NBMLHD 2024 Innovate Together Quality Awards

Published: 18 September 2024

NBMLHD Innovate Together Quality Awards 2024

The 2024 Innovate Together Quality Awards recognise the outstanding achievements of staff to achieve safety and quality improvement in our health care services.

This year 19 projects were nominated that contribute to innovations in care, improvements in service delivery and staff expertise and dedication to providing high-quality health care.

Winners of the awards were announced in a special ceremony presentation on Wednesday 25 September.

Congratulations to:

Keeping People Healthy 

Recipient of Chief Executive's Safety & Quality Award

Community Health Care Physiotherapy - A wait list management strategy

With waitlist challenges plaguing our community physiotherapy service, several initiatives were implemented to improve patient experience and expedite assessment and intervention. Clinicians were reassigned based on geographical needs, acute care schedules assisted with resource planning, enhancing the skill of allied health assistants expanded capacity for new assessments, while personalised phone screenings of waitlisted clients improved triage and referral processes. Along with a new physio-led strength and balance assessment clinic to categorise clients for group interventions, these efforts culminated in a 51% reduction in the waitlist with average wait times dropping from 216 days to 46 days.

By streamlining referrals and minimising wait times, the project effectively reduced risks associated with prolonged waits, ultimately enhancing overall health outcomes for individuals in need, including their physical, social, and emotional wellbeing. 

Excellence in Multicultural Healthcare 

Virtual Health Interpreters – saving the planet one km at a time

The "Virtual Health Interpreters Service" pilot at Nepean Hospital aimed to improve patient care and workforce experience by introducing a Video Interpreting service. The project successfully increased interpreter usage from 152 sessions in 2019 to 329 sessions in 2023, subsequently improving patient and clinician satisfaction. The project also resulted in significant cost savings and carbon emission reductions, with an estimate reduction in 1.82 metric tonnes of CO2e and a reduction in travel costs by 93%. The project's success has implications for long-term health outcomes and community well-being. By improving access to interpreter services, especially for culturally and linguistically diverse patients and the deaf community, the project contributes to equitable healthcare access, potentially reducing disparities in health outcomes. 

Environmental Sustainability

The Story of Big Foot and Little Foot  

Fitpacks are single use plastic containers widely used in NSW Needle and Syringe Programs (NSP) to vend sharps kits from needle vending machines. NBMLHD has 9 vending machines across the LHD and vends up to 79,000 packs per year. The Fitpacks project sought replaced the single-use plastic containers with cardboard packs. A trial at Nepean Hospital successfully demonstrated the feasibility of this change, leading to its extension to other facilities. The project has resulted in estimated reductions of 1.6 tonnes of single-use plastic waste and $26,000 in procurement costs, while maintaining positive patient outcomes. Future plans include replacing the remaining plastic fitpack machines with cardboard-compatible models.

Patient Safety First 

Stroke Rehabilitation – A Faster Pathway for all

With 1 stroke occurring every 19 minutes in Australia, strokes are a significant cause of acquired adult disability. Early rehabilitation is proven to reduce the functional impact of stroke and long-term disability. The stroke rehabilitation pathway at Nepean Hospital aimed to improve the timeliness of rehabilitation access for stroke patients. The pathway, implemented in February 2024, uses a rehabilitation Clinical Nurse Consultant role to screen all admitted stroke patients for suitability for a rehabilitation consultation. The time to rehabilitation assessment has reduced from 13 to 4 days and the time from acute to rehabilitation episode admission has reduced from 17 to 7 days. The pathway has also enabled early communication with patients about their stroke recovery and prognosis, and better coordinated care and out-of-hospital follow-up for discharged patients. 

Patient Safety First Highly Commended: Touchpoint Program – Nepean Hospital Access & Flow

The Touchpoint Program aims to improve patient and staff experiences at Nepean Hospital by enhancing access and flow. The program has achieved significant improvements in key performance indicators, such as time to treatment in Triage 2 categories up 31%, and discharges by midday up 10%. Initiatives implemented as part of the program include the development of an estimated day of discharge guide, staff engagement campaigns, and process improvements for Good to Go discharges. The Touchpoint Team has played a crucial role in the program's success through their ongoing engagement with staff and collaboration with various departments. 

People and Culture 

Safewards in Action

The Safewards project aimed to reduce workplace violence towards nurses in medical/surgical hospital wards. The project successfully implemented Safewards interventions in eight wards, focusing on strategies to avert, mitigate, and manage violence. The project has resulted in a positive impact on nurses' wellbeing, job satisfaction, and retention rates, ultimately enhancing the quality of patient care. Additionally, the project has contributed to a friendlier and safer environment for both patients and nurses. 

Innovation 

STEP in the right direction

The Short Term Escalation Plan (STEP) Tool was developed to address the challenges of resource allocation and prioritisation within Nepean Hospital's Physiotherapy Services. The tool, which categorises the impact on service delivery as Green, Amber, Red, or Black, has been successfully piloted and is now being extended to all wards. 

The STEP Tool has demonstrated significant improvements in staff perception of escalation processes, leading to enhanced coordination and responsiveness across the hospital's Physiotherapy Services. By ensuring timely intervention, the STEP Tool helps reduce the average length of stay for patients, leading to improved patient experiences and outcomes.

Physiotherapists are also able to dedicate more time to developing personalised treatment plans in line with the patients’ needs and goals, and helps staff use time for non-clinical tasks such as education, training, and quality improvement activities. 

Transforming the Patient Experience Award

Ticking off the Bucket List - Virtual Reality in Palliative Care

Patients admitted under Palliative Care often admitted into hospital with escalating symptom due to disease progression, often preventing them from travel and visiting ‘bucket list’ locations or returning to places that have personal meaning for them.

The project aimed to evaluate the impact of virtual reality (VR) on palliative care patients. Nine patients participated in the study, undergoing VR experiences in various locations. Pre- and post-VR symptom assessments and qualitative interviews were conducted. The results showed that VR was well-tolerated, provided a positive and enjoyable experience, and had a positive impact on patients' mood and wellbeing. While the study was limited by its small sample size and short duration, it suggests that VR holds promise as a non-pharmacological intervention for palliative care patients. 

Health Research

Recipient of Board Chair's Health Research & Innovation Award

Specialised Obesity Services Reduce Hospitalisations and ED Presentations

The Nepean Blue Mountains Family Metabolic Health Service (FMHS) has demonstrated significant reductions in acute hospital use and healthcare costs for individuals with severe obesity. A study of 640 patients found a 31% reduction in ED presentations and a 17.6% reduction in acute hospital admissions in the year following attendance at a dedicated obesity service. Adequate engagement with the FMHS, defined as ≥5 visits, was linked to a 48% decreased risk of acute admission. The study also revealed improvements in patient outcomes, such as reduced hospital admissions for specific diseases and enhanced quality of life. These findings highlight the effectiveness of public obesity services in addressing the burden of severe obesity on the healthcare system. 

Excellence in the Provision of Mental Health Services

Interdisciplinary Team Project

The Interdisciplinary Team Project redesigned clinical processes within NBMLHD Mental Health Services with the aim of improving continuity of care and collaborative care planning. Key components of the project included aligning clinical teams with community catchment areas, establishing a dedicated care coordinator role, and implementing a new care planning process that focuses on person-centered care. The project has been implemented in stages and has received positive feedback from consumers, carers, and staff.

Additional entries:

Community Health Care - My Care Plan (MCP)

My Care Plan aims to improve the care planning process for clients in Community Health Care. The project involved the development of a new care plan form that consolidated existing documents and focused on person-centered care. The new form has been well-received by both staff and clients, with positive feedback on its ease of use, effectiveness in promoting collaboration between clients and their clinician, and contribution to improved care planning. The project has demonstrated that the new care plan form is a valuable tool for enhancing the quality of care provided in Community Health Care while meeting NSQHS, Aged Care Quality Standards and clinical documentation requirements. 

DETECT-ability

DETECT aimed to improve training compliance and effectiveness for Allied Health staff working in Drug and Alcohol services. Recognising the need for tailored content, the project developed localised training programs that mirrored real-world scenarios faced by clinicians. The training incorporated practical procedures and scenarios relevant to patients, empowering clinicians to apply their new knowledge directly to patient care. The service has not only achieved remarkable compliance rates, but also improved staff skills and fostered a culture of continuous learning within the Drug & Alcohol service. 

Establishment of the Community Health Movement Disorders Pilot Service

The Movement Disorders Pilot Service has developed a unique model of care that focuses on early intervention and improved quality of life for people living with movement disorders in the community.

The service offers clear referral pathways for diagnosed movement disorder patients and provides early education and intervention for newly diagnosed individuals.

Patients in the service benefit from increased awareness of their condition, improved support throughout their medical journey, and implementation of self-management strategies. The service conducts comprehensive assessments and screens for appropriate referrals to allied health and nursing services, reducing inappropriate referrals and alleviating pressure on community health teams.

Introducing a Near-Peer Model of New Graduate Support

The New Graduate Occupational Therapy Program at NBMLHD has been redesigned to provide enhanced support to new graduates through a near-peer learning model. The program aims to address skill gaps, improve clinical skills and knowledge, and foster a supportive environment for new graduates. The redesign has been highly successful, with 100% of participants indicating that the program contributed to their skill development and feelings of support. The program's emphasis on peer support, education, and mentoring has positively impacted the quality of care provided by new graduates, ultimately leading to improved patient experiences.

New Graduate Recruitment: A New Perspective

To recruit more work-ready occupational therapy graduates with diverse clinical and non-clinical skills, the interview structure for the new graduate program was modified from a traditional 4:1 panel into a ‘café style’ interview. Interview questions were modified to focus more on emotional intelligence, empathy, awareness and risk assessment skills. As a result, there was a 43% increase in retention of new graduates in the District, up to $138k in savings on training and recruitment costs has been made, and staff with these skills are better placed to develop rapport and a productive therapeutic relationship with patients.

NURSE: Nurse Upskilling for Respiratory Service Excellence

NURSE is a pilot program developed to empower nurses through education and team environment to boost morale and retain skilled staff. Volunteers participated in a multi-modal curriculum program over four months on clinical and non-clinical topics. Through pre and post program questionnaires, confidence, ability and knowledge of our nursing staff was shown to be enhanced, ultimately leading to an improvement in workplace satisfaction amongst the involved staff as well as improved patient outcomes.

One form to rule them all

The Individual Threat Assessment form was developed to streamline the process of gathering information about patients exhibiting behaviours of concern. The form has proven to be an efficient tool, saving clinicians time and improving patient care. By providing a comprehensive understanding of patient behaviours and triggers, the form enables tailored interventions, reduces the risk of harm to staff and patients, and improves the overall patient experience. Additionally, the form has facilitated smoother transitions for patients to NDIS accommodation and aged care facilities.

Oral Health Patient Reported Experience Measures (PREMs)

The Patient Reported Experience Measures project aimed to improve patient experiences through the development and implementation of a comprehensive patient-reported experience measures (PREMs) survey to gather feedback on various aspects of care delivery. The surveys have been successfully used to identify areas for improvement, implement targeted interventions, and foster a culture of continuous improvement within the dental clinics. The project has demonstrated significant improvements in patient satisfaction, communication with staff, infection control protocols, and overall clinic experiences.

The dental clinics have significantly enhanced their ability to capture timely and relevant insights into patient experience, using QR codes across the clinics and sending the patients SMS with the survey links following their dental appointments. iPads were also offered for patients who do not have smart phones as a convenient and accessible platform for gathering patient feedback.  

Walanbang Gabingidyal - Very Strong Beginnings 

The Building Stronger Foundations Child and Family Health Service at Lithgow was renamed Walanbang Gabingidyal (Very Strong Beginnings) in 2023 after a community engagement process. The Wiradjuri name was chosen in consultation with local Aboriginal people and a language custodian. A Naming Ceremony attended by 70 staff and community members included a Smoking Ceremony and formal smoking of the Community Health Centre. The new name has been well received by the community and enhances the social and emotional well-being of families. The service is now more culturally safe and inclusive. Further feedback will be sought to assess the impact of the name change on community engagement. The launch was promoted through various channels, including media, invitations, and social media.  

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