frail, very unwell at the time,” Jennifer says. “We put just married on the wheelchair and everyone in the ICU was busting to see the bride and groom so we did a lap of honour, and everyone was cheering.” The entire staff of the ICU came together to celebrate the wedding, from the Unit’s receptionist to care staff and the doctors who had come to know the couple during Mike’s three stays in ICU. Mike says he was incredibly grateful for all of their support, and particularly thankful for Roz’s photography because: “I was so ill that for most of the day, I really wouldn’t be able to recall it if it wasn’t for having that record there. It’s a beautiful thing. “All of the staff were really wonderful. I know there were times with Gabby that I felt she actually brought me back when I was very close to dying. They were all wonderful, and the love that I had from Anna and my son was what gave me the buoyancy to be carried through and to be here now.”

Annual Review 2010/11

many journeys. one vision. | st vincent’s hospital | sacred heart | st vincent’s private hospital | mater hospital | st joseph’s hospital | st joseph’s village

01 Michael Aaron and bride Anna Bernardi exchange a kiss 02 Campus Chaplain Fr Laurie Christie officiates the wedding in the Intensive Care Unit at St Vincent’s Private Hospital 03 Nurses from the unit are moved by the occasion 04 Mike and Anna at home today 05 Just married, Mike prepares to return to his bed within the unit

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Our Stories

Youth mental health Help at last

35% of Australians support mental health reform as one of the top three issues on the agenda along with climate change and the economy

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75%

Before the age of 25

of mental disorders will appear ...............................................................

4·5 mil Ultimately they affect

Australians every year

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When the doors open to the young adult mental health unit at St Vincent’s Private Hospital in early 2012, a new era of treatment for young Australians will begin.

The unit will be the first of its kind, offering services for young people with mental illness, and its creators hope the model will spread across the Australian health system. “This is addressing a really critical unmet need,” says Kate Harel, the Nurse Unit Manager for the new facility. “In my practice over the years I have had a lot of phone-calls from distraught parents about young people who perhaps couldn’t be accommodated because they were too young. Generally in the private sector, adult mental health units will only take them from 18 years and above.” With young sufferers being housed alongside older patients, the young tended to reject treatment. “So even if you manage to persuade the young person to go to hospital, because clearly they are unwell, once

you manage to get them there the trick is to try to encourage them to stay, and that’s difficult when they are voluntary patients,” Kate says. “There is nothing you can do but let them go if they want to go and so often it is a case of missed opportunities.” The 20-bed unit will be housed in the new O’Brien Centre and its services will cater for 16- to 30-year olds and include an inpatient program, day program, outreach service and outpatient consultation. Architect Alan McMahon said the design had “moved away from what an institution feeling is.” “We took very simple concerns, like what do these guys generally tend to do? They hang out in cafes, they play games, and what we have tried to do is create areas in the plan that they can literally go and feel as though they belong to this space,” he said.

Annual Review 2010/11

many journeys. one vision. | st vincent’s hospital | sacred heart | st vincent’s private hospital | mater hospital | st joseph’s hospital | st joseph’s village

01 Kate Harel, Nurse Unit Manager of the young adult mental health unit, stands in the soon to be completed unit 02 Plans for the new mental health unit 03 Source: Prof Pat McGorry 2010 Australian of the Year

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Allied Health Allied Health work as part of the multidisciplinary team at St Vincent’s Private Hospital to enhance the recovery of patients. Strategies are planned and implemented to assist in regaining the patient’s independence in order for them to be discharged safely back into their own environment. Patients are supported by a team of health professionals in services such as physiotherapy, occupational therapy, speech pathology and massage therapy including lympoedema massage. The allied health team works in tandem with nursing, medical staff, the patient and their family to tailor pre and post operative therapy to match each patient’s individual needs. Inpatient and outpatient allied health services are provided by Therapy Services, located in St Vincent’s Clinic. Inpatient physiotherapy is provided to patients for practical advice and supervision in order to regain independent mobility and improvement in self care that may have been compromised by disease or surgical intervention. The outpatient service provided by physiotherapists with a background in intensive care and cardiothoracic physiotherapy is designed to meet the care requirements for patients living with sleep disordered breathing. Exercise and activity prescription in conjunction with education about the utilisation of nocturnal breathing support equipment required is provided to improve their quality of life. Patients who elect to return home following joint replacement surgery with the support of the Extended Care Program do so in the knowledge that they will receive occupational therapy advice to adjust their home environment following surgery. Physiotherapy needs for these patients are also met with exercise plans that are specifically designed to suit their home environment with daily visits from either the nurse or physiotherapist who provide a plan of care developed in conjunction with the patient and their family and individualised to meet the patient’s own needs and requirements. Acupuncture In a first for St Vincent’s Private Hospital, and for only the second time in an Australian hospital, acupuncture was introduced as an additional inpatient service in May, 2011. Conditions treated

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include digestive, neurological and musculo-skeletal complaints with specialisation in anxiety, depression and pain management. The initiation of acupuncture as a service to inpatients at the private hospital is aimed at embracing patient needs and future trends, while recognising that many practitioners can be involved in the recovery of a patient.

Intensive Care Unit Providing quality, timely 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 2010/2011, the ICU’s activities included cardiac patient pain research, oral care risk assessment and the commencement of a ventilation acquired pneumonia project. The ICU provided 2,973 patient days in 2010/2011 and continued outreach services, offering patients a preoperative visit and post-ICU follow up.

Medical Imaging Providing comprehensive diagnostic medical imaging services to St Vincent’s Private Hospital, St Vincent’s Clinic and external referrers, St Vincent’s Clinic Medical Imaging (SVCMI) is a joint venture between a partnership of radiologists and St Vincent’s Private Hospital. St Vincent’s Clinic Medical Imaging operates at two centres –St Vincent’s Clinic which also provides mobile and 24-hour on-call services to inpatients of St Vincent’s Private Hospital and Darlinghurst X-ray, a community based, bulk-bill practice. Building on significant equipment investments of recent years, SVCMI continues its commitment to facilitating optimal patient care via the use of leading-edge technology. The multi-slice CT has been upgraded to a 128-slice CT with low dose capability, providing a 40 to 80 percent reduction in radiation dose for all CT examinations. This CT can also perform single shot cardiac imaging with a dose of 2msv compared to 18msv for coronary artery evaluation CTs. A short-gantry, wide-bore 3Tesla MRI will be operational in November 2011, providing improved imaging, new

applications and enhanced patient comfort. This particular machine now makes a 3T magnet suitable as a general use MRI, as well as accommodating the more challenging neurological, musculoskeletal and breast applications. In 2011 SVCMI incorporated nuclear medicine into its imaging department, with a SPECT/CT and gamma camera to be operational in November. The number of ultrasound rooms was increased to four, using Phillips IU22 ultrasound machines to cater for the increased demand for breast and musculoskeletal imaging and diagnostic and therapeutic procedures. Excellent therapeutic outcomes have been achieved from the use of plasmarich injections into tendon tears and tendonopathy. The new matrix probe technology allows high-resolution volume acquisition technology with excellent diagnostic imaging especially in obstetric, gynaecological and abdominal imaging. The practice continues its support of the University of NSW St Vincent’s Hospital Clinical School through the provision of small group education sessions with radiologists and senior technical staff. Feedback from students has been extremely positive.

Medical Specialities St Vincent’s Private Hospital hosts a broad range of medical specialities complementing surgical activity to provide holistic care to patients. Cardiac Catheter Centre The Cardiac Catheter Centre provides a diagnostic and interventional cardiac and vascular service. In 2010/2011 the centre commenced the WATCHMAN procedure for left atrial appendage occlusion. This has involved a training program for all staff and the introduction of new equipment specific to the procedure. 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.


Endocrinology and Diabetes Centre

the cornerstone of modern cancer treatment. Particular advances were made in the area of the multidisciplinary team working in lung cancer. Strategic planning for future appointments of staff was also a focus of activity. Neurology

The Endocrinology Department’s activities cover the management, teaching and research of hormone and metabolic disorders. Its internationally recognised core services are in the management of diabetes, osteoporosis and pituitary disease, each of which is supported by active research programs based at the Garvan Institute of Medical Research.

The Neurology Department promotes rapid assessment of diseases affecting brain, spinal cord, muscle and peripheral nerve. All clinicians are experienced in management of common neurological conditions including epilepsy, headache, stroke and peripheral neuropathy, as well as management of neurological complications of systemic disease.

The Australian Centre for Metabolic Health is a multidisciplinary centre for management of diabetes and obesity, supporting long term lifestyle change through appropriate nutrition, physical activity and where required, responsible and ethical medication prescription and bariatric surgery.

The Department aims to provide a same-day service for urgent referrals, and to facilitate rapid access to diagnostic services including electroencephalogram (EEG), nerve conduction studies and (electromyography) EMG.

Education involves teaching of final year students from the University of Notre Dame and supervision of their public health projects. Teaching also extends to University of NSW (UNSW) third year medical students, UNSW independent learning project students, teaching to general practitioners and talks to the public on diabetes and obesity prevention and treatment. Outreach work includes contribution to metabolic management in youth with schizophrenia. Haematology and Bone Marrow Transplantation In a significant increase over recent years, the Haematology Department performed two allogeneic bone marrow transplants and 11 autologous transplants at St Vincent’s Private Hospital in 2010/2011. This was made possible with the expert care of the nurses on Level 10 at St Vincent’s Private Hospital. St Vincent’s campus continues to host the Australasian Bone Marrow Transplant Recipient Registry, which collects data on all transplants performed in Australia and New Zealand, as well as the offices of the NSW Bone Marrow Transplant (BMT) Network, which supports BMT activity across NSW. Medical Oncology Medical Oncology continued to provide leadership for multidisciplinary care for most tumour groups, such care being

The Neurologists at St Vincent’s Clinic have a broad range of subspecialty interests and offer expertise in multiple sclerosis, Parkinson’s disease, dystonia, ion channel disorders, cognitive disorders, CNS infections, neuro-oncology, mitochondrial disease, and neuro-ophthalmology. The Department is one of the few centres to offer botox treatment for spasmodic dysphonia. The Neurology Department is also establishing an Acute Stroke Unit at St Vincent’s Private Hospital which will be up and running by the end of 2011. Palliative Care The Palliative Care Service provides both palliative care and pain management. With a primary focus on treating those diagnosed with cancer, the service also offers symptom relief to sufferers of neurodegenerative diseases and advanced organ failure. In 2010 the service began treating severe breathlessness secondary to pulmonary hypertension. Where requested supportive care is provided for patients undergoing radiotherapy. The service uses the combined approach of a medical consultant and a palliative care clinical nurse consultant. In conjunction with the hospital’s pastoral care team, bereavement services are offered to family members. As the service sees patients from around NSW it links people to their local palliative care units to provide continuity benefits to them and their families.

Radiation Oncology The Radiation Oncology Department cares for patients within a multidisciplinary cancer environment. Radiation Oncology provides radiotherapy services for all adult malignancies, with specialised services including 3D conformal radiotherapy, image guided radiotherapy (IGRT) and highly-focused external beam techniques such as Intensity Modulated Radiotherapy (IMRT). An internationally recognised Prostate Brachytherapy program and a Total Body Irradiation (TBI) program is provided for prostate cancer and haematology high-dose chemotherapy transplantation patients respectively. Radiation treatment machines (Linear Accelerators) are located across the sites – St Vincent’s Hospital, St Vincent’s Clinic, and at the Mater Hospital. Rheumatology The department addresses the pain needs of patients with acute and chronic musculoskeletal diseases and problems and liaises closely with 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. Thoracic Medicine Thoracic Medicine offers a broad range of clinical services complementing those offered throughout the campus. Specifically, the Sleep Unit runs a busy investigative service to examine the burgeoning area of sleep disordered breathing which has an underappreciated but remediable impact on quality of life, development of pulmonary hypertension and right heart failure. Non-invasive ventilation strategies are an important adjunct to the ventilatory management offered in the Intensive Care Unit and serve to assist recovery from episodes of respiratory failure related to surgery and underlying pulmonary diseases. The Intensive Care and Cardiothoracic Surgical Units are two key areas where experienced management of patients with obstructive lung disease in particular helps minimise unwanted complications and thereby avoid an extended length of stay.

Annual Review 2010/11

many journeys. one vision. | st vincent’s hospital | sacred heart | st vincent’s private hospital | mater hospital | st joseph’s hospital | st joseph’s village

Computerised intracardiac mapping increases accuracy of localisation, consequently ablation of heart arrhythmias has been extended to the curative treatment of atrial fibrillation.

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The Bronchoscopy Service provides state-of-the-art approaches to the investigation and management of the solitary pulmonary nodule and is gearing up to provide a comprehensive bronchoscopic lung volume reduction service using airway valves to target hyperinflated lung segments without demonstrable collateral ventilation. Lung cancer staging and management remains a critical area for ongoing development in combination with other members of the multidisciplinary team which has operated so effectively within the campus. Vascular Medicine The Department of Vascular Medicine at St Vincent’s Private Hospital provides services for patients with a range of vascular disorders including venous, arterial and lymphatic disease. These services are undertaken with the support of vascular surgery, interventional radiology and diagnostic, Clinic Vascular Laboratory and allied health services. The department provides management for all aspects of venous thromboembolism (VTE) including lower limb deep vein thrombosis and pulmonary embolism. The service offers latest treatments including systemic thrombolysis for the management of massive pulmonary embolism and, in collaboration with vascular surgical and interventional radiology colleagues, endovenous techniques for the treatment of extensive deep venous thrombosis. The hospital’s wound Clinical Nurse Consultant provides support to clinicians, nursing and allied health staff in the management of wound care. The department is involved in the development and implementation of campus policies for the prevention of VTE. This is complimented by research into the area of VTE prevention with a multidisciplinary team of health professionals and a PhD research student.

Surgical Services Surgical Services at St Vincent’s Private Hospital provide a broad range of theatre services for surgical specialities using new technologies to deliver excellence in surgical care. Surgical Services undertake approximately 7,800 procedures per year within the Cardiac Catheter Centre, Day Surgery Unit, Operating Theatres and is supported by the Same Day Centre and Sterilising Services. 116

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Educational sponsorship opportunities are available to all staff and Surgical Services is committed to sustaining professional development of staff to enhance service provision. Anaesthetics/PACU/Same Day Centre Anaesthetics, Post Anaesthetic Care Unit (PACU) and the Same Day Centre are committed to providing a safe environment for patients to undergo surgery. In 2010/2011, the department commenced a number of training initiatives for staff, including the Introduction to Recovery Room Nursing Course as well as the Introduction to Anaesthetic Nursing Program. These two courses are open to any registered nurse, including registered nurses from outside St Vincent’s Private Hospital. There was also the introduction of a Cell Saver workshop for anaesthetic nurses, which is held on a Saturday so that a maximum number of staff can attend. The department introduced the Post Anaesthetic Recovery Score (PARS), which means all patients must achieve a certain score before they can be discharged from the recovery room to the ward. In another advance, the Nursing Unit Manager joined the hospital’s Pharmaceutical Committee and introduced a new system, whereby any changes in drug supply and packaging are done in consultation with the Pharmacy, in order to reduce the margin for error. This year has seen the development and introduction of a patient care orderly (PCO) manual, a set-up book and a resource folder. These three learning and reference books aid in the orientation of new staff and ensure that all patients are safe when they come to the theatre. Day Surgery Unit The Day Surgery Unit contains five operating theatres, a three-stage recovery area and pre-operative area undertaking approximately 10,000 cases a year in a range of surgical specialties. The five year refurbishment of the Day Surgery Unit was completed in April 2011. This entailed the upgrade of four operating theatres, building a fifth theatre, upgrading the pre-operative area and expanding the recovery areas to include a more comfortable postoperative area, recliner chairs for some pre-operative patients and moving of the staff lounge.

In 2010/2011 there was an increase in clinical minimally invasive neurosurgery in the unit and support and education for recovery room and anaesthetic nurses was increased with a part-time clinical support nurse position. The unit continued to expand its stateof-the-art offerings with the introduction of new endoscopic equipment, which is used for bronchoscopy, colonoscopy and gastroscopy treatments. The unit minimised the risk to staff when using formalin, with the introduction of a fume cabinet on Level 5 and the cessation of formalin decanting in the Day Surgery Unit. Operating rooms The Operating Rooms consist of eight theatres in which complex surgery in specialties including cardiothoracic, orthopaedic, ear, nose and throat, plastics, vascular, urology, general/ colorectal surgery and gynaecology are performed. Highlights for 2010/2011 included upgrading to a new model Da Vinci Robot and implementation of the Evolve laser for benign prostatic hypertrophy. There was also a renovation of the managers’ offices and extensive work was performed on intraoperative medications, such as labelling, electronic recording, doctors standing orders and doctors documentation. Sterilising Services Sterilising Services continues to support eight operating rooms and five day surgery rooms. After the installation of new instrument washers in the theatre sterilising unit in 2010, the service has continued to streamline processes to improve the delivery of services to all areas within the hospital. Sterilising Services further enhanced the working environment by introducing automated height adjusted workstation and saddle chairs. The service continues to be an active participant in the South Eastern Network Sterilising Group with a view to standard policies, products and conducting AS/NZ 4187 sterilising audits. This ensures consistency with practices across the network.

Surgical Specialities St Vincent’s Private Hospital provides a wide range of surgical specialities with the exception of obstetrics and paediatric surgery and offers exceptional quality in care.


Cardiothoracic Surgery delivers a complete range of adult cardiac and thoracic surgical services. A number of these activities are performed in conjunction with St Vincent’s Hospital, with approximately 900 procedures performed on the campus each year. The main internationally recognised activities relate to the management of heart and lung failure and transplantation of these failed organs is a core activity of the department. Also, there is a full range of mechanical assistance for the failing heart and lung, including extracorporeal membrane oxygenation (ECMO) and continuous flow ventricular assist devices. The implantation of a total artificial heart was a ground-breaking achievement in 2010/2011. Another key procedure has been introduction of pulmonary thromboendarterectomy for recurrent pulmonary emboli. With these innovations the department remains at the forefront of provision of surgical relief for the most complicated cardiothoracic problems. Colorectal Surgery The Colorectal Surgery team treats all aspects of colorectal surgery, with a particular focus on colorectal cancer, anal cancer and inflammatory bowel disease. There has been an increase in the number of laparoscopic procedures required in 2010/2011 and the department has also increased its expertise in colonoscopic removal of large polyps. While the department’s research interests include the value of multidisciplinary meetings, the genetics of colorectal cancer, the treatment of anal intra-epithelial cancer, and solitary rectal ulcer syndrome, the department remains steadfast in its commitment to student teaching. Gastroenterology/Diagnostic Endoscopy Centre The Diagnostic Endoscopy Centre has been specialising in the treatment and diagnosis of diseases of the gastrointestinal tract for the past 21 years and has seen remarkable changes in that time. There were more than 8,200 patients admitted in 2010/2011 and more than 11,300 procedures performed. A further 6,600 outpatient consultations occurred and the centre extended its hours of operation to accommodate patient needs.

The centre comprehensively overhauled its cleaning room, installing three Soluscopes to eliminate the use of glutaraldehyde. The installation of drying cupboards facilitated gold standard infection control, while the alteration of the existing workspace enhanced lighting and created additional space for the installation of more sinks. The unit also replaced its previous endoscopic equipment with state-of-the-art Olympus equipment. The centre once again successfully completed the requirements to be awarded full accreditation with Australian Council on Healthcare Standards in May 2011, a status the centre has maintained since its inception.

will be in adult stem cells to treat degenerative diseases of the brain. With provision for both inpatients and outpatients, it is the state’s largest Department of Neurosurgery, performing more than 1,700 procedures in the past 12 months across the Darlinghurst campus. The department comprises of more than 65 neurosurgical beds (45 of which are based at St Vincent’s Private Hospital) and a dedicated neurosurgical outpatient clinic.

Finally, the centre maintained its contract status with the majority of health funds, resulting in little or no out of pocket expenses for patients.

Conditions treated by the Department include brain tumours, brain and spinal injury, degenerative and malignant processes of the spine. The department offers pituitary, skull base and endoscopic skull base neurosurgery, minimally invasive and complex spine surgery, deep brain stimulation and endo-vascular neurosurgery.

Gynaecology

Ophthalmology

The Gynaecology Department offers a range of gynaecology services involving all benign and pre-invasive pelvic pathology, including endometriosis and acute gynaecological emergencies.

The department provides a full range of ophthalmological services, in particular treating cataracts, glaucoma, retinal disease and ocuplastic problems. Caring for bothinpatients and outpatients, the department facilitates a wide range of specialist clinics.

The department focuses on endoscopic gynaecology, complicated major pelvic surgery and provides subspecialist urogynaecology, prolapse as well as urinary incontinence services. The department’s reputation in these areas attracts nation-wide tertiary referrals. Robotic gynaecology surgery is offered using the Da Vinci Robot and the department has a strong research output, garnering national and international acclaim. Neurosurgery With a strong commitment to clinical research, the Department of Neurosurgery provides many fields of expertise including the treatment of cancers, minimally invasive neurosurgery with computer guided assistance, skull base, pituitary, functional and neurovascular neurosurgery and all spinal surgery. The establishment of the Neurosciences Research Unit is a combined research team within the Departments of Neurosurgery, Neurology and the St Vincent’s Academic Medical Research Institute. The department will be expanded with the appointment of an Academic Professor in Neurosurgery, and the new unit’s primary laboratory research

2010/2011 was an exciting and successful year for the department, with an increase in surgical procedures to almost 1,000 for the year, the majority of which were cataract operations. Orthopaedics More than 5,000 orthopaedic procedures are carried out each year across the St Vincent’s campus, the majority of them in 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 and ankle surgery and shoulder surgery. Patient treatments relating to musculoskeletal oncology continue to grow. Otolaryngology, Head and Neck Surgery St Vincent’s Private Hospital is the leading Australian centre for otology, neuro-otology and skull base surgery. The department of otolaryngology also provides a full range of services for hearing with the use of a wide range of implantable hearing aids and Cochlear implants. It is also one of the only centres in the state to use lasers in middle ear surgery. Each year the department performs over 1,000 cases

Annual Review 2010/11

many journeys. one vision. | st vincent’s hospital | sacred heart | st vincent’s private hospital | mater hospital | st joseph’s hospital | st joseph’s village

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in all fields of otolaryngology including head and neck tumour surgery, advanced nasal and sinus surgery as well as voice disorders. Teaching is provided to trainees with the Royal Australasian College of Surgeons as well as fellowships in otology, neuro-otology, skull base surgery, rhinology and head and neck surgery. Students from the University of NSW and Notre Dame are also taught by members of the department. Improvements to clinical care in 2010/2011 included the introduction of structured histopathologic sinus mucosa reporting, which has been used by international groups after successful research. The department also benefitted from the fit out of the dissection lab with new endoscopic equipment and a St Vincent’s Clinic project grant and purchase of sinonasal training models for education at all levels, from medical students to registrars. The department provides outreach services to the indigenous community in Moree. Plastic and Maxillofacial Surgery The St Vincent’s Private Hospital Department of Plastic and Maxillofacial Surgery provides an extensive service across the full range of plastic and maxillofacial surgery, with the exception of paediatric plastic surgery. The referral network for head and neck reconstruction after cancer surgery continues to widen, as does the number of patients requiring breast construction after mastectomy. The department hosted a hands-on St Vincent’s Advanced Plastic Surgery (VAPS) Nurses Course in October 2010, the first of its kind in Australia. Interest generated by participants from interstate and New Zealand has been high for a repeat course in late 2011. Now in its fourth year, the Plastic Surgery Journal Club has expanded substantially, updating consultants together with trainees from across Sydney on the latest publications. Several innovative papers by St Vincent’s plastic surgeons have been published in peer-reviewed journals in the past 12 months. The department has benefited by the creation of a new registrar position shared with Bankstown Hospital, anticipating possible accreditation of the post for advanced training in 2011. The St Vincent’s plastic surgery training post is currently at or near the first

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preference for many senior advanced trainees in the speciality. Created to service patients referred from rural centres, a new telemedicine service is in the early stages of development, with its hub at St Vincent’s Hospital. Urology The department consists of seven urologists covering the breadth of urological endeavours including oncology, reconstructive urology and urinary calculi. Benign prostatic hyperplasia treatments are performed, with expertise in laser therapy, infertility and impotence work. Outpatient investigations include urodynamics, cystoscopy, transrectal and transperineal biopsies and outpatient chemotherapy. Complex kidney work includes partial nephrectomy and laparoscopic renal work. With particular expertise in robotics and laparoscopic surgery, the department has close collaborations with the radiotherapy, medical oncology, and x-ray departments, as well as a strong research collaboration with the Garvan Institute of Medical Research. Highlights of 2010/2011 include the completion of more than 1,500 cases of robotic radical prostatectomy, commencement of the robot-assisted partial nephrectomy therapy and completion of the quality of life research project. The new EVOLVE laser to complement the green light and holmium YAG laser therapy was introduced and the department continued participation in the fellowship program for robotics and research. Vascular Surgery The vascular surgeons at St Vincent’s Private Hospital provide a full range of vascular and endovascular surgical techniques in the treatment of arterial venous and lymphatic disorders. The department is complimented by a diagnostic vascular laboratory at St Vincent’s Clinic and by interventional radiological services at St Vincent’s Hospital and St Vincent’s Private Hospital. The department treats complex disease of thoracic aorta with a combination of open surgery or the latest fenestrated grafts for endovascular repair. Combined opened and endovascular repair (hybrid grafting) has been used in the treatment of patients with aortic arch and extensive thoracic abdominal aneurysms.

The stent graft program has increased the workload of the unit, with surgery performed in the operating theatres or the cardiac catheter laboratory of St Vincent’s Private Hospital. Campus plans for a hybrid operating theatre will further increase this area of work for elective and emergency vascular surgery. Open surgery for occlusive disease of the aorta and branches are performed as are complex cerebrovascular procedures for stroke or patients at risk of stroke. Venous disease including varicose veins, malformations and venous thrombosis are treated with surgery and endovascular procedures. Thrombolytic therapy is used for extensive venous thrombosis. Access procedures for chemotherapy, haemodialysis and peritoneal dialysis and surgery for renal transplantation are performed by all members of the vascular surgical service. A live donor renal transplant program is to be introduced to St Vincent’s Private Hospital in late 2011.

SydPath SydPath provides 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. SydPath is comprised of several divisions: The Division of Anatomical Pathology provides core diagnostic services to the Darlinghurst campus and various other clinics in metropolitan Sydney and regional NSW. The Division of Chemical Pathology, which has continued to develop an automation project aimed at returning results to doctors in the shortest possible time. In 2010/2011, the division was again active in research and presentations in the field of chemical pathology.


The Division of Haematology Laboratories provides a comprehensive service which includes blood transfusion, coagulation and general haematology diagnostics. The Contract Pathology Unit operates a specialist clinical trial business, which has been in operation since 1995, during which time it has established an international reputation for the provision of quality, central-laboratory services, locally and internationally. The Division of Immunopathology Laboratories provides diagnostic laboratory and contract services that span an extensive range of immunochemistry, autoimmune serology and flow cytometry. The introduction of the FACS Canto II eight-colour flow cytometer has helped facilitate the diagnosis and monitoring of cancers and HIV.

The Division of Microbiology provides a high quality comprehensive clinical microbiology diagnostic laboratory service to the St Vincent’s campus and to general practitioners in Sydney, Narrabri and Moree. A new diagnostic PCR test for respiratory viruses has significantly improved the detection rate of viruses in patients with respiratory illnesses, which has important therapeutic implications. SydPath follows all relevant principles of International Conference on Harmonisation on Good Clinical Practice (GCP), Organisation for Economic Co-operation and Development (OECD) on Good Laboratory Practice and is National Association of Testing Authorities, Australia (NATA) accredited and Therapeutic Goods Administration licensed. And through the specialist clinical trial business unit, provides a comprehensive range of clinical trial laboratory services across local, central and global laboratory operations.

Volunteers With a volunteer workforce close to 70, vital contributions were made to St Vincent’s Private Hospital over the past 12 months. Volunteers provided patient support in areas such as day surgery and patient admissions, as well as helping in the Same Day Centre, acting as hospital guides and manning reception. They also worked in customer support roles such as the Wintergarden café and the doctor’s dining room. The volunteers undertook administrative duties in medical records, patient accounts, nursing administration and the executive office, while also servicing patient wards with the library and flower trolleys. There were five new and effective areas where volunteers helped during 2010/2011 which include working on patient wards, with the internal communications department, in the Finance Department, with Friends of St Vincent’s Private and as hospital guides for patients and their families and visitors.

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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.

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Established by the Sisters of Mercy in North Sydney in 1906, the Mater Hospital was acquired by the Sisters of Charity in 2001 and is now part of St Vincent’s Health Australia, along with St Vincent’s Hospital, Sacred Heart and St Joseph’s Hospitals. Together with St Vincent’s Private Hospital these facilities form St Vincents & Mater Health Sydney. The Mater Hospital is a leading private hospital renowned for its quality care and compassion.

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01 The operating suite at the Mater Hospital 02 Kimberley Sheather and A/Prof Fran Boyle look at scans in the Patricia Ritchie Centre 03 Mother, Jacqueline McCarthy strokes the head of two day old Benjamin

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A year in review The Mater’s reputation for excellence will continue long into the future with the completion in 2011 of several large projects set to enhance the delivery of health to patients and the wider community.

With the opening of the new Patricia Ritchie Centre for Cancer Care and Research in the renovated convent building, the Mater’s cancer patients now receive ongoing chemotherapy and supportive care in a unique, home-style environment. The move into the new premises was completed in September 2011, providing increased office space and work stations for the clinical trials department. The Governor of NSW, Her Excellency Professor Marie Bashir AC CVO, officially opened the new Patricia Ritchie Centre at a function in February 2011. Following the move of the Patricia Ritchie Centre, the Mater day therapy rehabilitation unit was relocated to its former site at 11 Gillies Street. The internal area was completely refurbished and is functioning well. The Mater undertook a minor upgrade of the Day Surgery Unit to allow a greater volume of patients to be admitted as Day of Surgery Admission (DOSA) patients. An increased number of patients are now being admitted directly to the DOSA Unit, which freesup bed capacity in line with the strategy to increase complex overnight surgery. There were also upgrades to Operating Theatres 5 and 6 in the main Operating Suite over the period of Christmas and January 2011.

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The Mater is developing a business case to expand its Special Care Nursery, as there is not sufficient space within the current Hospital footprint. An opportunity exists to combine the project with expansion works in other key areas of demand, including critical care beds and operating theatres. The proposed area for the development is above the existing loading dock at the front of the hospital, as this location provides a number of advantages. The overall project cost is expected to be in the order of $8 to $9 million and funding will be provided via a combination of donor contributions and other sources. In recognition of its outstanding maternity services, the Mater Hospital was named the best provider of private maternity care in NSW following a major survey of Medibank private patients. The Medibank Private Maternity Experience Index evaluated the experiences of more than 2,000 patients who have recently given birth in private hospitals across Australia, rating hospital performance, environment, staff and support throughout the pregnancy, birth and early parenthood. Surveyed topics in the maternity index range from pre-admission care such as antenatal classes and hospital familiarisation, to


breastfeeding support and caring for newborn advice. The survey was part of Medibank’s Member Experience Index, which is the largest and most comprehensive study of private patient experiences in Australia.

mentoring, quality assurance, clinical audit, policy and procedures, and committee representation. She is a key liaison person for the Mater’s medical consultants regarding relevant issues and potential areas for review.

A newly formed group of cardiologists, Cardiology at the Mater (CATM) opened consulting rooms at the Mater Clinic in April. It is envisaged that the addition of this group will result in increased cardiology, interventional cardiology, cardiac surgery and thoracic surgery volumes at the Mater. In particular there is now a more comprehensive interventional cardiology service available at the Mater.

The Mater undertook a review of all accredited Visiting Medical Officers in line with its quinquennium, and recommendations for reaccreditation were made to the Chief Executive Officer, St Vincents & Mater Health Sydney.

As part of the overall plan for the refurbishment of patient rooms and nurse’s stations, the Mater engaged an interior designer for professional advice. Some interim work in relation to the refurbishment program has been completed, including the refurbishment of the Delivery Suites in Maternity and the repainting of some of the ward areas. In response to the increased volume and complexity of cases, Dr Maggie Mathers has been appointed Career Medical Officer (CMO) Coordinator. Dr Mathers is responsible for CMO education,

External and internal communications were improved following an upgrade of the Mater’s website, which includes the profiles of the active Visiting Medical Officers at the Mater. Following a nomination by the Mater Hospital, Mr Greg Poche was awarded the 2010 Great Australian Philanthropy Award at the Research Australia Awards ceremony held at NSW Government House on 25th November 2010. This is a highly prestigious award with past winners including Dame Elisabeth Murdoch, Lady Mary Fairfax, the Myer Family and Frank Lowy.

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place in June 2011. The report by the surveyors presented an overwhelmingly positive view of the Mater in terms of its services and systems and, in particular, doctors, staff and volunteers. Most significantly, the report attracted a dramatic increase in the number of excellent achievement ratings which increased by five to a total of twelve. There were only nine recommendations on areas for improvement. The Mater has been accepted as the first and only Australian member of International Society of Orthopaedic Centers (ISOC), a prestigious group of some of the world’s leading orthopaedic centres. The mission of ISOC is to facilitate the exchange of ideas and best practices among the premier specialty orthopaedic institutions in the world, and to collaborate on patient care, education, and research-based programs to advance improvements in orthopaedic care on a global scale. Membership of ISOC confirms the Mater’s position as a world-class provider of orthopaedic services.

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The Mater received excellent results in the Australian Council on Healthcare Standards Periodic Review, which took

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Our Stories

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Taking

CONTROL When Melissa Hayes-Smit was diagnosed with aggressive breast cancer, while 10 weeks pregnant with her second child, the communications executive was thrust into an unfamiliar world of treatment and fear. “It was a strange juxtaposition, because it was such a happy time, and then all of a sudden it was a struggle,” says Melissa, 42. Melissa was initially reluctant to undergo the chemotherapy her doctors at the Mater recommended, following a lumpectomy at 12 weeks, because she was under the common misconception the treatment would harm her unborn baby. “I had to put myself at the mercy of a lot of professionals and medical specialists and rely on them to give me the best advice, not just for my treatment but in the interests of my little passenger as well,” she says.

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When Melissa learned that certain chemotherapy drugs are safe after the first trimester of pregnancy, and

that without it, her chances of survival were lower, she went ahead with the treatment. “I was absolutely terrified because as much as people say to you that it is fine, you don’t really know until the day you meet this little person. And God willing that you do meet this happy little person,” she says. “The ladies that were doing the chemotherapy were particularly sensitive of the circumstances, and were at pains to let me know they had another lady who was due to be delivered who was doing well.” As the main breadwinner for her family – husband Erik is a hairdresser and the couple have a three-year-old son, Lucian – Melissa was also conscious of not wanting to tell too many people about her condition.


A/Prof Fran Boyle Director of the Patricia Ritchie Centre for Cancer Care and Research at the Mater Hospital

03 01 & 02 Melissa Hayes-Smit who is photographed with six month old Liam underwent treatment 03 A/Prof Fran Boyle speaks with a patient undergoing cold cap therapy to decrease hair loss during chemo

“I really wanted to conceal that aspect of what I was going through, so everyone could focus on the pregnancy. I didn’t want the pregnancy marred by a dark cloud,” Melissa says. Her desire to keep the fact she had cancer a secret made Melissa the perfect candidate to take part in a trial at the Mater in the use of cold cap therapy, which is used to decrease or even prevent hair loss during chemo. A/Prof Fran Boyle, Director of the Patricia Ritchie Centre for Cancer Care and Research, describes the therapy as similar to “wearing a rugby cap at minus 35 degrees for two full length games.” It is strapped to a patient’s head for periods of up to an hour before, during and for some hours

after chemotherapy, in order to prevent the medicine reaching and damaging the hair follicles.

As she smiles at little Liam, who recently turned six months old and is indeed “perfect,” Melissa says she is grateful for what the cold caps did for her.

“For many women with breast cancer, the “I don’t want to mince words, it was not loss of hair due to chemotherapy adds comfortable and was quite painful for insult to injury. Women report that they the last session, but by the same token suddenly look sick, and that changes it meant that I kept 20 percent of my in appearance provoke unwelcome hair,” says Melissa, who is responding questions at work and may increase well to her treatment following a distress for children,” A/Prof Boyle says. mastectomy. “The cold cap system, donated by The Friends of the Mater Foundation, allows “That doesn’t sound like a lot, but it was enough to tie it back and make it less women like Melissa to regain a sense noticeable. I found it very empowering of control over this side effect of cancer and I definitely think it was worth doing.” treatment.”

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“For many women with breast cancer, the loss of hair due to chemotherapy adds insult to injury. The cold cap system, donated by The Friends of the Mater Foundation, allows women like Melissa to regain a sense of control over this side effect of cancer treatment”

The therapy is not new but the equipment has been refined for wider use, and the trial at the Mater is continuing.

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Best private maternity care in NSW in Medibank Private survey of 2,000 patients

The Mater’s Maternity Unit delivered

2,387

babies in the 2010/2011 financial year, including 35 sets of twins 02

01 The Suttie family enjoy time together 02 Katy Farley stands in front of the Mater Hospital

A perfect start

“So many of the staff who work in maternity – midwives, mothercraft nurses and doctors, have worked here for many years. I often hear women say they have had the same midwives for all their babies and they feel a real part of the maternity family, it’s like coming home.” Katy Farley Manager Obstetric Services Mater Maternity

Anu Suttie didn’t set out to have five children, and while she won’t say the quality of care at the Mater was the whole reason she kept going back for more, she won’t say it didn’t help! Relaxing in the backyard of her north west Sydney home with Tara, 10, George, seven, Jack, five, Max, four, and 17-month-old Eve, former marketing executive Anu describes her birthing experiences at the Mater Hospital as “simply wonderful.” “I know I am very lucky to be able to say that,” Anu, 40, says with a smile. “But really, from start to finish I wouldn’t have changed a thing. The midwives take such good care of you and you always felt they were going over and above for you. They would stay that extra couple of minutes with you even if their shift had ended. It was never the case that you felt you were in a rushed place, you never felt hurried. They really did honestly care.

“It wasn’t just that you knew you were getting absolutely the best medical care, it was that everything – from the way the rooms are laid out, to the food – it’s all really lovely.” According to Katy Farley, Manager of Obstetric Services at Mater Maternity, Anu’s experience is typical of the lucky ladies known as Mater Mums. “We recently celebrated 20 years of maternity at the Mater with a reunion at Luna Park and there were so many familiar, smiling faces,” Katy says. “I think the difference with us here is that we are very family oriented.” Katy said the recent introduction of a twice-weekly high tea for grandparents, parents and babies in the maternity ward had cemented this feeling of family.

“The high tea is very popular. It’s wonderful for the grandparents to come in, and some of their other visitors come, and the mums can get out of their room and talk to each other,” Katy said. “We like to think we make their stay as much like home as possible, to normalise the whole process for them. Getting new mums ready for that transition to home, and then following them up at home and seeing how they are going, we think it’s incredibly important.

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The Mater named

“Women tend to focus on the day they have the baby, the labour, but in fact it’s what we teach in those first few days that’s important as well.”

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Mater celebrates

100 years

“Generations of local families fondly report a high quality of care from within these walls.” Maria Richards Honorary Archivist and President of the Mater Graduate Nurses

The incredible contribution of Mater nurses past and present was recognised with a special event to celebrate 100 years of nurse education at the hospital The event occurred on International Nurses Day in May 2011, and Maria Richards, Honorary Archivist and President of the Mater Graduate Nurses’ Association, presented a lively history of nurse education at the Mater. Established in 1906, the Mater was the first Catholic healthcare facility on the North Shore. More than 2,000 nurses have been educated there since the first four Sisters received their graduation certificates in 1911. “Generations of local families fondly report a high quality of care from within these walls,” Maria said as she presented a photographic journey through the decades from the Hospital archives. In the 1920s she described how “all comers were treated and the poor were not burdened with the worry of payment,” while in the 1940s, with the establishment of the Maternity Unit “education and high standards of care laid the foundations for what is still recognised as a world class health service to mothers and babies.”

01 New graduate nurses at the Mater Hospital

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Hardik Sanghadia See his story on page 140

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“I was really excited, because when I was in hospital, all I could think of was going back to work and going back to my normal life.”

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Clinical Activities Angiography The Angiography Suite provides cardiac and vascular diagnostic and interventional procedures as well as cardiac electrophysiology studies. Following the refurbishment of Angiography Suite 1, specifically to accommodate complex electrophysiology studies and ablations using three dimensional-mapping techniques and coronary angiography, the department has observed a steady increase in these types of cases being undertaken at the Mater. In addition, the Angiography Suite continues to provide a comprehensive percutaneous vascular intervention service, including peripheral angiography and stenting, and fenestrated AAA stenting. Day Surgery and Endoscopy Department The Day Surgery and Endoscopy Department provides pre- and postoperative nursing care for day surgery patients; procedural and post operative care for endoscopy patients and admission procedures for day of stay surgical patients at the Mater. In 2010/2011 the refurbishment of the Day Surgery Unit was completed, and now provides 10 pre-operative bed bays, two private admission rooms, four interview rooms and an anaesthetist consulting room. New furniture has been purchased for the reception area and Stage III discharge areas. There is also a pre-operative waiting lounge area for patients and families to wait for transfer to the operating theatres. New equipment includes patient trolleys and additional computers for all nursing stations and interview rooms. The Endoscopy Unit has benefited from the purchase of a new anaesthetic machine and two new sterilising reprocessing machines, as well as commencement of the use of carbon dioxide for patient comfort. In recognition of the importance of continuing education, one staff member is completing a Post Graduate Certificate in Peri-operative Nursing through the College of Nursing and evenings of education have commenced for staff to increase knowledge of developments in treatment.

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Staff are progressively being rotated through the operating theatre recovery room and surgery in order to observe procedures for better understanding of how these two areas need to work more closely together for better patient outcomes. Volunteers are also assisting to speak with patients, prepare documentation inserts, and general help as required and a closer working relationship is evolving with Pastoral Care.

but also provide increased office and work stations for the clinical trials department. The Opening & Blessing of the Patricia Ritchie Centre was held in February 2011. The Governor of NSW, Her Excellency Professor Marie Bashir AC, CVO, officially opened the centre and Father Paul Coleman SJ, Hospital Chaplain, blessed the facility.

McAuley and McQuoin Wards provide optimal care, education and support for general surgery, palliative and paediatric patients. The general surgical/medical wards continued their high level of care for patients due in part to the enhanced collaboration of services. The partnership with The Melanoma Institute ensures optimal care for patients requiring treatment is also available.

With the added space the centre has been able to introduce use of the penguin cold cap system to prevent hair loss during certain chemotherapy protocols kindly supported by Friends of the Mater in 2010. Evaluation is ongoing with many variables identified as to the success of the caps. A further grant from the Friends of the Mater in 2011 will allow, for the employment of a staff member for 12 months to aid in consistency of application. A more in depth study as to use of the caps will commence in early 2012.

Intensive Care Unit

Heart, Lung and Vascular Services

The eight-bed department continues to expand its services with increased cardiothoracic and complex general and orthopaedic surgery. The Friends of the Mater recently donated a Storz video laryngoscope, benefitting both the unit’s consultants and anaesthetists, with its use for complex patient anatomy and educational purposes.

Hutchinson Ward, which provides the Mater with its core heart, lung and vascular services, has had an upgrade of its bed status and monitoring system, in order to accommodate the increased Intensive Care, High Dependency and Cardiac Care Unit demands.

General Surgical/Medical

Operating Suite The Nolan Operating Suite comprises nine theatres, an Anaesthetics Department and Recovery Unit, a newly refurbished Day Surgery Unit and a modern Sterilising Department. Surgical specialties include both elective and emergency procedures with a major focus on orthopaedics and obstetrics services. Over 2010/2011 the theatres saw a growth in neurosurgery, including minimally invasive discectomy surgery and craniotomies. The complex has also seen an increased number of medical and nursing students drawn both locally and internationally, as well as international postgraduate medical students.

Specialties Cancer Care The relocation into the new home of the Patricia Ritchie Centre for Cancer Care and Research was completed in September 2011. The new premises not only allow patients to receive ongoing chemotherapy and supportive care in a home-style environment,

This demand came as a result of increasingly complex surgical cases and the recent establishment of Cardiology at the Mater, which offers additional cardiology services on site. Hutchinson now has 10 level-one, centrally monitored Intensive Care Unit beds, whilst the remaining 12 beds are monitored by telemetry. Mater Orthopaedic Day Surgery The Mater Orthopaedic Day Surgery (MODS) is a purpose built day surgery, catering for sports injuries and minor orthopaedic procedures. Situated in the Mater Clinic, it consists of three state-of-the-art operating theatres and an efficient three-stage recovery unit. In July 2011, MODS held a celebration of its second year in operation where the quality of care and expertise of staff was recognised. With a focus on building on its excellent service and reputation, MODS aims to increase procedure totals for 2011/2012 to reach full capacity. There will also be enhanced educational resources for staff to support the needs of the growing department, and further research into ways to improve delivery of care and uphold the core values of St Vincents & Mater Health Sydney.


The Mater’s Maternity Unit delivered 2,387 babies in the 2010/2011financial year, including 35 sets of twins. A unit makeover converted two share rooms into family rooms with double beds. This not only allows fathers to stay on site and makes for a more familyfriendly environment; it also guarantees private rooms to every patient. With the Mater now training their own midwives, the hospital saw another three students graduate with a Graduate Diploma in Midwifery. In September 2010 some 60 midwives attended a Professional Midwifery Update Workshop. As an added value offering to patients, the Mater commenced a regular high tea in the Maternity Unit. Held each Monday and Friday, the tea offers an opportunity for grandparents, parents and baby to come together over a cup of tea and cake. New parents are also able to network with fellow new parents, making their hospital stay more nurturing and comfortable. Orthopaedics and Rehabilitation With one of the busiest orthopaedic departments in the Southern Hemisphere, the Mater’s Orthopaedic and Rehabilitation Unit specialises in elective orthopaedic joint replacement, orthopaedic surgery and post-joint replacement rehabilitation. The unit performs more than 1,770 joint replacements each year and the department experienced continued growth in all other orthopaedic and spinal surgeries. The rehabilitation ward celebrated its first anniversary with greater than expected occupancy for the first year. Education and research into orthopaedic peri-operative, intra-operative and post-operative management continues.

Support Services Central Sterilising Unit The department is responsible for the sterilisation and reprocessing of reusable surgical instruments and trays in the operating theatres, wards and delivery suites. The Mater is one the busiest orthopaedic hospitals in the Southern Hemisphere and the volume of work in the unit reflects this, with the regular supply of orthopaedic loan kits for sterilisation.

In 2010/2011 the department purchased a Pronomic loan kit lifter, designed to lift all surgical instrument transport cases and tubs. The door to the loan kit lifter was also enlarged to improve access. LinkAGE LinkAGE is a community service program that provides trained volunteers to visit elderly and socially isolated residents in 54 aged-care homes and retirement villages in Sydney. Volunteers receive ongoing training and support from the program managers based at the Mater. In the past financial year 20 new volunteers were recruited and trained, while four new aged care homes joined the program. The LinkAGE volunteer team was nominated for the 2010 NSW Volunteer Team of the Year Award and commenced two new pilot projects, the LinkAGE Hearing Helper and LinkAGE Volunteers in Day Centres. More than 4,000 hours of caring companionship were provided by the LinkAGE volunteers. Mater Imaging Mater Imaging replaced its CT with a high definition 128 slice GE Gemstone CT scanner. This has delivered an average of 65 percent less radiation dose. The breast imaging service has upgraded to digital mammography with Tomosynthesis. The system produces three-dimensional images which reveal the inner architecture of the breast, free from the distortion typically caused by tissue shadowing or density.

to the introduction of face-to-face and bedside handover. This initiative has already seen improved patient satisfaction rates. Quality Risk and Management The Mater has been working in partnership with the Studer Group, one of the world’s leading healthcare cultural change and organisational improvement organisations. The company has since partnered with over 1,500 healthcare organisations across the USA, Canada, Australia and New Zealand, which include teaching, university, metropolitan, regional and rural facilities.

Volunteers The Mater Hospital’s volunteers assist with multiple duties to enable staff to provide better patient care. Nine new volunteers have joined the team of 140, who dedicate 1,200 hours a month. Roles filled by volunteers include helping support Day of Surgery Admission (DOSA) patients, knitting bears for juvenile patients, helping patients with their meals and leading meditation classes.

Patient Safety A number of new initiatives were implemented to improve medication safety for patients, including participation in the National Medication Safety Self Assessment (MSSA) for Australian hospitals. The hospital also undertook pharmacy medication reconciliation, which involves a pharmacist review of patient’s medications within 24 hours of admission. This process ensures that the patient’s home medications are reconciled with their hospital medications to ensure accuracy and safety. The Mater has seen a steady decline in patient falls after adopting some initiatives from St Vincent and Mercy in Melbourne, including the use of ’Call don’t Fall’ signs in all patient rooms and L.A.M.P (Look at me Please) signs for high risk patients. The Mater also commenced the move from using taped clinical handover

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Maternity Unit

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St Joseph’s Hospital Founded in 1886 by the Sisters of Charity, St Joseph’s Hospital is an 81-bed public 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 palliative care, medical and aged care rehabilitation, and aged care psychiatry and neurosciences. St Joseph’s Hospital is a facility of St Vincents & Mater Health Sydney and now forms part of the St Vincent’s Health Network, operating under an agreement with NSW Health. 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 support groups and outreach programs.

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01 Dorothy Farlow is cared for in the Aged Care Assessment and Rehabilitation Unit at St Joseph’s Hospital 02 Thank you cards line a noticeboard at St Joseph’s Hospital 03 Nurse Unit Manager Thelma Rayhanabad speaks with a colleague 04 St Joseph’s Hospital located in Auburn, Sydney

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A year in review A new era of certainty and sustainability is set to begin with completion of a capital master plan for the Auburn campus, St Joseph’s Hospital and St Joseph’s Village. Meanwhile, the first patients for the new Huntington’s Disease Unit on the campus have been welcomed.

Over the past year, provision of services previously provided by the former Sydney West Area Health Service commenced transitioning to St Vincent’s & Mater Health Sydney. The four streams to be transitioned are Financial and Accounting, Purchasing and Stores, Human Resources and Payroll, and Information Technology. With a commitment to successfully meeting all future needs, the capital master plan for the Auburn campus is nearing completion. Architect Jackson Teece will be translating the vision into the built form and the plan will be used to secure funding and will give shape to any future developments. One of the key new developments is establishment of a Huntington’s Disease Unit. The state-wide Huntington’s Disease Service consists of the Western Sydney Local Health District (WSLHD) Huntington’s Disease Unit, currently located in the Lottie Stewart Hospital at Dundas, along with a Huntington’s service at Westmead. In 2012 the unit at Lottie Stewart will be decommissioned and a new Huntington’s Disease Unit will be established at St Joseph’s Hospital, which will be owned and operated by

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St Vincent’s & Mater Health Sydney in partnership with WSLHD Huntington’s Service at Westmead Hospital. The new unit’s revised model of care will see the construction of a 20-bed dedicated facility, comprising 14 intensive management residential aged care beds, four neuropsychiatric beds and two assessment and monitoring beds. St Joseph’s has received its first Huntington’s Disease patients in subacute beds. These patients have been accommodated within the current facilities in the hospital and feedback to date regarding their care and progress has been very positive. St Joseph’s Hospital has once again demonstrated excellence in compliance with the requirements of the NSW Health Occupational Health and Safety and Injury Management Profile, which was reflected in an outstanding score of 95 percent achieved in March 2011. Among the commendations from surveyors, who observed interactions between staff, managers and patients, was that St Joseph’s has a positive, safety-focused culture.


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A key facet of the Aged Care Psychiatry and Neurosciences Outpatient Service, the Kamberra Group seeks to address increased social isolation and decreased community participation for older people with a mental illness. The group was established in 1996 as part of Diversional Therapy Services and its work was enhanced in 2011 with three key grants. A Positive Ageing Grant from the NSW Government and funding from Community Development Support Expenditure Grant and Auburn RSL allowed for the enhancement of staffing to the service, procurement of resources to assist with intervention and outings, and the implementation of regular art classes. The key benefits of the program identified by participants included improved relaxation and concentration. Members of the group also reported increased enjoyment, happiness, pleasure in doing something new and an overall increase in art appreciation. Paintings were entered in the Mature Art Exhibition coordinated by Auburn Council and displayed in Auburn Library in November, 2010.

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In 2010 St Joseph’s Hospital continued a partnership with The Order of Malta, a Catholic charitable organisation who donated $29,000 to St Joseph’s Palliative Care Unit. These funds were used for the purchase of morphine pumps and refurbishment of the family lounge and quiet room. St Joseph’s Hospital continues to support the undergraduate and postgraduate education of medical, nursing and allied health students and provides clinical partnerships with the Australian Catholic University, Charles Sturt University, Macquarie University, University of Newcastle, University of New South Wales, Sydney University, University of Technology Sydney, University of Tasmania, Notre Dame University and University of Western Sydney. In an exciting period of transition, St Joseph’s looks forward in coming years to the development of new and future services, working in partnership with Western Sydney Local Health District to improve the quality of care for the Western Sydney community.

Annual Review 2010/11

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As Tom Stewart tends the final brush strokes of his latest acrylic still-life, the former railway designer can’t help but reflect on how different things are for him now.

With every Tuesday and Thursday set aside for “regaining my sanity, ” Tom, 89, is no longer living with a crushing sense of isolation and fear that life is passing him by. Whether it be creating artworks, wielding drumsticks or cooking a barbecue for his new friends, Tom says inclusion in St Joseph’s Hospital’s diversional therapy offering, the Kamberra Group, has changed him. “You get to our age and you find a lot of your friends have disappeared, and it’s hard to make new ones,” Tom says. “And as you slow down in life, I suppose you don’t think as much and you don’t do as much and it can be pretty hard to find a way to get back into things.” Tom says when he felt he was starting to slow down, he wasn’t quite sure where to turn. Tom’s wife Amy passed away 13 years ago and although his daughter and grandchildren are regular visitors to his Auburn home, he was overwhelmed at times. “This has been a great way to make really good friends,” Tom says of the Kamberra Group, which has 25 members 136

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Art The

and was established in 1997 in recognition of the isolation and mental health issues impacting older people living alone. “The benefits I have got from it are many. They get us out into the fresh air and we do some exercise and get out and do different things. It’s good for all of us. ” Tom says while the Kamberra Group is involved in a host of activities, his favourites have been painting and drumming, which all the members agreed had given them a good emotional release. “At first there were complaints that they had never painted before and they didn’t know what they were doing. But after they sat down in front of an easel with some paint and brushes, you could see a real change in attitude,” Tom says. “They were all commenting backwards and forwards and you could see there was a genuine interest. Most of them had never had any tuition or instruction but what they turned out was just astounding, to themselves, and to others.” So pleased were they with the results that some were displayed in the local library at the Mature Art Exhibition


and all were displayed at an art exhibition at St Joseph’s Hospital. Diversional therapist Suzanna Majewski, who runs the Kamberra Group, also created a calendar of the artworks for 2011 for group members. “The group enjoyed the painting, and we are about to start some more music therapy,” Suzanna says. Suzanna says the group originally started as part of the continuation of care for geriatric psychiatric patients, with a history of depression or associated issues. “But it has evolved a bit towards proactive service and a proactive environment, so people like Tom who are living by themselves and people who have problems going out, we offer them social interaction to minimise the chance of them getting depressed,” Suzanna says.

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“It has evolved a bit toward proactive service and a proactive environment, so people like Tom who are living by themselves and have problems going out, we offer them social interaction to minimise the chance of them getting depressed.” Suzanna Majewski Diversional Therapist St Joseph’s Hospital

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of healing

“And it’s also good because if I notice someone is deteriorating in terms of self care or mobility then I can refer them to hospital services here.” 01 Suzanna Majewski, Diversional Therapist, stands with Tom Stewart 02 & 03 Tom Stewart and some members of the Kamberra Group Annual Review 2010/11

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Helping hands

“He came in to our ward fully incapacitated. He needed full nursing care and was not able to do anything for himself, but he was very determined to get better. We all came to care very much for Hardik.” Pam Chen Acting Nurse Unit Manager Medical Rehabilitation Unit St Joseph’s Hospital 01

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Hardik Sanghadia may have been confined to a bed, almost paralysed by a virus and unable to do anything for himself, but in his mind he was running. Struck by viral myelitis, an inflammation of the spinal cord which often results in loss of spinal cord function, at the age of 26, Hardik required full nursing care when he arrived at St Joseph’s Hospital in Auburn for rehabilitation.

“I was aware of everything that was happening, but my body wouldn’t do anything, so instead I focussed on what I needed to do,” Hardik says. “I saw myself running, sitting, standing and walking. There was no way I was going to be in a wheelchair my whole life.” Hardik was moved to St Joseph’s Hospital in February 2011 after acute treatment for his condition was completed at Westmead Hospital. “He came in to our ward fully incapacitated,” says Pam Chen, Acting Nurse Unit Manager of the Medical Rehabilitation Unit at St Joseph’s Hospital. “He needed full nursing care and was not able to do anything for himself, but he was very determined to get better.” Having come to Australia from his native country India as a student, and currently in the process of applying for citizenship, Hardik has now come to call the staff at St Joseph’s his second family.

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Hardik describes his time at St Joseph’s – where he has ongoing outpatient treatment – as very positive. “I was in good company, the staff are the best,” Hardik says. “When I come here now, after nine months, I feel like I am coming home. They are very good to me, all the staff, I feel like they are my family here in Australia.” During his four-month stay at St Joseph’s, Hardik’s fear was that he wouldn’t be able to return to his job as a manager at McDonald’s. Recently he was overjoyed to make a part-time return to his old role. “I was really excited, because when I was in hospital, all I could think of was going back to work and going back to my normal life. That kept me motivated all the time,” Hardik says. “And I think all my friends, my staff and my bosses may have been even more excited than I was when I came back, because they were all worried that I might not make it.”

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01 Hardik Sanghadia is back working at McDonalds 02 Pam Chen, Acting Nurse Unit Manager of the Medical Rehabilitation Unit at St Joseph’s Hospital, has seen Hardik come full circle 03 Hardik is known as Ravi at work and to his friends

“We all came to care very much for Hardik because he is a lovely young man, and because a lot of the nurses here are in their 40s and their 50s he would call them his mum,” Pam says.

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St Joseph’s Hospital Aged Care Assessment and Rehabilitation Unit This 15-bed unit has a focus on helping patients achieve maximum function and independence through rehabilitation. More than 80 percent of admissions are aged over 80 years, suffering from conditions such as fractures, falls, strokes, dementia, Parkinson’s disease and hip and knee revisions. Following the introduction by the unit’s physiotherapist of a ‘traffic light system’ for mobility assistance, nursing staff have been able to quickly respond to patient care needs. Daily group exercise classes with the physiotherapist have not only improved patient strength and balance but also established a fun social atmosphere. Among other improvements have been the expansion on the utility of functional electrical stimulation for stroke rehabilitation and implementation of a patient safety nursing handover checklist, improving outcomes with early detection of patients’ deteriorating conditions. The unit continues to offer a supportive environment for ongoing staff education, and participates in the provision of clinical placements for medical, nursing and allied health students, whose numbers have significantly increased from last year. Aged Care Assessment Team The team assesses the overall care needs of the older population in the Auburn area and assists them to gain access to appropriate services. The primary focus is to enable older people to remain independent for as long as possible in their own homes. Aged Care Assessment Team (ACAT) approval is required for some federally funded community based services, and for entry into all hostels and nursing homes in Australia. The multidisciplinary team comprises medical, nursing, social work, occupational therapy, physiotherapy and administrative staff. The team received 581 referrals in 2010-2011, resulting in 641 home visits to the local community and 207 visits to inpatients of St Joseph’s and Auburn Hospitals. All Auburn ACAT assessors were accredited under the new NSW ACAT Assessor Accreditation System, and the team is also actively involved in community education and works closely with Home and Community 140

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Care (HACC) services, general practitioners, and aged care providers in the local area.

and are participating in outpatient physiotherapy visiting the ward to convey their appreciation.

Aged Care Psychiatry and Neurosciences Unit

A variety of multidisciplinary education sessions have been conducted to enhance the staff’s skills and the unit also participated in national stroke week.

The 15-bed Catherine Mahoney Aged Care Psychiatry and Neurosciences Unit provides comprehensive assessment and care for people aged 65 and over suffering from psychiatric illness in a secure unit. Treatment plans are developed and reviewed regularly by a dedicated multidisciplinary team. The unit also has four beds for Huntington’s Disease patients with neuropsychiatric features. Clinical Psychology The department offers neuropsychological assessment for diagnosis and development of rehabilitation plans and behavior management. Families and patients are also supported with the provision of feedback and education regarding dementia and acquired brain injury. Comprising three clinical neuropsychologists who work across the Medical Rehabilitation and Aged Care Psychiatry and Neurosciences Units, the department has also been involved in the development of a multidisciplinary service for patients with Huntington’s Disease. Neuropsychological assessment interpreter training for the Sydney West Area Health Care Interpreter Service commenced and is ongoing. This has been well received by participants, who do not undergo such education in their routine training as interpreters. As part of National Psychology Week, community education was provided to the local Trinity Catholic College on the neuropsychological consequences of risk taking behaviour. Medical Rehabilitation Unit The unit provides a 15-bed rehabilitation inpatient service and two assessment beds for Huntington’s Disease patients. There are also two speciality outpatient services: the Motor Neurone Disease Multidisciplinary service and the Spasticity Clinic. Among the past year’s achievements, there has been the acceptance of three posters from the Motor Neurone Disease service for the 2011 International Motor Neurone Disease Conference. The unit has also had tremendous success at reintegrating severely disadvantaged patients into the community, with 95 percent of those who have been discharged

Occupational Therapy and Diversional Therapy Services Supporting patients in rehabilitation, aged care assessment, palliative care, aged care psychiatry and the community, this unit provides therapeutic services to assist in recovery. Occupational therapy services comprise assessment of disabilities and retraining, including daily activity tasks and driver training. The department also provides student education for occupational therapy students. The Diversional Therapy Service runs various groups including activities for former patients over 65 years of age who have a mental illness or behavioural disorder. The aim is to promote increased self-esteem and to enhance motivation and participation in social and recreational activities. Palliative Care Unit A core specialty of St Joseph’s, the 21-bed Palliative Care Unit provides symptom management, respite and terminal care. An outpatient service is also provided. In 2010-2011, the unit participated in the National Standard Assessment Program (NSAP) and completed the NSAP program for palliative care patients. The unit participates in a weekly journal club with inter-hospital teleconferencing, while staff are involved with the education of community groups, particularly those from minority groups. There was ongoing ward education for all staff on a weekly basis and the unit also participated in palliative care week. Physiotherapy Providing physiotherapy services to patients undergoing rehabilitation and palliative care, this department retrains functions such as bed mobility, walking indoors and outdoors, stair climbing and upper limb function. Two staff from the Physiotherapy and Occupational Therapy Departments travelled to Florida for the International Motor Neurone Disease Conference.


Auburn Campus Mission St Joseph’s Mission Directorate comprises Mission, Pastoral and Volunteer Services, and Hospital Auxiliary. The Mission Directorate at the Auburn campus caters for the needs of St Joseph’s Hospital and St Joseph’s Village.

from around the state and ACT at the Palliative Care Interest Group meeting in March. Part of the day was dedicated to working toward setting competencies for palliative care social work, which remains an ongoing process. The interest group is an important way of information sharing for palliative care social workers. Speech Pathology

This year the Hospital proudly celebrated 125 years of service in the community and honoured the tradition and heritage of the Sisters of Charity, who established St Joseph’s in 1886. Staff, volunteers and the many supporters of St Joseph’s continue this vibrant service meeting new challenges and new models of care.

Comprehensive speech pathology services are provided to inpatients and outpatients referred through the Medical and Aged Care Rehabilitation Service. The department’s core activities focus on assessment and management of communication and swallowing disorders, as well as education of patients and carers.

Mission outreach activities included a Christmas appeal for refugee and disadvantaged children, while efforts to support Sudanese refugees included a winter appeal for St Bakhita’s Refugee Centre in Sydney and a fundraiser morning tea to support the building of a Catholic Health Clinic for women and children in Southern Sudan.

During 2010/2011 the department’s services to those with motor neurone disease continued to grow and services to the new Huntington’s disease unit commenced. There was also continued contribution to the clinical education of speech pathology students from the University of Sydney, Macquarie University and Newcastle University.

The importance of the 41 volunteers, who work across the Auburn campus, was recognised with a morning tea at Government House. In 2010/11 the volunteers gave 7,288 hours of service. With fundraising efforts including hairdressing, stalls and raffles over $7,000 was raised throughout the 12 month period and the volunteers once again demonstrated that they are a small band with exceptional dedication. St Joseph’s Hospital Auxiliary has 10 volunteers who gave over 1,700 hours of service and raised over $5,000. Monies raised are used specifically for patient equipment. Mission and Pastoral Services at the Auburn campus include ministry to patients, residents and their families, a bi-monthly memorial service for palliative care patients, marking important feast days such as St Joseph’s Foundation Day, and Mary Aikenhead Day. Social Work With a commitment to providing a social work service to inpatients and outpatients of the hospital, this department’s role entails psychosocial assessments, counselling, practical assistance and home visiting. St Joseph’s Hospital accepted the first Master of Social Work student from the Australian Catholic University for placement, while the hospital’s social workers hosted their peers

The department’s speech pathologists contributed to the promotion of Speech Pathology Week and also celebrated “Wednesday Without Words.” Information emails were sent daily to all staff during that week and a board was displayed in the foyer. The department also initiated several quality-based activities aimed at improving services, and with the support of the hospital wish list was able to purchase new computer therapy programs.

Administrative Services Catering and Dietetics Catering and Dietetic Services supply more than 310 nutritionally sound meals a day to staff and patients, as well as catering for in-house functions. Staff also provided a high standard of catering to external functions, such as the Lion’s Club Annual Dinner which provided a substantial donation for hospital equipment.

Health Information and Records Service The department provides an effective health information and record management service by ensuring the healthcare record is available to facilitate an optimal level of direct and indirect patient care. Core activities involve management, maintenance, secure storage, and retrieval of health care records as well as access, training, support, system maintenance, clinical coding of inpatient episodes and provision of information for medicolegal and research purposes. In October 2010 inpatient Cerner Computerised Order Entry was implemented at the hospital and in November 2010 the PAS i.PM was upgraded to State Base Build version 1.86. Occupational Health and Safety St Joseph’s Hospital excelled in the Mutual Solutions Benchmark Injury Management Audit in October 2010, achieving a rating of 72.8 percent, above the Australian industry average of 63.9 percent and global average of 63.7 percent. St Joseph’s Hospital has once again clearly demonstrated excellence in compliance with the requirements of the NSW Health Occupational Health and Safety and Injury Management Profile, which is reflected in the outstanding score of 95 percent achieved March 2011. After observing interactions between staff, managers and patients, the surveyors stated St Joseph’s has a positive, safetyfocused culture. Patient Safety and Quality Unit The unit successfully recruited a Patient Safety and Quality Coordinator, as well as transitioning from Incident Information Management System to Riskman in early 2011. St Joseph’s Hospital also achieved Australian Council on Healthcare Standards accreditation until 2014 following an organisation-wide survey in June 2010.

In September 2010 Catering and Dietetics received an A rating from a NSW Food Authority Audit for a compliance audit for a vulnerable population facility and in December 2010 won a Team First from Sydney West Area Health Service.

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Clinical Support Services

Ninety percent of catering staff graduated in March 2010 from their two year Certificate III in Hospitality Operations from NSW TAFE. Annual Review 2010/11

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StJoseph’s Village

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01 St Joseph’s Village resident Neville Spence with wife Patricia 02 Bethany, a refurbished area of the hostel caring for 10 residents with high care needs 03 The exterior of Carinya, a dementia specific unit

A residential aged care facility servicing Sydney’s west, St Joseph’s Village is collocated with St Joseph’s Hospital on the Auburn campus. The village comprises a new 18-bed dementia specific unit known as Carinya, 27 self-care apartments, 80 hostel beds for low care residents ageing in place, 35 community aged care packages and Bethany, a new 10-bed unit for residents with high care needs. The facility works collaboratively with St Joseph’s Hospital and is part of the residential aged care services provided by St Vincents & Mater Health Sydney.

A year in review 01

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In March 2011, St Joseph’s Village officially opened Carinya, which caters for people with dementia, and increased the facility’s dementia specific beds from 10 to 18. At the same time St Joseph’s opened Bethany, a refurbished section of the hostel catering for 10 residents with high care needs. The new facility has allowed some residents, who would previously have been transferred to nursing homes, to remain at St Joseph’s Village for a longer period of time, fulfilling their wishes and those of their families for better continuity of care. Carinya is the aboriginal name for home and evokes a picture of a family dwelling, while the name Bethany was chosen for its biblical origin, and is the name of a village near Jerusalem. Residents with

St Joseph’s Village met all necessary accreditation requirements, following audits on the facility’s fire safety and food safety. An unannounced support contact visit by the Aged Care Standards and Accreditation Agency in April 2011 found St Joseph’s Village was compliant in all 44 expected outcomes. In addition St Joseph’s Village was compliant in a Fire Certification Inspection carried out in November 2010 and was awarded an A rating, from the NSW Food Authority, following a Food Safety Audit in October 2010. In 2010-2011 occupational health and safety audits for self-care residential apartments, which align with the requirements of the NSW Retirement Villages Act, were undertaken and a list of work required was compiled and prioritised for rectification. Inspections will continue to be carried out annually.

A new Quality Coordinator for the Auburn campus was appointed in January 2011, charged with reviewing and improving the falls management program at St Joseph’s Village. New initiatives have included education for staff and residents, and fortnightly meetings with staff to review each incident, and to look for opportunities for improvement. In November 2010, a new Nurse Unit Manager was appointed to oversee a team of dedicated staff. The Nurse Unit Manager is overall clinical manager of the hostel and independent living residents. Many employees at St Joseph’s Village are improving their credentials, currently 11 are completing Certificate IV in Frontline Management, three are completing Certificate IV in Aged Care Work and two are completing Certificate III in Aged Care Work. This training is funded by the Department of Health & Ageing.

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The number of elderly people aged beyond 85 years, over the last two decades has increased by 170.6% compared with a total population growth of 30.9% for the same period (ABS 2010). Elderly population growth (85+ yrs) Total population growth

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65-84 yrs

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170·6%

30·9%

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Demographers expect the number of older people (65-84 years) to double and the very old (85 years and over) to quadruple by 2050 (Australian Government 2010).

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complex care needs also benefited from the purchase of new clinical equipment to help staff.

With the opening of two new units tailored to meet the complex challenges of an ageing population, St Joseph’s Village cemented its reputation as a leader in aged care.

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Spend five minutes with  Charles & Margaret Dulhunty and you know you would be lucky to end up like them. Still so close after 66 years, still chuckling together over shared jokes, it’s easy to see why care staff at their home in St Joseph’s Village call them the lovebirds.

Perhaps it’s because things were so rocky in the beginning for young Charles and Margaret that they have spent so long appreciating each other. After meeting in 1940 during Charles’ RAAF training, the pair was kept apart for four long years when Charles was serving with 450 Squadron overseas during World War II. “I came home when the war had just about finished in Europe, but it was still going up north and in Japan and I thought they were going to send me back out,” Charles says. “Nobody thought the war was ever going to end, so we decided to hurry things up a bit and get married.” They found a room above a milk bar in Maroubra for the 9am reception, invited their families and booked a fortnight’s honeymoon at the Blue Mountains.

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“And this,” Charles says proudly, as he points at the simple cream satin dress still hanging proudly in Margaret’s closet, “is the dress. She made it herself you know, in five days.” Margaret picks up the story. “I used my mother’s Singer sewing machine and did the fancy work by hand. I don’t know what sort of material it is, but at the time it was in fashion.” Charles and Margaret have been making up for lost time ever since that day in April 1945, and share three children, seven grandchildren and nine great grandchildren. Last November, they moved from their home in Merrylands into St Joseph’s Village, a residential care facility at Auburn in Sydney’s west.


“Now I have my own unit where I live, but Margaret needs a little bit more care, so she is up here in Bethany. Moving here has made a big improvement in my health, and a really big improvement in Margaret’s health. We are both happy because we spend as much time as we want together, and I know Margaret is getting all the care she needs.” This sense of connection is extremely important for residents at St Joseph’s Village, says the facility’s General Manager, Vicki Dean.

“We try to encourage couples to spend quality time together but we also encourage them to take care of themselves, and allow the care staff to be the primary care giver,” Vicki says. “We listen to their concerns about how the care was and should be delivered, in order that they feel that they are in partnership with us in the delivery of care, especially to the frailer partner.” Vicki says the experience of Charles and Margaret is reflective of St Joseph’s aim to provide ageing in place, supporting and caring for residents with complex care needs for the duration of their life, rather than transferring them to a nursing home.

“Charles visits Margaret often, they love to play scrabble together and Charles puts a smile on Margaret’s face when he reads her stories,” Vicki says. “Charles loves keeping in touch with family and friends using his computer and whilst time spent with Margaret is an integral part of his day, he also enjoys going out for coffee with friends. Charles continues to be involved in mainstream activities as part of his need to feel part of the village community. “And this is our hope, that St Joseph’s Village is a place where the village community supports each other, and where the residents feel at home.”

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“We try to encourage couples to spend quality time together but we also encourage them to take care of themselves, and allow the care staff to be the primary care giver.” Vicki Dean General Manager St Joseph’s Village

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“Margaret has been unwell for a few years but I was able to care for her until my legs gave away,” Charles says.

01 Margaret Dulhunty’s wedding dress hangs in her wardrobe at St Joseph’s Village 02 Charles & Margaret Dulhunty at home in St Joseph’s Village 03 Charles & Margaret hold a photograph of Margaret on their wedding day in 1945 04 Charles & Margaret share an embrace 05 Vicki Dean the General Manager of St Joseph’s Village

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St Joseph’s Village Activities A variety of activities are offered at St Joseph’s Village to entertain residents and engender a sense of belonging within the community. With regular entertainment offerings and group participation, the centre creates 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 and anniversaries are celebrated and entertainers visit regularly. Carinya and Bethany In August 2010, St Joseph’s Village opened Carinya, which caters for people with dementia, and increased the facility’s dementia specific beds from 10 to 18. Residents of the original 10-bed Carinya unit in Cardigan Street, Auburn, transferred to their new home following a meaningful ritual arranged by Pastoral Services. This allowed the residents to farewell their previous home and helped ease them into their new surroundings. Carinya is now fully occupied and the Auburn campus continues to provide a pastoral care program specifically designed for these residents. At the same time, St Joseph’s opened Bethany, a refurbished section of the hostel catering for 10 residents with high care needs. With a higher staff to resident ratio than previously, the new Bethany allows staff more time to care for residents. St Joseph’s Village now offers better continuity of care, with residents who would previously have been transferred to nursing homes now able to be cared for in the hostel environment for a longer period of time. The new Carinya and Bethany units celebrated an official blessing and opening in March 2011. More than 100 invited guests enjoyed a high tea and the official party and a tour of the facilities. Clinical Care A new Nurse Unit Manager was appointed in November 2010 as overall clinical manager of the hostel and independent living residents. The Nurse Unit Manager heads a team of dedicated staff, who are responsible for assisting residents with their personal care needs, while at all times treating them with dignity and respect. Finance St Joseph’s Village was successful in obtaining grants from Dooley’s Lidcombe Catholic Club under the Community Development Support Expenditure Scheme and from the NSW Government Community Building Partnership Program, totaling $74,430. These funds will be used to erect security gates and fencing along the Alice Street boundary of the village, providing better security for residents and staff. Outreach St Joseph’s Village Outreach provides 35 community aged care packages to the elderly living in the Auburn Local Government Area. The services provided include personal care, social support, transport to and from appointments, 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.

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Our people

As a leading employer in the healthcare sector in NSW, St Vincents & Mater Health Sydney (SV&MHS) recognises and acknowledges that this is only made possible through the dedication, commitment and compassion of staff, volunteers, partners and supporters, as well as an overall willingness to be innovative and develop strategic partnerships which strengthen the future of healthcare.

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The SV&MHS vision to achieve excellence in holistic care and be recognised as a leader in research, teaching and education is founded in a relationship model, which requires partnering with staff, clinical and education partners and research institutions. Developing these partnerships ensures that the organisation is equipped to create new models of care delivery that are at the forefront of patient centred care. The education and teaching strategy is guided by the SV&MHS mission and values. Strategic initiatives ensure that the mission is strengthened and that the organisation has the capacity and agility to respond to, and influence, the changing healthcare landscape as we move into the future.

Current situation The organisation’s strategic framework is underpinned by best practice in human resources and continuous improvement principles and is delivered through innovative programs with a focus on the principles of connection, attraction, retention and engagement. The current programs address a number of key SV&MHS strategic initiatives, creating opportunities for personal growth and development as well as innovation and participation. This ensures current and future staff and supporters are engaged in meaningful and satisfying work which is delivered in harmonious working environments.

Staff and volunteers at SV&MHS have access to a number of learning pathway opportunities. These include: Personal Growth and Skills Development Staff are encouraged to participate in a number of programs which provide for the development of skills, personal reflection and spiritual renewal. These programs include The Gift retreat program, wellness and lifestyle programs and a variety of skills development programs aimed at improving personal effectiveness, interpersonal skills and technical capabilities. Professional Development The organisation supports staff participating in postgraduate studies through a variety of means, including scholarships through university partners, access to leave for formal study. The organisation also offers sponsored university degrees in clinical specialities and courses in ethics and leadership, which have been developed in order to meet the future needs of SV&MHS. Leadership Development SV&MHS offers an extensive leadership development program for current and future leaders. The program is focused on values-based leadership and encourages individual and organisational exploration of leadership models and competency development. This equips leaders with the skills and competencies to address the changing nature of healthcare and ensure sustained leadership across SV&MHS.


workforce, a higher number of students and learners within the organisation, greater reliance on the translation of research to inform clinical outcomes and improve practice, and new and changing models of healthcare delivery, as well as increasing demand for services.

Safety is a number one priority and SV&MHS prides itself on providing a safe work environment. The organisation has received a number of prestigious awards and acknowledgements for innovative occupational health and safety practices in recent times.

The future proposes an exciting opportunity for SV&MHS to be at the forefront of healthcare delivery. However, there are a number of significant challenges to implementating strategic initiatives. These include workforce shortages, access to funding, silo mentality and preparedness to change, infrastructure to support change and the investment required to implement leading edge technology to support communication, education and changing healthcare delivery models.

Aspirations for the future

Our response

The future presents an exciting opportunity for SV&MHS to engage with staff, partners and supporters in the development of innovative programs which will engage the community in the delivery of healthcare. St Vincents & Mater Health Sydney aspires to be at the forefront of innovation by leading the way and working with government, higher education institutions and the community to implement health reform.

SV&MHS has responded to these challenges through the development of the People & Culture Strategic plan 2010-2014. The plan outlines future aspirations for SV&MHS and focuses on the future development of staff through integrated models, programs and learning opportunities. It will result in greater integration of clinical services, as well as providing increased understanding and involvement in research and teaching, and it will maximise the health benefits for patients and society.

There are a number of large scale changes in the future of the healthcare sector including significant improvements in the use of technology and increased partnership in education, teaching and research. There will be an increased requirement to develop future

During 2012 SV&MHS will implement a number of programs which will further enable the future development of staff and the organisation as a whole. These include but are not limited to:

• The implementation of an organisation-wide formation program to ensure that the Organisation’s culture and Catholic identity are embedded, protected and preserved as SV&MHS moves into the future. • To further foster partnerships which enable clinicians to work in partnership with affiliated research institutes to develop research and teaching governance models that respect the individual autonomy of each institute. This is necessary in order to further a shared vision and deliver world class, cost effective research, thus attracting the best and brightest clinicians and clinician researchers to SV&MHS campuses.

many journeys. one vision. | OUR PEOPLE

Additionally, SV&MHS has implemented a number of initiatives to address recruitment and retention across the organisation. These include innovative enterprise agreements for clinical and support staff, reward and recognition programs, electronic performance management systems as well as employment relations toolkits for managers and staff. There is also and an employer branding strategy, which is supported by a dedicated careers portal and online candidate management system.

• The implementation of the St Vincent’s Health Australia Reconciliation Action Plan, including designing and implementing programs which create awareness of Aboriginal and Torres Strait Islander culture, the development of employment programs and the connections with Aboriginal and Torres Strait Islander high school students to provide opportunities in the creation of careers in healthcare. • The implementation of employee self service, which enables staff to access and manage their personal information and development programs whilst allowing management access to important human resource information to improve decision making & workflow. • The implementation of reward and recognition, an electronic in-house reward and recognition program, which is aligned to the demonstration of values, innovation and excellence.

• The implementation of an e-learning and remote access platform to support staff across a broad spectrum of professions, locations and shifts to participate in learning opportunities. The development of such platforms will require a significant investment in technology. • The development of collaborative models which engage education and teaching partners to develop new models of education which embrace the alignment between continuum of learning and the continuum of care.

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The profession of nursing across St Vincents & Mater Health Sydney (SV&MHS) embraces the values and traditions of the Mary Aikenhead Ministries, inherited from the Sisters of Charity and Sisters of Mercy, which has inspired compassion and patient care of the sick and needy for more than 150 years. 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.

Nursing at SV&MHS St Vincent’s Hospital The Division of Nursing at St Vincent’s Hospital focuses both on the experience of staff and patients in healthcare delivery and outcomes. There are numerous opportunities for the professional development of nurses to ensure the clinical effectiveness of nursing practice, as well as optimising personal satisfaction and work-life balance in day-to-day work. In 2011 the Nursing Research Institute (NRI), a partnership between the Australian Catholic University and SV&MHS, celebrated its two-year anniversary. The NRI has established a body of nurse-led research, offering many learning opportunities to build research skills for nurses undertaking and contributing to clinical research. In a major achievement, registered nurse Paul Esplin from the Homeless Health Service was named Australian Nurse of the Year in the 2011 HESTA Awards. The Division of Nursing at St Vincent’s Hospital continues to build on areas of knowledge, clinical skill development and accomplishments. St Vincent’s Hospital now has a permanent full time Clinical Emergency Response System

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(CERS) Clinical Nurse Consultant (CNC). This role coordinates the ongoing development and monitoring of strategies for the early detection and intervention of deteriorating patients. The aim is to reduce adverse events such as unplanned Intensive Care Unit admissions from the ward and unexpected cardiac arrests. The patient with acute condition for escalation (PACE) program, a component of CERS, is building clinical awareness, knowledge and specific skill development to optimise both understanding the clinical trajectory and the response to the deteriorating patient. The CERS CNC has a vested PhD interest in studying underlying clinical aspects in the deteriorating patient, specifically clinical thinking, behaviours and decision-making that influence the efficacy of rapid response systems at St Vincent’s Hospital and also the different models of clinical response across peer hospitals. With a commitment to nurse education and development there are now more than 90 enrolled nurses with extended practice. Increasing numbers of high school students are also undertaking work experience and one such student is already pursuing a career in nursing

in the early offer program at the University of Notre Dame. In 2011, 74 registered nurses undertook the Transition Support Program, and there was a rapid increase in e-learning opportunities. The Nursing Leadership Team at St Vincent’s Hospital identified a number of aspirations to ensure growth and support, with the ultimate aim of ensuring optimum patient care. These include empowering and engaging the workforce - including new recruits; the promotion of nurses as clinical leaders; delivering evidencebased practice with responsive practice development; driving innovation in all aspects of patient care, and celebrating, promoting and profiling excellence in nursing care. The team also focuses on ensuring integrity and uniqueness in nursing practice and working collaboratively with other healthcare professionals. The Nursing Leadership Strategic Plan takes St Vincent’s Hospital nurses into the future, and guides decisions affecting workforce and career, models of care and nursing practice, education and training. The plan also seeks to ensure an engaged workforce within an environment that fosters innovation, performance, accountability and passion.


St Vincent’s Private Hospital was proud to be awarded Magnet designation in May 2011. Magnet designation represents the recognition of nursing excellence and identifies healthcare organisations that epitomise outstanding quality and professionalism. St Vincent’s Private Hospital is the first private hospital to achieve the designation in Australasia. A shared governance model was established to develop shared decisionmaking, responsibility and accountability for autonomous nursing practice. The shared governance framework consists of six practice councils, including the Nursing Executive Council, Clinical Management Council, Nursing Quality and Safety Council, Clinical Policy and Procedure Council, Nursing Education, Training and Development Council and Nursing Practice Development and Research Council. Peer review was introduced as part of the Magnet framework as a mechanism

to reflect upon nurses’ professional practice, and to provide constructive feedback on performance. The review has been trialled in a number of clinical units and it is anticipated that it will extend throughout the hospital as the response to date has seen that peer review improves clinical practice. Building an empowered workforce requires commitment and leadership and is essential to create and sustain a thriving system that is dynamic, adaptive and continually improving. Much work has been undertaken in strengthening rostering practices to ensure a fair and appropriate skill mix across the three shift patterns to provide the best possible patient care. Excellent patient outcomes, that were measured using Nurse Sensitive Indicators (NSIs), were also achieved. These indicators are ‘nurse sensitive’ because nurses have a direct impact on the prevalence of nosocomial

pressure ulcers, nosocomial MRSA rates, medication errors and the rate of patient falls. In all these NSIs, the hospital’s outcomes came within the Australian Council of Healthcare Standard’s national benchmark for 2010/2011. Another major achievement was the successful implementation of a project to reduce the patient’s length-of-stay. The aim was to ensure an appropriate length-ofstay in line with the industry average and was achieved by providing a service for same day admission and also through strong collaboration between nursing and medical staff. In 2010 St Vincent’s Private Hospital commenced planning for a new mental health unit to provide care for young adults between the ages of 16 and 30, stroke service and the redevelopment of the private hospital.

Mater Hospital

St Joseph’s Hospital

The nursing division at the Mater Hospital continues to foster clinical education & a supportive environment for all nursing staff, ensuring continuity of excellence in patient care.

Nursing Administration at St Joseph’s Hospital continues to support nurses with ongoing education and training opportunities. In particular, additional funding was sourced to provide specialty training for palliative care and rehabilitation nurses.

Quality & safety underpin all endeavours and 2010/2011 saw numerous projects with a focus on falls management, medication safety, hand hygiene and prevention of pressure ulcers. In addition, in pursuit of excellence, the Mater, in partnership with the Studer Group, launched Hardwiring Excellence, which assists organisations to create and sustain a culture of service, clinical and operational excellence. The Mater continues its focus on developing and educating an undergraduate and postgraduate nursing workforce. Of particular note is a scholarship program to assist enrolled nurses to achieve registered nurse status. This program has been particularly popular and successful. In partnership with universities, the Mater continues to maximise the number of undergraduate clinical placements. Postgraduate nursing and midwifery student placements are also undertaken at the Mater.

many journeys. one vision. | NURSING AT SV&MHS

St Vincent’s Private Hospital

During 2010/2011, nursing unit managers and nurses supporting in this role were registered to attend the NSW Health “take the lead” programs. Nurses at St Joseph’s Hospital have also been encouraged to consider research activities through the Nursing Research Institute (NRI) and support from the Director and Professor’s of Nursing Research. Regular meetings with the NRI help to keep nurses informed of nursing research activity.

Retention of staff is another key focus. In September 2011, more than 300 staff were set to receive badges commemorating greater than five years’ service at the Mater. Staff satisfaction remains high with the Best Practice Australia staff survey showing 75 percent of staff rated the hospital as a “truly great place to work.”

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St Vincents & Mater Health Sydney (SV&MHS) is assisted in its mission through broad community support and the generosity of many. From local areas in Sydney, to the city, rural NSW and beyond, private and corporate philanthropy & sponsorship play a vital and ongoing role in making the SV&MHS vision, of bringing hope and healing to all, a reality. In 2010, more than $9.5 million was given in donations and bequests, all of which went directly to funding the latest in technology, research and clinical care.

Community support

St Vincents & Mater Health Sydney is grateful to all who join the mission, for all the hard work and dedication, and for the often behind-the-scenes efforts of volunteer groups, supporters and staff. The organisation sincerely thanks all our supporters, donors, bequest donors, friends and volunteers, whose generosity ensures many lives can be saved and many more offered hope and healing than would otherwise be possible.

01 Together with students from local Darlinghurst Primary School, St Vincent’s Hospital and the Garvan Institute of Medical Research create a unique community mural 02 Her Excellency Professor Marie Bashir AC CVO, Patricia Ritchie AM and Dr Keith Hartman

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St Vincents & Mater Health Sydney is generously supported by many trusts, foundations and 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 NELUNE Centre, a world-class centre of excellence in holistic cancer care. The Centre will be located within the new $120 million Kinghorn Cancer Centre - a joint initiative between the Garvan Institute of Medical Research and St Vincent’s Hospital.

Centre for Cancer Care and Research, was officially opened by the Governor of NSW, Her Excellency Professor Marie Bashir, at a garden party. The Foundation is privileged and very grateful for the enduring generosity of Mrs Patricia Ritchie and family.

The Curran Foundation

The NELUNE Centre will provide fully integrated care to cancer patients, regardless of their personal or financial circumstances. Patients will have access to world-class multi-disciplinary services including oncologists, clinical psychologists, researchers, and cancer care co-ordination, as well as access to a variety of patient support services.

The Foundation is also grateful for the continued and generous support of Mr Les Shirato AM. In the past financial year Mr Shirato has given the Foundation a major gift to upgrade the humidicrib in the Special Care Nursery.

The Curran Foundation was established in 1984 in response to funding shortages for public health services in St Vincent’s Hospital. Recognising how a shortage of discretionary funding compromised patient care, staff morale and clinical innovation, the Foundation sought to create an endowment whereby financial support could be provided in perpetuity to the campus. The endowment now stands at close to $13 million, and this in turn has enabled more than 400 equipment, education and research grants. To date the Curran Foundation has provided more than $13 million in grants to the St Vincent’s Hospital campus with a further $4.79 million provided in 2010/2011. In 2010/2011, support from the Foundation included providing financial support for many vital advances. These included the commencement of Australia’s first total artificial heart program at St Vincent’s, development of the homeless health medicottage, intensive care research and equipment grants for theatres, intensive care and general wards. The NELUNE Foundation

The Friends of the Mater Foundation Since 2001 The Friends of the Mater Foundation has provided the Mater Hospital with approximately $6.4 million in grants. Of this total, $2.9 million in grants was awarded in the 2010/ 2011 financial year for a number of purposes including: • Breast cancer research • Orthopaedic research • Purchase of vital equipment for different areas of the hospital • Establishment of a Surgical Oncology Fellowship In addition, through the generosity of the Foundation’s supporters Jim and Jo Miller, accommodation in the form of a cottage close to the hospital has been provided, free of charge to patients from country NSW who are receiving chemotherapy.

Established in 2003, founders of the NELUNE Foundation, Nelune Rajapaske OAM and Anna Guillan, are passionate about helping patients fight cancer with dignity and hope.

Over the past financial year the Foundation increased the number of supporters in the 30 to 45 year old age bracket, following a successful recruitment drive in the second half of the year.

The NELUNE Foundation is fully committed to raising $2.5 million over the next year to complete the establishment of their new initiative,

Mrs Patricia Ritchie AM and family have continued their generous support of the Foundation. In February 2011, the new premises of The Patricia Ritchie

Direct mail fundraising The services of St Vincent’s Hospital are continually strengthened through the generosity of individual supporters. Each year more than 7,000 individual gifts are received from friends, supporters and former patients responding to direct mail appeals, with each appeal focusing on an area of immediate need.

many journeys. one vision. | COMMUNITY SUPPORT

Trusts & foundations

These gifts are vitally important to the Hospital and even the smallest donations add up together to make a big difference. The projects supported in the past financial year include enhancing the care of cancer patients who require Social Work assistance and the purchase of additional critically needed equipment for the wards, theatres, the Speech Pathology Unit, and the Rehabilitation Unit.

Bequests Bequests and donations are essential sources of funding that enable SV&MHS to purchase vital medical equipment, expand activities and ultimately improve both treatment & outcomes for patients. Some key areas that benefited from bequest giving in 2010-2011 were blood diseases and cancer research, oncology research, HIV/AIDS research, orthopaedics, cardiac and urology research, the Heart Lung Transplantation Unit and St Joseph’s Village.

To date the Curran Foundation has provided more than

$13m in grants to the St Vincent’s Hospital campus with a further $4.79 m provided in 2010/2011. 02

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St Vincents & Mater Health Sydney is sincerely grateful for the generosity of those individuals, and their loved ones, who left a bequest to SV&MHS. In particular, the following are acknowledged: St Vincent’s Hospital and the Sacred Heart Estate Joyce (Joy) Monica Allen Estate Leslie Altree-Williams Estate Rosalie Lynette Belcher Estate Dorothy Bennett Estate Gertrude Adeline Bertelsmeier Estate William Frederick Bradshaw Estate Keitha Miriam Brooks Estate Charles Ivan Byard Estate Joan Miriam Claybrook Estate Robert Ian Craig Estate Lalla Marcell Crawley Estate Laura M Crombie Trust Estate Patricia Margaret Garven Estate Harold John George Estate Margetta (Mary) Georgeson Estate Violet Falls Estate Morris Zion Forbes Estate Kevin Vincent (Peter) Hatfield Estate Bernard Kaine Estate Peter David Kells Estate Ralph & Kitty Kiefel Estate Domencio La Rosa Estate Joseph Robert Lawrence Estate Eileen Theresa Mariner Estate Douglas Richard Medland Estate Noel Moylan Estate Cynthia McIntosh Estate Rudolf Frank Muller Estate Linda Estelle Redding Estate George Thomas Richards Estate Bernard D Rothbury Estate Susan Elizabeth Rutherford Estate Esther Rennie Shadler Estate Norma Enid Sheraton Estate Tibor Siklos Estate John Laurence Smith

St Vincent’s Private Hospital Estate Reschs Family Trust Estate Peter David Kells Estate Emma Georgina Norton The Trust Company, as trustee for the Sir Robert & Lady Mollie Askin Charitable Trust The Mater Hospital Estate Devella Joan Dunn-Locke Estate Betty Grace James Estate Domencio La Rosa Estate Clarice Margaret Moloney Community Groups SV&MHS 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 enables 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 clinical staff. SV&MHS has been fortunate to have the support of special groups such as the Australian Federal Police, Sydney TAFE, QBE Insurance, Bondi Junction Rotary Club, Audio Vixen, Rainbows for Kate, Eldersley High School and AAMI Insurance, to name a few.

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. 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.

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The Order of Malta

Love of Life

George and Effie Paliouris

Gorman House offers ongoing, nonjudgemental support and refuge for those with severe drug and alcohol dependency. Since 2006 the Order of Malta has worked to ensure that Gorman House remains a seven-day service. To date, the Order of Malta has donated a total of $834,125 for Gorman House.

Since 2001, Mrs Josephine Minni, the late Mrs Angela Desiderio and their volunteers have raised about $150,000 through donations, charity raffles and the ‘Love of Life’ charity dinner. These funds have enabled research activities within medical oncology at St Vincent’s Hospital.

Since 2004 George and Effie Paliouris have raised in excess of $155,000 for improved patient care and new equipment for St Vincent’s Heart Lung Unit. They recently formed a committee called ’Save a Life‘ which will focus on fundraising initiatives not only in support of the Heart Lung Unit but also for cancer services.

Building on five years of fundraising success, the Order of Malta is aiming to raise a further $170,000 by the end of 2011, bringing total funds raised for Gorman House to $1 million. 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 more than $6.5 million for the enhancement of equipment and educational resources. The support from SIRENS has made a significant impact 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.  In 2010 SIRENS equipment purchases included the Philips Cardiac Ultrasound Monitor System and TOE Machine for the Anaesthetic Department. Planning also commenced for the refurbishment of the Emergency Department’s triage. As St Vincent’s Hospital looks beyond 2011, SIRENS’ special project will be to raise funds to procure a 1.5 Tesla Digital magnetic resonance imaging (MRI) machine (which will allow St Vincent’s to provide a comprehensive state-of-the-art MRI imaging service for patients). SIRENS celebrates its 10 year anniversary in 2011.

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. Malinda Jarry Fund Established in memory of Malinda Jarry, the nursing education trust fund within the St Vincent’s Hospital Intensive Care Unit (ICU) has funded approximately 70 critical care scholarships and 68 nurses to attend ICU conferences. Barry and Carol Pryer Over the past 15 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.’ George and Charis Schwarz

many journeys. one vision. | COMMUNITY SUPPORT

St Vincents & Mater Health Sydney is very grateful to its many supporters, including:

The Mater Lives Committee Formed in 1985 by a group of volunteer women, the Mater Lives Committee supports the hospital through organising fundraising events such as their annual St Patrick’s Day Lunch. These events enable them to not only raise funds for the hospital, but importantly, to also build on the special community feeling and the long standing relationships that are a unique hallmark of the Mater. Some of the recent achievements of the Mater Lives Committee have been their contribution to the refurbishment of the Hospital’s foyer and the establishment of the Mater’s Healing Garden. The garden is a valuable addition to the Hospital and offers a place of quiet reflection for patients, family, friends and staff. The Committee has also contributed to the purchase of vital new equipment for the hospital, including the purchase of a central foetal monitoring unit for the Maternity Ward.

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 generosity 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. Motorcycle Accident Rehabilitation Initiative continues to be strongly supported by the Motorcycle Council of NSW & the BMW Touring Club.

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Group services

In collaboration with the individual facilities that comprise St Vincents & Mater Health Sydney (SV&MHS), a number of departments work across the organisation to provide seamless support and ensure consistency in approach.

Corporate Governance & Planning Corporate Governance & Planning delivers a range of services in support of the organisation’s operational and strategic objectives.

Capital & Service Planning Initiatives Darlinghurst Campus Darlinghurst Clinical & Capital Master Planning Program A major planning process is underway on the Darlinghurst campus to define the future services vision for the campus and to look at the facilities and related technologies required to support that vision in the future. Redevelopment of St Vincent’s Private Hospital Planning has now commenced for the redevelopment of St Vincent’s Private Hospital. The development of a 20-bed unit to provide care for young people with mental illness marks the first step in what will be a staged planning and redevelopment program for the hospital. The new unit, which will be the first of its kind in the private sector within Australia, will open in early 2012. The Kinghorn Cancer Centre St Vincent’s Hospital and the Garvan Institute of Medical Research are working together to create The Kinghorn Cancer Centre. The new centre, which is due for completion in mid 2012, will provide modern, integrated clinical and translational research facilities focused on the prevention and treatment of cancer.

St Joseph’s Campus Capital Master Plan A capital master plan has been developed for the St Joseph’s campus. The plan will guide decision making about future service and capital investments for both St Joseph’s Hospital and St Joseph’s Village.

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many journeys. one vision. | GROUP SERVICES

Huntington’s Disease Unit

Griffith Community Private Hospital

Planning is advanced for the development of a new 20-bed facility to care for people with Huntington’s Disease. The new $4.8 million unit is being funded by a grant from NSW Health.

Griffith City Council continues to seek funding to develop a 40-bed community-owned private hospital in Griffith. A capital funding contribution is being sought from the Commonwealth’s Health and Hospitals Fund, with Council’s funding bid, which was prepared by SV&MHS, to be considered in the second round of funding to be announced in 2011 and awarded in 2012.

Youngcare SV&MHS is working with Youngcare to explore the potential to develop a new facility to house young people with disabilities on the St Joseph’s campus. A capital grant will be sought from the Commonwealth to fund the new development.

North Sydney Campus Poche Centre The Poche Centre, which houses Melanoma Institute Australia (MIA), opened in early 2010 and will contribute to improved research and clinical care for those with or at risk of melanoma. As a final stage in the project, work is in train to integrate the new building into the day-to-day operations of the Mater. Patricia Ritchie Cancer Centre With the opening of the new Patricia Ritchie Centre for Cancer Care and Research in the renovated convent building, the Mater’s cancer patients now receive ongoing chemotherapy and supportive care in a homestyle environment. The move into the new premises was completed in September 2011, providing increased office space and work stations for the clinical trials department.

Rural & Regional Projects Griffith Community Private Hospital and Murrumbidgee Teaching & Learning Centre As part of its commitment to rural health, SV&MHS continues to work with Griffith City Council to improve healthcare services for the benefit of Griffith and the surrounding community, with two key initiatives in planning or development.

Murrumbidgee Teaching and Learning Centre SV&MHS has secured $5 million in capital funding from the Commonwealth’s Innovative Clinical Teaching and Training Grants Program to develop a teaching and learning centre in Griffith. The new centre, which will host students from five affiliated learning institutions, will commence construction in 2012. Wollongong Private Hospital In collaboration with the University of Wollongong and NSW Health, SV&MHS continues to explore the feasibility of establishing an academic health complex in Wollongong. The development, which is intended to bring additional health services and health expertise to serve the Wollongong and surrounding community, is subject to the university securing capital funding. Corporate Risk Management: To optimise effective risk management, SV&MHS released an enterprise-wide Risk Management Framework in 2011 and appointed two key roles. A Risk Officer has been appointed to provide day-to-day support and risk management education across SV&MHS, and Legal Counsel has been appointed to provide legal advice on new business opportunities and day-to-day operational matters. Assets and Facilities Management: In February 2011, Corporate Governance and Planning assumed responsibility for assets and facilities management across SV&MHS. The restructure will provide continuity at a strategic and operational level in the planning, development and maintenance of the asset base across the organisation.

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Throughout 2010/2011 Financial Performance and Analysis provided financial support for a number of major strategic initiatives, including the new young adult mental health unit for St Vincent’s Private Hospital, and campus master planning for the future.

Environmental Services Environmental Services caters for the environmental needs of St Vincent’s 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. There have been improvements in cleaning standards at all SV&MHS facilities following the implementation of the Top Cleaning Audit Tool (CAT), which has pinpointed any areas for improvement and seen them immediately acted upon. The Nocospray patient room disinfectant spray system has been implemented and this together with a full cleaning review in St Vincent’s Hospital is designed to reduce maintenance, repair and operations and further improve patient outcomes. Waste management has also improved with theatres now recycling scissors and endomechanical devices, in addition to recycling all Kimguard plastic. Special new recycling stations are being rolled out to continuously lessen waste sent to landfill.

Financial Performance & Analysis The Financial Performance and Analysis Centre provides management accounting support for St Vincent’s Private Hospital, Mater Hospital, St Vincent’s Clinic, Sisters of Charity Outreach and to the Chief Executive’s Office. The centre provides a variety of services, including co-ordination of the annual budget process, reporting and analysis of performance, and provision of clinical costing data. Throughout 2010/2011 the centre provided financial support for a number of major strategic initiatives including the new young adult mental health unit for St Vincent’s Private Hospital, and campus master planning for the future. Significant improvement was achieved with enhancement to reporting and provision of information with the implementation of QlikView, a new online reporting system. The department also coordinated the facilitation of data for the new group office Board scorecard reporting process. Recognising the value of education, the centre mentored a number of students from the accounting body CPA Australia, as well as participated in the graduate accounting program. 160

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Finance & Performance Department The Financial and Performance Department provides management accounting and case mix support for St Vincent’s Hospital, Sacred Heart, St Joseph’s Hospital and St Joseph’s Village. The department provides a variety of services, including co-ordination of the annual budget process, reporting and analysis of performance, and provision of clinical costing data. Financial support was provided for a number of major strategic initiatives including the transfer of St Joseph’s Hospital finance function from Sydney West Area Health Service to the SV&MHS Finance Department, the new Huntington’s Disease Unit at St Joseph’s Hospital, implementation of activity-based budgeting for clinical supplies, revenue de-centralisation and salary and wages classification. Significant improvement was achieved with enhancement to reporting and provision of information with the implement of QlikView, a new online reporting system. The department also coordinated the collection of data for the new St Vincent’s Health Australia group office Board scorecard reporting process. During 2010/2011 the Department established an effective relationship with the NSW Department of Health, following the move to St Vincent’s Local Health Network (SVLHN), as per current service performance agreement when published. No longer reportable to the Area Health Service, the Department instead reports directly to NSW Department of Health. The Department has been working in partnership with the NSW Department of Health on a number of different strategic projects including a heart/ lung funding model, activity based funding (ABF), work streams and ABF technical reference group. Recognising the value of education, the Department mentored a number of students from the accounting body CPA Australia, as well as participating in the graduate accounting program.


many journeys. one vision. | GROUP SERVICES

Financial Services Centre The Financial Services Centre (FSC) provides financial shared services to SV&MHS, including accounts payable, accounts receivable, billing, credit control, financial accounting, revenue, tax and treasury. In 2010/2011, the centre paid more than 132,000 invoices and raised more than 330,000 patient and health fund bills. The team prepared and audited annual accounts for 12 legal entities and received a clean audit report. Two notable achievements were the transition of St Joseph’s Hospital accounting from Sydney West Area Health Service to the FSC and the conclusion of a banking tender, which retained incumbent bankers National Australia Bank. The latter kicked off a major project to transform and improve billing, receipting and use of cash within SV&MHS. This showed tangible benefits within its first three months. Finally, a graduate accounting program was initiated where five full time accounting graduates rotate every 12-months through different roles in each section of the department. This enables them to gain practical experience while studying for the professional qualification of either Chartered Accountant or Certified Practising Accountant.

Food & Nutrition Services Food and Nutrition Services gained an A rating accreditation from the NSW Food Authority for the second year running and was awarded SGS Hazard Analysis and Critical Control Points (HACCP) annual certification for all food service facilities at the St Vincent’s campus and Mater Hospital for the first year. In recognition of the diversity of those served across SV&MHS, the Mater Hospital implemented a high tea for maternity patients and a special paediatrics tray was developed for younger patients. With the renewal of the coffee contract, Sacred Heart will receive two special coffee carts and the St Vincent’s Hospital hot beverage service has been improved. The entire patient menu is being reviewed to comply with the updated Nutrition Standards for Adult Inpatients in NSW hospitals, while the current seven-day menu cycle is being expanded to 14-days in preparation for the new young adult

mental health unit at St Vincent’s Private Hospital. A recipe testing and evaluation program has been developed and all new recipes have been measured against the new NSW Nutrition Standards for Adult Inpatients. The computerised wireless Bedside Menu Service has been implemented across the St Vincent’s campus and a detailed survey of more than 200 patients and staff was conducted to monitor its effectiveness. Results indicated a three-fold increase in patient and staff interactions, significant improvements in patient satisfaction and strong staff support for the new system. Overall the patient feedback scores measured via Press Ganey have improved significantly over the year. Nutrition screening and assessment reporting systems have been developed for dietitians to improve monitoring of patients at risk of malnutrition. Dietitians have access to information providing a snapshot of patients who have been nutritionally screened on admission or have not eaten for three or more days.

Group Purchasing & Supply Responsible for the storage, issue, delivery and receipt of items, Group Purchasing and Supply supports the operations of all facilities across SV&MHS. In 2011 the implementation of the SV&MHS Theatre Management System project was completed across all entities, including peri-operative areas. The department also commenced the St Vincent’s Health Australia Group Procurement Committee with a target to reduce expenditure by $3 million and to standardise product and prices across all states. St Joseph’s Hospital was serviced with the commencement of procurement and distribution of goods and supplies from February 2011. Staff at the department’s warehouse commenced pre-introduction to the Certificate 111 Transport and Logistics course and there has been the development and implementation of the Group Product Catalogue for SV&MHS, with more than 78,000 already logged.

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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 human resources transactional model, the department assists managers in delivering a stronger, more competitive business by helping them to engage with their people to maximise the service delivery across the continuum of care. SV&MHS HR provides expert specialist knowledge in leading edge human resource solutions which can be translated an operational level. Professionals from the department work closely with business leaders to influence strategy and steer its implementation. The department’s excellence has recently been recognised by a number of awards, including winner of Mental Health Promoting Workplace from the NSW Mental Health Association. The department was also a finalist and highly commended by the National Safety Council of Australia and GIO, as well as Workcover NSW, for Best OHS Management System and Best Solution of an OHS Specific Risk and was a finalist in the NSW Treasury Managed Fund Awards for risk and injury management.

Information Technology Service Centre Servicing SV&MHS, the Information Technology Service Centre continues to develop and implement the deLacy clinical information system at St Vincent’s, St Vincent’s Private and Mater Hospitals. The system supports multi-disciplinary care teams and quality patient care, through the provision of clinical communication, effective and efficient processes and risk identification and management. Following its successful commercialisation in 2010, and being re-badged Emerging Health Solutions, the system is being implemented across all South Australian public hospitals. In 2010 the hospitals on the Darlinghurst campus commenced implementation of several new systems projects that will allow wireless access to patient’s vital signs monitors and infusion pumps. These projects are examples of Australia-first

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implementations and will raise the bar for the safety and quality information technology initiatives. SV&MHS was successful in attracting Commonwealth Department of Health and Ageing funding to be one of six e-health, wave-two implementation sites for the personallycontrolled electronic health record. The e-health project will improve interaction and engagement with general practitioners and local divisions of general practice. The electronic sending and receiving of medical referrals, discharge summaries and specialist letters will be enhanced with the implementation of a personally-controlled, shared electronic health record during 2011/2012.

Medici Graphics Medici Graphics supports the activities of SV&MHS with graphic design, photography and printing services. In 2010/2011 Medici Graphics continued to make significant contribution to the organisation’s endeavours through the creation and development of a wide range of collateral, including posters, programs, magazines, patient booklets and books. Throughout the year, Medici Graphics engaged in many projects including The Evolution of Haematology (a book following the history of haematology at St Vincent’s Hospital), the St Vincent’s Public Health Services Strategic Intent document, a new patient compendium for St Vincent’s Private Hospital and the SV&MHS Reconciliation Action Plan. Working closely with Internal Communications, Medici Graphics continues to publish Health Spirit, a full colour bi-annual magazine for staff from across SV&MHS. Medici Graphics completed a branding review, which looked at use of the corporate brand across various mediums. Findings and recommendations will be valuable in the roll out of the new brand in the coming months particularly in relation to promoting consistency in use of brand, helping to support brand recognition and the overall image of SV&MHS.


Occupational Health & Safety

Security Services

The SV&MHS Occupational Health and Safety (OH&S) team provides advice and consultancy, training, injury management and workers compensation services and resources for all SV&MHS facilities. The injury management team is International Disability Management Standards Council (IDMSC) certified.

The Security Service has a mission statement to provide a safe and secure environment, protect the assets of the campus and contribute to the organisation’s reputation as a leading provider of quality healthcare.

In 2010 the face-to-face mandatory training program was converted to an online e-learning platform called Workplace Safety & Culture. The new training package allows staff to undertake training at any time, stopping and starting as many times as they like. This program covers all key safety disciplines such as OH&S, fire and emergency response training, human resources, mission and values, waste, minimisation of aggression and infection control. In July 2010 a new Clinical Manual Handling Associates Program was introduced for staff working in clinical areas. Each ward and department nominated a manual handling champion to act in the associate role, whose responsibility it is to provide clinical staff in their department with hands-on training in the manual-handling equipment most commonly used.

many journeys. one vision. | GROUP SERVICES

In July 2010 a new Clinical Manual Handling Associates Program was introduced for staff working in clinical areas. Each ward and department nominated a manual handling champion to act in the associate role, whose responsibility it is to provide clinical staff in their department with handson training in the manual-handling equipment most commonly used.

Staff manage access to the site, conduct security patrols, respond to safety and security issues at a unit level and monitor key sites on the campus that have a high risk factor including the emergency department, campus perimeter after hours and the adult acute mental health unit. In 2010/2011, the department upgraded existing electronic security infrastructure and systems to support security functions for emergency response, access control, CCTV monitoring and key management. Ongoing planning continues for the development of a single SV&MHS security system. Meanwhile, a new security technology has been introduced to the O’Brien Centre.

With the establishment of the new St Vincent’s Health Network, the injury management team of St Vincent’s have taken over the management of workers compensation for St Joseph’s Hospital. To ensure staff are offered best practice, evidence-based medical treatment at the time of injury, appointments are available with either IMMEX, for Darlinghurst and North Sydney staff, or Quality Occupational Health for St Joseph’s staff. Staff of SV&MHS are provided with access to specialised medical and physiotherapy services to facilitate a timely recovery and return to work.

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Contacts & Acknowledgements

St Vincents & Mater Health Sydney

Mater Hospital

406 Victoria Street, Darlinghurst NSW, 2010, Australia

Rocklands Road, North Sydney NSW, 2060, Australia

www.svmhs.com.au

P +61 2 9900 7300 F +61 2 9959 4110 www.materhospital.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 Sacred Heart 170 Darlinghurst Road, Darlinghurst NSW, 2010, Australia P +61 2 8382 9444 F +61 2 8382 9518 St Vincent’s Private Hospital

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 9646 8200 F +61 2 9649 9614

406 Victoria Street, Darlinghurst NSW, 2010, Australia P +61 2 8382 7111 F +61 2 8382 7234 www.stvincentsprivatehospital.com.au

St Vincents & Mater Health Sydney (SV&MHS) sincerely acknowledges all staff, patients and volunteers for their participation.

The 2010/2011 SV&MHS Annual Review was produced by the Public Affairs & Communications Department of SV&MHS. Editor: David Faktor Production Manager: Denise Coughlan Writer: Sarah Blake Design & Art Direction: Designer Rice Pty Ltd Photography: Grant Turner, Roslyn Sharp & Mark Tedeschi For all inquiries contact: SV&MHS Public Affairs & Communications P +61 2 8382 2866 E dfaktor@stvincents.com.au St Vincents & Mater Health Sydney Ltd ABN 36 054 594 375

© 2012 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. 164

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