quality of care report 2015-16 - monash health · 2020-02-05 · dari quality of care report text...

MonashHealth

QUALITY OF CARE REPORT 2015-16

DELIVERING EXCEPTIONAL CARE, OUTSTANDING OUTCOMES

Contents

About Monash Health Report of the Chair of the Board and Chief Executive

Partnering with consumers

National Standards Feedback and distribution

4 6 7

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Monash Health acknowledges the Traditional Owners of this land, the Wurundjeri and Boonwurrung People, who are part of the Kulin Nation.

We pay respect to their Elders past and present whose ancestral land it is upon which we provide care to the community.

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Quality of Care Report text for translation

English Arabic The purpose of this Monash Health Quality of Care Report is to inform consumers, carers and our community about our quality and safety performance and what we are doing to improve our services.

Chinese Croatian Monash Health

Svrha ovog Izvješća organizacije Monash Health o kvaliteti zdravstvene skrbi je informirati korisnike, skrbnike i našu zajednicu o kvaliteti i sigurnosti davanja usluga i što činimo da unaprijedimo naše usluge.

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Ο σκοπός της Αναφοράς Ποιοτικού Ελέγχου Φροντίδας του Monash Health είναι να εμημερώνει τους χρήστες υπηρεσιών υγείας, φροντιστές και πολίτες της περιοχής μας για το επίπεδο της παρεχόμενης ποιότητας και ασφάλειας καθώς και τις ενέργειες που καταβάλλονται για τη βελτίωση των υπηρεσιών μας.

Khmer Russian

Организация Monash Health подготовила этот отчет о качестве обслуживания и ухода, чтобы проинформировать наших клиентов и тех, кто ухаживает за больными и инвалидами, о качестве, безопасности и совершенствовании наших услуг.

Serbian Somali Овај Извештај о квалитету здравствене неге организације Monash Health има за циљ да информише кориснике, неговатеље и нашу заједницу о квалитету и безбедности давања услуга и шта радимо да унапредимо наше услуге.

Ujeedada Warbixintan Daryeelka Tayada Monash Health waa in la wargeliyo isticmaalayaasha, daryeelayaasha iyo bulshadeena wax ku saabsan waxqabadka ammaanka iyo tayadeena, waxaan sameynayno si aan u hagaajino adeegeena.

Spanish Turkish El objetivo de este Informe sobre la Calidad de los Servicios de Atención prestados por Monash Health es comunicar a nuestros clientes, cuidadores y comunidad sobre la calidad y seguridad de nuestros servicios y nuestros planes para mejorarlos.

Monash Sağlık Kalitesi Bakım Raporunun amacı, kalite ve güvenlik performansımız hakkında tüketicilere, bakıcılara ve toplumumuza haber vermek ve hizmetlerimizi geliştirmek için neler yaptığımızı bilgilendirmektir.

Italian Vietnamese Lo scopo di questo Rapporto sulla Valutazione dei Servizi prestati da Monash Health è di informare ai nostri clienti, badanti e la nostra comunità riguardo la qualità e sicurezza dei nostri servizi e i nostri piani di miglioramento di questi servizi.

Mục đích của bản tường trình thành quả chất lượng chăm sóc của Dịch Vụ Y Tế Monash là để thông tin cho bệnh nhân, người chăm sóc người bệnh và cộng đồng chúng ta về hiệu năng an toàn và phẩm chất phục vụ của chúng tôi; đồng thời thông báo những gì chúng tôi sẽ làm để cải thiện các dịch vụ này.

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The purpose of this Monash Health Quality of Care Report is to inform consumers, carers and our community about our quality and safety performance and what we are doing to improve our services

BURMESE:

ဤ “ေမာန္က္ရွ ္က်န္းမာေရးဌာန ျပဳစုုေစာင့္ေ႐ွာက္မႈ အရည္အေသြးဆုိင္ရာ အစီရင္ခံစာ” (Monash Health Quality of Care Report) ၏ ရည႐္ြယ္ခ်က္မွာ ဝန္ေဆာင္မႈရသူမ်ား၊ ျပဳစုုေစာင့္ေ႐ွာက္သူမ်ား ႏွင့္ ကၽြႏ္ု္ပ္တို႔၏ လူမႈအသုိင္းအဝိုင္းအား ကၽြႏု္ပ္တုိ႔၏ အရည္အေသြးဆုိင္ရာ ႏွင့္ ေဘးကင္းလုံၿခံဳမႈဆိုင္ရာ ေဆာင္႐ြက္လုပ္ကုိင္ေနမႈမ်ားအေၾကာင္းကုိလည္းေကာင္း၊ ကၽြႏ္ုပ္တုိ႔၏ ဝန္ေဆာင္မႈမ်ား ပိုၿပီးေကာင္းမြန္လာေအာင္ ကၽြႏု္္ပ္တုိ႔ မည္သည့္အရာမ်ား လုပ္ေနျခင္းအေၾကာင္းကုိလည္းေကာင္း၊ သတင္းေပးရန္အတြက္ျဖစ္ပါသည္။

Burmese

EnglishQuality of Care Report text for translation




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Monash Health | Quality of Care Report 2015-164

Our vision and valuesVISION

Exceptional care, outstanding outcomes.

PURPOSE

To deliver quality, patient-centred healthcare and services that meet the needs of our diverse community.

About usWe are proud to provide healthcare to one quarter of Melbourne’s population.

We uniquely provide healthcare across the entire life-span from newborns and children, to adults, the elderly, their families and carers.

We improve the health of our community through:

• Prevention • Early intervention • Community-based treatment and rehabilitation • Highly specialised surgical and medical diagnosis, treatment and monitoring services • Hospital and community-based mental health services • Comprehensive sub-acute and aged care programs • Palliative care • Research • Education and teaching the next generation of healthcare professionals

VALUES

We remain firmly committed to our iCare values:

• Integrity • Compassion • Accountability • Respect • Excellence

Monash Health | Quality of Care Report 2015-16 5

Our care at a glance in 2015-16

Total episodes of care

Hospital admissions

Emergency presentations

Surgical operations

Outpatient services

Ambulance arrivals

Mental health contacts

Babies delivered

Paediatric admissions

Pathology tests

3.47 MILLION 251,372 218,272

47,436 1.14 MILLION 53,026

249,415 9,896 39,628

990,000

More than 3.47 million episodes of care provided across the community.

More than 251,372 people admitted to our hospitals.

More than 218,272 people came to our three emergency departments for treatment.

More than 47,436 operations performed.

More than 1.14 million occasions of service provided by our outpatient services.

More than 53,026 ambulance arrivals handled by our emergency departments.

More than 249,415 client contacts. There were 9,896 babies delivered. More than 39,628 admissions of children under age 19 to our children’s wards and neonatal units.

There were 990,000 tests carried out by our pathology service.


Report of the Chair of the Board and Chief Executive

It is with great pleasure that we present Monash Health’s Quality of Care Report for 2015-16. This report provides our valued and diverse community with details of our performance against healthcare standards and highlights our achievements of 2015-16.

Improving the patient experience is everyone’s responsibility and everyone’s opportunity.

A significant focus for us in 2015-16 has been delivering care to each and every patient in a way which we would advocate for our own loved ones.

In our continued pursuit to ensure the highest quality patient care, we have developed the Patient Experience Strategic Plan which outlines the steps we need to take over the next three years to become national leaders in patient experience. The plan includes a focus on fostering a culture of accountability, transparency and collaboration and giving

frontline staff the power to act and lead change.

We engage with consumers on many levels in our planning and improvement processes, and our Community Advisory Committee provides valuable strategic advice and a community perspective which informs the way we provide our services.

We will continue working to implement a wide range of quality-related initiatives that aim to deliver superior care and improved experiences for our patients.

In this report, you will learn how we have worked to improve quality and safety at Monash Health over the past 12 months.

In 2015-16, we delivered more than 3.47 million episodes of care, 218,272 patients attended our three emergency departments, there were 9,896 babies born, our mental health team made 249,415 contact appointments with clients, and our paediatric service admitted

39,628 children and babies and adolescents.

This would not have been possible without the commitment of our staff and volunteers who work tirelessly every day in providing care to our community.

We look forward to continuing to work in partnership with our consumers and the community to deliver safe, effective and world-leading healthcare in Victoria.

Barbara Yeoh Chair, Board of Directors

Andrew Stripp Chief Executive


Monash Health is working together with patients, their families and carers, to create an environment in which we deliver exceptional experiences for all.

Improving the patient experience

The Beryl Institute defines patient experience as the sum of all interactions, shaped by an organisation’s culture, that influences patient perceptions across the continuum of care. It is everything that the patient feels, sees, hears and touches throughout their care journey.

Patient Experience Strategy

Monash Health has developed a Patient Experience Strategic Plan 2016-20 that describes where we want to be with regards to the experiences of our patients, families and carers. The supporting Patient Experience Business Plan 2016-18 outlines the steps we need to take to become national leaders in patient experience.

Our plan includes:

• A focus on fostering a culture of accountability, transparency and collaboration, giving frontline staff the power to act and lead change.

• Obtaining specific, timely and relevant patient experience data for continuous measurement and reporting on patients’ experiences.

• Using data to assess progress, strengthen accountability and drive improvement in high priority areas.

Partnering with consumers

• Appointing multidisciplinary teams of Experience Champions to create localised leadership for patient, family, carer and staff experience.

Throughout this journey, the focus will not be limited to the experiences of our patients, but will include the experiences of our clinicians and staff.

Patient Experience Principles

We have actively partnered with our patients, families and carers to develop 10 patient experience principles which allows us to describe a Monash ‘Signature’ Experience.

1. Care is delivered with respect for a person’s values including preferences, religious beliefs and cultural needs.

2. The patient is a partner in decision making about their care.

3. The patient has access to safe, effective and high quality healthcare delivered by skilled staff.

4. There is clear information that helps patients understand and manage their health as independently as possible.

5. Communication is open, honest and respectful, ensures confidentiality and is responsive to individual needs.

6. The physical environment promotes healing, is comfortable, clean, safe and allows for privacy.

7. Staff listen, provide emotional support and treat patients, their families and carers with respect and compassion.

8. Family and friends are involved in care in accordance with the wishes of the patient.

9. Care is well coordinated to ensure the patient experiences continuity and smooth transitions.

10. Meals are enjoyable and nutritious.

Improving the patient experience is everyone’s responsibility and everyone’s opportunity.


Measuring patient experience

The state-wide survey of public healthcare experiences, the Victorian Healthcare Experience Survey (VHES) allows a wide range of people to provide us with feedback on their experiences. The VHES results are reported quarterly.

The 2015-16 results for Monash Health patients who rated their overall experience as either ‘very good’ or ‘good’ are presented in the table below.

Overall experience

Adult inpatient

Adult emergency

Paediatric inpatient

Paediatric emergency Maternity

Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4

83% 86% 89% 87% 85% 88% 86% 87% 80% 83% 91% 87% 93% 89% 91% 94% 83% 84% 90% 78% -- -- 91% 91%

Percentage of patients who rated their overall experience as either ‘very good’ or ‘good’

Monash Health uses the VHES to:

• Make improvements in patient experience while working towards a clear goal.

• Engage front line staff in improvement work that is aimed primarily at improving patient experience.

• Foster capability for continuous improvement at all levels of our organisation.

• Encourage improvement teams to work collaboratively to test and implement changes in their local areas.

This process of continuous improvement, particularly at the point of care, is a crucial part of improving the patient experience.

Respecting our patientsMonash Medical Centre introduced an initiative to improve the respect and dignity experience of patients in care. The outcomes included:

• A better understanding of what ‘Respect and Dignity’ means to our patients.

• Education sessions for staff.• A ‘Respect and Dignity’ commitment signed by staff.• ‘I can help you’ badges for staff.


Expanded meal optionsA review of post-surgery meal

requirements for ear, nose and throat patients at Moorabbin

Hospital resulted in the provision of vegan meal options and a cool diet option for patients

who undergo nose and throat procedures.

Children’s televisionsInstallation of individual televisions in the Monash Children’s Hospital

wards at Dandenong Hospital, where previously there was one television per four beds. We are now meeting the needs of all children and their families at all times, day or night.

The sound is better as it is controlled at the bedside and parents also have more control over what their children watch. Installation of the televisions

has resulted in positive feedback.

Pet therapyA pet therapy volunteer-led program was established at

Casey Hospital to enhance the patient experience. Pet therapy with “Heather”, the greyhound,

brings joy and excitement to the paediatric and rehabilitation

wards and patients across Casey Hospital.

Residents participating in handover

Resident-centred handover, implemented at Kingston Centre’s AG Eastwood Hostel, focused on

involving the residents in their care. Evaluation of resident-centred

handover identified that all residents enjoyed the interactions; and are more aware of who was caring for them and

the capacity for staff to be able to prioritise care on commencement

of the shift.

Handover at the chairThe dialysis unit at Moorabbin

Hospital implemented a chairside handover to increase interaction with patients and involve all staff working

on shift. The chairside handover enables discussions with patients

around management, fluid removals, pending appointments and how they

are coping at home; and allows for additional safety checks of machines,

orders and documentation.

Improvements to patient experienceOpportunities to improve the patient experience are identified across a variety of settings from care and comfort to communication.

Inflatables programThe volunteer-led inflatables program provides diversional

activities for patients and their families, by making balloon

animals and toys. The inflatables provide a welcome distraction

and bring enjoyment to children across the emergency department,

pre-operative clinics and the Monash Children’s Hospital wards.

Volunteer conciergeThe volunteer concierge service

assists patients and their families in finding their way across the various services provided at Cranbourne Centre. Newly recruited volunteers speak

numerous languages to better meet the needs of our diverse

multicultural community.


Through the “Have a say” program we have increased the number of consumer advisors by 17% over the last year. Our consumer advisors play a crucial role on both strategic and operational committees, in co-design and in recruiting clinical leaders across our health service, particularly Nurse Unit Manager positions.

Monash Health Community Advisory Committee (CAC)

Over the past year, the Monash Health Community Advisory Committee has concentrated on diversity, medication safety and mental health; key focus priority areas in our workplan.

The Committee’s work will culminate in project plans, community-focused deliverables and recommendations to the Monash Health Board of Directors. Some key highlights:

• Medication safety – a working group has co-developed myMedication Rights; patient information that offers patients the opportunity to ask questions about medication administration.

• Diversity (aged care) – committee members participated in a dementia and

delirium community workshop, with plans to co-produce patient information.

• Mental health – exploring mental health service provision, gaps in services and the resulting emergency department presentations.

The Committee would like to thank all of our consumer advisors, the Monash Health Board and staff for their ongoing support for what has been a very productive year for the Community Advisory Committee and for partnering with consumers at Monash Health.

Peter McDonald Chair

Betty Wilderman Vice-Chair

Have a say


Board Quality Committee

In October 2015, Monash Health took the step of appointing a consumer advisor as an independent member of the Board of Directors’ Quality Committee.

The Board Quality Committee supports strategic leadership in relation to the clinical governance of quality and safety at Monash Health. It serves to ensure, on behalf of the Board of Directors of Monash Health, that the following broad objectives are fulfilled:

• Effective and accountable systems are in place to monitor and improve the quality and effectiveness of all health services provided by Monash Health.

• Any problems identified with the quality or effectiveness of the health services provided are addressed in a timely manner.

• Monash Health continuously strives to improve the quality of all the health services it provides and to foster innovation.

I commend Monash Health for embodying the ideals of consumer participation and for recognising the important role that consumer advisors play in strategic activities and making recommendations at the highest levels of the organisation.

Having consumer advisors as full members of critical service-wide committees helps Monash Health move towards being a patient-centred organisation and deliver measurable improvements in patient experience, clinical outcomes and staff experience.

I have appreciated the trust that the organisation has shown by embedding consumer advisors in the “heart” of the organisation’s governance structures. I am looking forward to the work ahead and for consumer advisors to “Have a say” in all parts of the organisation.

Sue Viney Consumer Advisor Board Quality Committee

Speciality Program Quality and Safety Committee

I have been involved in the Specialty Program Quality and Safety Committee for more than eight years. It was the first such committee to bring a consumer advisor into its membership, initially as a 12 month pilot project. This was a momentous step as it meant that consumer advisors were directly involved in assessing real situations and assisted in analysing cases where patient outcomes were unexpected or less than satisfactory.

It has been a privilege to be entrusted to share in meaningful discussion about how Monash Health cares for patients and what we can do better.

Membership of this committee, which includes representation from medical staff across a spectrum of specialities, sheds light on the complexity of issues that staff have to deal with and the dedication to patient care that is the driving force behind decision-making.

This important role provides me with an extra insight into how we can improve the patient experience here at Monash Health. It assists me to add value to my complementary position as a long-standing member of the Monash Health Community Advisory Committee. These dual operational and strategic roles are informed by knowing what is important to patients, families, carers and staff.

Pauline Hopkins Consumer Advisor Speciality Program Quality and Safety Committee


Co-design is a partnership between patients, family, carers, the community and the health service. It’s about sharing and understanding the experiences of all stakeholders to design better services by doing the designing together.

Over the past five years, we have embarked on a journey of co-design of services, capital developments and change from the strategic to the operational levels of the organisation.

The past 12 months have been no exception with a number of key initiatives and developments, including the Hospital Without Walls program, Pakenham Health Hub, Monash Health Chronic Disease Strategy, Electronic Medical Record (EMR), Child Safety Standards and Transitions in Care services.

Hospital without walls

The potential game changing concept of ‘hospital without walls: connecting care for better health’ was the theme of the Open Board meeting held at the Dandenong Civic Centre in September 2015.

Clinical Program Director, General Medicine Program Don Campbell and Chief Allied Health Officer Kate MacRae are leading this innovative integrated healthcare concept.

“One of the most widely-recognised challenges in healthcare is fragmented care of patients with chronic and complex care needs,” said Monash Health Board Chair Barbara Yeoh.

“Some become extremely heavy users of health services, including hospitals. Some brilliant thinking—and work—is being done to design an alternative way of doing things. We call this revolutionary approach: a hospital without walls.”

Monash Health is proud to be part of this initiative.

Monash Children’s Hospital Consumer Advisory Panel

I have been involved in the Monash Children’s Hospital Consumer Advisory Panel since its inception. Along with a dedicated group of parents and kids, we have seen the Monash Children’s Hospital go from a concept on paper, to seeing the first sod turned and now a building which provides us with the exciting reality of improving healthcare in our community. We would like to thank Gill Pisani for her leadership as Consumer Co-Chair of the advisory panel and to each of the amazing individuals, schools, fundraising activities, staff and organisations who have been part of the journey. With the ongoing involvement of our consumer advisors, families and carers, we will be able to provide Monash Health with direction and sustainable solutions as we move to the new hospital, but more importantly to “Have a Say” in the models of care and service redesign. I encourage the staff of the new Monash Children’s Hospital to include the voice of the users of the service in ongoing decision making and improvement and to recognise what it is to work in partnership.

Donna Goldsmith Consumer Advisor Monash Children’s Hospital Consumer Advisory Panel

Partnering with consumers through co-design


Students enable emergency department research

Monash University medical students undertook a research study to help determine why parents bring their children to the emergency departments at Monash Health. Participation in the study was voluntary, and all medical students were recruited through the Monash University Paediatric Promotion, Interest and Training Society (MUPPITS) Facebook page. “Student involvement was vital to the project,” said MUPPITS Chair Scott McNeil.

“In order to gain the required study participants, we had a 24-hour presence in emergency departments at Monash Medical Centre and Casey Hospital, allowing us to get real-time data.”

Monash University Associate Professor Craig Hassed was keen to give the students a taste of research. “The students experienced how data is collected in ‘real life’, with all of the challenges of approaching patients and families, asking questions and data entry, they were also exposed to a large amount of time in the emergency department—a great opportunity to see how the department really works.”

Fourth year medical student Mariam Hassan said being involved in the study was a terrific opportunity to see first-hand how research works. Mariam and fellow student Neda So volunteered to cover the emergency department for the project from 11pm to 8am, their first night shift experience. “It was really interesting to see the patient experience and how the emergency department operates at night,” said fourth year medical student Neda. “As well as contributing to this research and helping Associate Professor Craig with the project, we’re getting great clinical and teaching experience.”


From our volunteers…

The children and parents really enjoy having us visit them at Casey Hospital. They so appreciated volunteers spending time with them and their children. As you give them the balloons , activity pack and the ‘trauma teddy’ they cannot believe that they are receiving so much. Joking with the older children (especially high school age) lifts their spirits especially if you say things like ‘there must be a better way of getting out of school work.’

One of our volunteers, Kristen is a natural with the children and it is great to have her with me when she can make it. Given she is doing her VCE, she should be commended for giving up this time to make a difference. Thanks to her dad for being the taxi so that Kristen can come along and cheer up our patients and families.

David Hale, Volunteer Team Leader, Casey Hospital Inflators

Patient and consumer feedback tells us what we need to do better. What patients and consumers told us

The mental health patient and visitor areas at Monash Medical Centre needed to be brighter and more welcoming.

What we did

In partnership with patients, families and carers, staff provided input into the areas that could be improved. This saw the refurbishment of the patient kitchen and courtyard, the installation of an outdoor barbeque, new chairs in the patient and visitor lounge and the introduction of the pet therapy program.

What patients and consumers told us

We need to have wheelchairs available to transport patients and families from the drop off zone to their appointments, especially for those patients who find it difficult to walk the distance to clinics. What we did

Wheelchairs are now available from main reception at Monash Medical Centre and similar improvements are underway at Dandenong Hospital.

What patients and consumers told us

Outpatient waiting times for neurosurgery are far too long.

What we did We have recently established a new service, the Back and Neck Clinic, which provides an expert diagnosis of back and neck conditions by an experienced physiotherapist and a consultant rheumatologist. This has reduced the neurosurgery waiting list by 4%.

Feedback at Monash Health

Goodcare

48%

26%

4%

Goodcommunication

Top three compliment categories

Staff helpful

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Health literacy

Providing patients, families, carers and our community with information on services available and how to access them, communicating with staff, treatment and care, and support when they leave us, is as important as providing excellent clinical care.

We have undertaken a review of a number of areas which impact patients and visitors to our organisation over the past 12 months.

Access and wayfinding

We recognise that knowing how to get to, and find your way through, a building can be difficult. The implementation of a new wayfinding strategy, which has been rolled out on Level 2 of Monash Medical Centre, has included removal of unnecessary signage, new screens with wayfinding points, colour-coded lifts and volunteer guide desks being placed in visible positions.

WiFi for patients

Our patients and their families can spend significant amounts of time in our facilities. To ensure a more pleasant experience, we are providing free patient internet access via WiFi across our facilities. WiFi is currently accessible at Monash Medical Centre, the Monash Health Translational Research Precinct, McCulloch House, 122 Thomas Street Dandenong, Yarraman Nursing Home, Moorabbin Hospital and Dandenong Hospital.

Communication

Supporting our patients, families, carers and staff through effective communication of care is an integral part of the work that we do every day at Monash Health.

We provide face-to-face and online training on how to have difficult conversations, both with patients and families and between staff. In dealing with conflict resolution and open discussion, we are able to provide the tools, knowledge and skills to support our clinical and frontline staff.

Patient information

Our patient information is routinely reviewed by consumers through dedicated site and program based Consumer Advisory Groups and patient cohort groups. The consistency and quality of patient information being produced has seen significant improvement over time, with staff understanding the impact that appropriate and accessible patient information has on health and care outcomes. The volume of information has grown significantly in the past 12 months with review of site and service admission information and the information for the new Monash Children’s Hospital.


Monash Health delivers care and services to one of the most diverse patient populations in Australia.

In partnership with our community, Monash Health delivers specialist services and programs for Aboriginal and Torres Strait Islanders; refugees and asylum seekers; the Lesbian, Gay, Bisexual, Trans and gender diverse and Intersex (LGBTI) community; young people; people with disability; the homeless; and aged. While the majority of these programs and services are provided from Monash Health Community and Allied Health, the connection to our hospitals and other services is crucial to improving care and providing an experience that meets the needs of all our patients and staff.

Meeting the needs of our diverse community

Aboriginal Health

Monash Health is committed to promoting reconciliation and providing culturally appropriate health services and improved health outcomes. We continue to develop our Reconciliation Action Plan which details work across the organisation in partnership with our Aboriginal and Torres Strait Islander community.

Monash Health works closely with the Dandenong and District Aborigines Cooperative Ltd, where we plan and deliver our services and engage with the community.

We have embarked on the development and implementation of the Monash Health Aboriginal Employment Framework which provides the organisation with a strategic direction to employ more Aboriginal staff and provide a safe and supportive environment for our Indigenous and non-Indigenous staff.

We have implemented a training program that provides our staff with a greater appreciation of the Aboriginal and Torres Strait

Islander history, stories and culture so that we can deliver culturally appropriate services.


Reconciliation Week 2016

Monash Health held a Reconciliation event on 27 May. Two proud young Aboriginal women spoke about what reconciliation meant to them.

“I have come across some incredible people who have helped motivate and influence me in striving to pursue my dream with

“I have come across some incredible people who have helped motivate

and influence me in striving to pursue my dream with my

studies...”

my studies, as well as my future plans of working within the mental health sector as a psychologist,” said Psychology Cadet Chantelle Davis. “I have only been working at Monash Health for a few months now but I believe there is great success that has occurred through the very dedicated workers within

this organisation and community members who have been integral instruments in breaking down cultural barriers and attitudes.”

Reconciliation requires commitment, respect, compassion and unity and Monash Health is dedicated to providing high quality, culturally safe care to the Aboriginal and Torres Strait Islander community.

Walking to kick the butt

Smoking remains high in the Aboriginal and Torres Strait Islander community, with the most recent data indicating that 42% of Indigenous people across Australia smoke tobacco compared with only 26% of non-Indigenous people. On Sunday 29 May 2016, Dandenong and District Aborigines Cooperative Ltd (DDACL) held a walk to coincide with Reconciliation Week and No Tobacco Day to highlight the health impacts of smoking and encourage quitting or reducing smoking. Monash Health continues to support and partner with DDACL and participated in the walk and provided dental checks to all participants.


As we see the growth of our refugee and newly arrived migrant population, Monash Health continues to build its services and programs to support a community which represents over 280 countries and speaks more than 100 different languages and dialects.

Through the Monash Health Cultural Diversity Plan, we have highlighted a number of our achievements:

• The Refugee and Asylum Seeker team has provided secondary consultations and training for service providers including general practitioners, nurses, case workers and specialists.

• The Refugee and Asylum Seeker volunteer program has continued to expand its scope and volunteers are involved in different departments of Monash Health. Volunteers are working in concierge roles, patient support roles, maternity and sporting programs.

• Thriving Women is a weekly group program coordinated by Refugee Health and Wellbeing under the priority of social inclusion. The most common outcomes for women related to increasing their confidence, and having a safe place to connect with other women. Approximately 20 participants attend the group each week.

• During Refugee Week we organised a morning tea for staff and volunteers and collaborated with the City of Greater Dandenong, Ermha

and the Southern Migrant and Refugee Centre to run a soccer tournament.

• During Ramadan, special arrangements were made at the 122 Thomas Street, Dandenong site to provide a prayer space for clients and interpreters.

• We are developing a process to review delivery of pastoral care and allocation of healing spaces across Monash Health.

• A ‘cultural diversity’ key priority area in the Community Advisory Committee workplan has been developed, focusing on the issue of dementia and delirium and providing care to our ageing and culturally diverse community.

• A health literacy audit across Monash Health Community has identified areas to improve how our Culturally and Linguistically Diverse (CALD) community accesses and understands health services.

• We have provided ethno-specific education to community groups on impending Aged Care Reforms.

• We provided Cultural Diversity Training to 66 staff during Monash Celebrates. The training focused on the Chinese, Indian and Afghan communities.

• The Culturally and Linguistically Diverse Aged Care Coordinator pilot project is complete and the care coordinator position

has become permanent. This role links CALD patients in hospital into aged care services in the community. It also builds the capacity of hospital staff to assist clients through the process.

• Our Hands on Health program is for year 10, 11 and 12 students from disadvantaged backgrounds with an interest in the health sciences to explore work and study options. Students experience a full week placement in Monash Health learning about various roles from acute to community care. Students come from schools across the Monash Health catchment.

Cultural diversity

The most common requests for language

services in 2015-16 were:

Dari - 12,328 Mandarin - 9,828

Vietnamese - 9,739 Greek - 7,889 Khmer - 7,275


Growth in halal and multicultural meals at Monash Health

Halal meals

10,000

2011 20112012 20122013 20132014 20142015 20152016 20160

20,000

30,000

40,000

50,000

60,000

Multicultural meals

16,7

44 21.9

21

30,5

43

38,5

58

47,0

11 51,0

15

2,71

5

3,51

4

4,40

4

6,52

0

7,95

4

9,30

8

Use of interpreting services at Monash Health

10,000

Total occasions of interpreting

services

Cancellation Confirmed Late cancellation

Phone interpreter offered but

not used

Unconfirmed Unmet request

0

20,000

30,000

40,000

50,000

60,000

70,000

80,000

90,000

100,000

87,3

31

65,3

98

8,41

9

7,68

8

3,56

3

1,24

3

1,02

0

We have increased the provision of halal, multicultural and allergy-specific meals across all of our sites in the past 12 months. Our Central Production Kitchen provides meals to 19 metropolitan public hospitals and aged care facilities operated by Monash Health and Eastern Health, and cook freeze specialised meals to more than 30 facilities.

With growing demand and costs, Monash Health has embarked on a review of its interpreter services. Telephone interpreting was identified as an initial and potential solution in some clinical areas as it offers a more cost-effective and efficient solution than traditional face-to-face (onsite) interpreting.

Num

ber o

f mea

ls p

rovi

ded

Year

Occ

asio

ns o

f int

erpr

etin

g se

rvic

es

Outcome


Challenging family violence

Monash Health partnered with the City of Greater Dandenong, City of Casey and Shire of Cardinia to deliver the successful family violence primary prevention project, Challenge Family Violence.

This project encourages male leadership in the prevention of violence against women. Monash Health supported the project through leadership and mentoring roles.

Marama Kufi, Community Development Worker, has been involved in the project for three years as a community mentor. Mr Kufi has engaged 12 men from the Oromo community of North East Africa who hold positions of influence, to raise awareness of violence against women being unacceptable. Through community events, Mr Kufi has reached more than 700 community members and raised awareness of family violence.

The limited number of leadership positions held by women in this community was also identified and training was provided for Oromo women resulting in a number of female leadership roles. Mr Kufi also held challenging conversations about male privilege, sexism and bystander violence within the Oromo community.

Welcome to our community through photography

A collection of photographs taken by clients of Monash Health Community was exhibited at 122 Thomas Street Dandenong. The exhibition, titled the Welcome Project, invited the local community to submit an image that represented their interpretation of ‘welcome’.

The 2015 project was a joint initiative across many Monash Health departments with the aim of making Monash Health Community a place to meet and one where people felt welcomed and comfortable.

Community Development Worker Lucette Talbot said the artwork was wonderful.

“A broad range of community members participated in the project to represent the wonderful diversity of Dandenong and the images submitted demonstrate this beautifully,” she said.

“There is no shortage of depth in the content of the visual images and some of the descriptions accompanying the photos,” she said.


Restricting a person’s freedom of movement through the use of seclusion and bodily restraint is used only as a last resort to ensure the safety of the person and others at risk of immediate harm.

Staff are trained in de-escalating techniques to diffuse critical situations that may result in the need to seclude or restrain.

We have introduced two key strategies to reduce the use of restrictive interventions in Mental Health acute inpatient wards:

Mental Health

• A Reducing Restrictive Interventions Committee is working towards reducing restrictive interventions around seclusion and restraint.

• ‘Safe Wards’, an international initiative that improves the consumer and staff experience was introduced across all Mental Health units.

We have a rigorous program of review for all episodes of seclusion and restraint. Internally, incidence of physical and mechanical restraint is reported monthly to service and program quality and

Monash Health strives to reduce seclusion and has maintained an average rate of seven episodes

per 1000 occupied bed days for 2015-16. This is well below the Department of Health and Human

Services’ set rate of 15 episodes.

Our mechanical restraint rate is 1.73

episodes per 1000 bed days. This is under the statewide standard set

at 4.8 episodes.

Episodes of mechanical restraint

Mechanical Restraint Mean Lower Control Limit Upper Control Limit

-2

-1

0

1

2

3

4

5

6

7

Jul-15 Aug-15 Sep-15 Oct-15 Nov-15 Dec-15 Jan-16 Feb-16 Mar-16 Apr-16 May-16

safety committees. The results are informing ongoing quality improvement initiatives which will have a positive impact on the patient experience.

Externally, a physical restraint report is prepared and endorsed by our authorised psychiatrist and submitted to the Office of the Chief Psychiatrist at Department of Health and Human Services on a monthly basis.

Year

Epis

odes

of M

echa

nica

l Res

trai

nt

Monash Health’s mean mechanical restraint rate is under the statewide standard


Drug and alcohol support for the community

The Breakfast Club is run by the Monash Health Drug and Alcohol Services Primary Health Clinic and Needle and Syringe Program and provides clean injecting equipment, support and advice to injecting drug users. The Breakfast Club commenced in early 2014 after a need was identified by service users to support them to have a healthy start to the day. This simple change in providing a positive start has seen service users regularly turn up to appointments and to receive information about referrals, sexual and mental health advice, wound care, training and education, care coordination and recovery support, and assistance on navigating healthcare and community welfare services.

Mental Health Consumer and Carer Advisory Committee

The Mental Health Consumer and Carer Advisory Committee was implemented in 2013, and provides the Mental Health program with a broad consumer and carer

perspective. This committee meets monthly and over the last 12 months, has revised and reviewed its directions through Terms of Reference, position descriptions and a supportive meeting environment.

The Committee has been involved in a number of key activities which support our mental health program. These activities included a submission to the Department of Health and Human Services’ response to the Mental Health Tribunal, Victoria’s 10-year mental health plan. The submission reported on the Committee’s first year of operation and on details of the first report released, including the first consumer and carer forum event and attendance at the Primary Health Network mental health co-design forums.

Mental Health art awards

For the seventh year, the Mental Health Program Consumer and Carer Relations Directorate has run the successful Mental Health art competition. Fifty five submissions were received from mental health consumers, family, carers and staff across a broad range of categories. Through this initiative, the Mental

Health Program is breaking down stigma and barriers in the community and promoting recovery through art. The artworks were displayed across Monash Health during Mental Health Week in October.

Votes were collected from the community, consumers, carers, staff and visitors at all sites and through online voting for each of the 10 categories. An awards ceremony was held at Dandenong Hospital for the winners of each category. The Mental Health Complaints Commissioner and Monash Health staff gathered to celebrate the art awards.

The winning piece chosen by former Chief Executive, Shelly Park, was My Girls by Joelene Cocker, with further presentations made for the Mental Health Complaints Commissioner Award, the Monash Health Community Advisory Committee Award and the Mental Health Advisory Committee award.

Improving our community’s mental health

Community groups have been run as part of a pilot program in 2016 to engage participants in useful lessons and interactive learning.

Five adult community mental health clinics were involved in the program. These groups offer participants the opportunity to learn and to share experiences and conversations with their peers in a relaxed and friendly environment. “The art group has inspired me to pull out my things at home that I used to enjoy doing,” stated one participant.

The groups offer participants the opportunity to learn or expand their knowledge and have helped


“The art group has inspired me to pull

out my things at home that I used to

enjoy doing.”

make a difference to Monash Health patients. Now a permanent component of the adult community mental health program, a participant from the Cranbourne group stated, “it’s given me a reason to wake up”.

The community groups program is linked to the mental health occupational therapy program, allied health, various internal community agencies for community service education, and independent learning service presentations.

Students from various disciplines, including nursing, social work and occupational therapy have been involved in the program.

We deliver a number of services in partnership with community organisations to support people who are homeless.

In May 2016, we collaborated with the Department of Health and Human Services and local service providers, to host the ‘South East Housing Forum – Housing Risk and Homelessness’.

Over 100 health and community workers heard from a range of housing services that support people who are homeless, or at risk. The forum highlighted the complex needs of people who are homeless and the importance of health and housing services working collaboratively.

Following the successful forum, a resource was developed and provided to all attendee organisations. Additionally, we have explored possible partnership opportunities and initiatives to improve the health outcomes of at risk communities.

Homelessness


and services available.• Provided a partnership model for

our community partners.• Co-designed a promotional flyer

with key messages to recruit young people.

• Supported the production of artwork reflecting what is important to young people in our diverse community.

Monash Health Transitions in Care Conference

The Monash Health Transitions in Care Conference was held in December 2015.

A range of presentations from clinical and community staff and a keynote presentation from Dr Paul Harden from the United Kingdom, highlighted that the focus on the patient or client is the most important aspect of providing care.

The highlight of the conference was a panel discussion facilitated by Susan Brunton, who is a mother of two teenagers and a Monash Health consumer advisor.

The panel consisted of six young people with many different healthcare experiences, who shared their perspective on what we get right and what can go wrong when we don’t acknowledge the young person being at the centre of their care and decision making.

Young people

Monash Health recognises the need to provide health services that meet the needs of all ages. We also partner in other areas that impact on young people’s lives, including education, justice, financial and other social supports.

Young people who access healthcare across Monash Children’s Hospital, and transition in care to adult services, sometimes find it difficult.

Paediatric and adult care professionals have collaborated to develop a proposed transitions service.

Monash Health Youth Advisory Group

The Monash Health Youth Advisory Group was launched in June 2015, and provides a unique perspective on the range of issues and gaps in service provision.

In the last year the Youth Advisory Group has:

• Explored the range of programs


Paddy is 25 years old and is in his third year of a Bachelor of Counselling. He works for SCOPE as a community educator and goes to different schools to raise awareness of disability. Paddy really likes to play poker, but has trouble with his arms, so he needs assistance from his friends who he hangs out with in his spare time.

Paddy has been accessing health services since he was 18 months old. He has asthma and regular chest infections. Paddy has seen local general practitioners, Monash Children’s Hospital specialists, occupational therapists, counsellors, psychiatrists and physiotherapists at many health services.

Overall his journey has been fairly positive with doctors and the specialists he has seen. Paddy reflected that the doctors and ICU nurses understood him, were helpful, supportive, genuine and empathetic to his needs. He said the nurses were caring and willing to build rapport with their patients and understand their needs. Paddy has been supported over the past few years by counselling and psychiatric services for depression. He is happy with the care he has been receiving, but it took a while to build relationships with the staff.

Paddy has also had a number of negative experiences in his journey. During one of his extended hospital stays, Paddy was only helped in the shower twice a week by ward nurses and his bed sheets were not changed frequently. Nurses also didn’t help him to eat his food, so his food turned cold. He felt that they had no people skills, did not keep an eye on him (except for standard clinical care) and did not take the time to understand his diagnoses. He would have found it useful to have a health professional explain what the doctor had discussed with him. Similar to a translator, information needs to be explained to him in a way that is age-appropriate.

Paddy felt the transition process was difficult. After turning 18, he felt that there was no one to help him regarding adult services and that a case worker would have been helpful to link him in with services or relevant agencies. As he was being admitted to hospital two to three times each year, he found it difficult to catch up with his friends and school work as he was away for weeks at a time. Having a tutor would have supported him to catch up with his studies.

Paddy is a consumer advisor on the Monash Health Youth Advisory Group. He is active in the community raising awareness about disability. Paddy says it is important that staff recognise the issues that young people have in their care and support those with a disability to know what services are available for patients, families and carers.

Paddy reflected that the doctors and ICU

nurses understood him, were helpful, supportive, genuine and empathetic

to his needs.

Paddy’s story


We are committed to providing a safe and accessible health service to everyone who accesses our services across our hospital, rehabilitation and community health sites.

Over the last 12 months, we have reviewed our Disability Action Plan. Being mindful of National Disability Insurance Scheme (NDIS) and myAgedCare initiatives launched on 1 July 2016, the review will provide the organisation with policy direction on how we support patients, families, carers and the broader community who identify with disability, and provide services and programs that meet their needs.

Overcoming barriers

A resource has been developed to provide online training to individuals supporting people with disabilities on how to discuss and access cancer screening.

The Overcoming the Barriers online training modules were designed by experts in the field of disability and cancer screening, with regional

Disability

and rural disability support workers in mind. The modules present evidence-based strategies to overcome the barriers to accessing national bowel, breast and cervical cancer screening programs often encountered by people with cognitive, communication and physical disabilities. People with lived experience of disability contributed their experiences and insights.

Disability support workers and family members play a crucial role in supporting screening, such as showing the client how to use a bowel screening kit or discussing the sensitive topic of cervical screening.

We know that up to 80% of women diagnosed with cervical cancer have either never had a pap test or did not have them regularly in the 10 years before diagnosis. This tool enables those working with people with disabilities to access and share cancer screening information with those they support.

“People with disability have the same need for preventative healthcare,

including cancer screening, as anyone else in the community and yet they face additional barriers to accessing these

services.”


Engaging with the LGBTI Community

In 2016 Monash Health hosted a Lesbian, Gay, Bisexual, Trans and gender diverse and Intersex (LGBTI) cabaret in partnership with Cardinia Cultural Centre.

The first of its kind in the southern region, the ‘Twist and Turn’ Cabaret starred Matthew Mitcham OAM, the 2008 Olympic diving champion and one of the very few Olympians to compete as an openly gay man.

The cabaret showcased local health and community service providers. In line with our commitment to delivering services that respond to the needs of our diverse community, events such as these celebrate the local LGBTI community. Inclusive practice sessions were delivered by Gay Lesbian Health Victoria to staff providing care to the aged across acute and community care.

Regional LGBTI inclusive practice and engagement forums were also held in collaboration with the City of Casey, Department of Health and Human Services and Uniting AgeWell. These forums have been attended by more than 100 local community care providers.

Using community resources and a shared care approach with general practitioners, psychologists and other health professionals who work with TGD clients, the practice has increased service delivery incrementally. Demand for services has increased exponentially. The current aim of the clinic is to improve health and mental health outcomes, minimise regret and lower suicide rates of TGD individuals by addressing evidence-based risk and protective factors. With a recent State government announcement

of increased funding for the clinic, there is an opportunity to expand existing services and address increased demand to comprehensively meet the needs of Victoria’s trans and gender diverse population. Monash Health is developing a consumer participation framework and will embed consumer and community consultation in each part of the planning process.

Gender Dysphoria Clinic – planning for the future

To ensure Trans and Gender Diverse (TGD) Victorians have access to clinical and support services, the Gender Dysphoria Clinic operates as a state-wide service, through metropolitan, regional and rural Victoria. Through supported multidisciplinary care, the clinic has built up a local, national and international reputation.


Improving staff experience

We are committed to providing a safe, satisfying and engaging work environment for our staff. This enables us to deliver high quality and safe care to our patients, families and carers.

People Matters Survey and OneMonash survey

In 2014, we participated in the 2014 People Matter Survey, an employee opinion survey run by the Victorian Public Sector Commission. The survey identified positive responses towards patient safety. Feedback also suggested opportunities for improvement in relation to training and supervision of employees, reflecting on issues and what we can learn from our mistakes.

Strengths identified included the provision of high quality patient care and wide variety of services

and programs, appropriate handling of patient care errors, and how we put our iCare values into practice.

Areas for improvement included how we support staff development, reward and recognition, how we enable staff to spend more time with patients and how we continue to support the overall wellbeing of our staff.

In 2015, we conducted the One Monash Health Survey, an individual engagement survey through Best Practice Australia. This survey identified that 62 per cent of staff believe Monash Health is a truly great place to work. We are committed to improving the staff experience through genuine initiatives in line with our iCare values. Since the feedback from these surveys, Monash Health has implemented a number of

initiatives, some of which have been highlighted throughout this report. These initiatives include:• Monash Medical Centre has

developed an X-ray room to reduce patient transfers by per month, allowing us to re-invest that time in direct patient care.

• Recertification of staff in iBelong Bullying and Harassment Training. Since July 2014, more than 10,000 staff having completed this training.

• Information about sustaining a culture free from bullying and harassment has been developed and rolled out in August 2016.

Results of the People Matter and One Monash Health surveys

Patient safety Staff agreed (%)

I am encouraged by my colleagues to report any patient safety concerns I may have 95Patient care errors are handled appropriately in my work area 94My suggestions about patient safety would be acted upon if I expressed them to my manager 90I would recommend a friend or relative to be treated as a patient here 89The culture in my work area makes it easy to learn from the errors of others 84Trainees in my discipline are adequately supervised 84Management is driving us to be a safety-centred organisation 81This health service does a good job of training new and existing staff 80

Engagement

I am proud to tell others I work for my organisation 71I would recommend my organisation as a good place to work 68Engagement index 66I feel a strong personal attachment to my organisation 65My organisation motivates me to help achieve its objectives 64My organisation inspires me to do the best in my job 64


• A new conversation and engagement toolkit called ‘Give Me Five’ has been developed. The tool replaces traditional performance frameworks and focuses on creating connection and engagement between managers and team members. The new tool will be implemented in September 2016.

• Building culture and improvement through the Institute of Healthcare Improvement framework for senior leaders, operational staff and consumer advisors.

• Development of videos related to manual handing to demonstrate to front line staff appropriate safety processes and self-care.

• Implementation of ‘Let’s Talk’, a campaign designed to provide a framework for positive communication between staff.

• Leadership rounds have been established at many sites for senior leaders to engage with staff and patients.

• Implementation of a mentoring program between leaders and staff across the organisation.

• The Learning Management System (LMS) has improved functionality and now offers more than 200 online development opportunities.

• 1800Respect is being piloted at Monash Women’s as a 24/7 counselling service with a worker’s toolkit to support people experiencing family violence.

Most recently, Monash Health undertook the 2016 People Matter survey which closed at the end of June 2016. We are reviewing the results to identify areas for improvement.

Reward and recognition

Our iCare reward and recognition program recognises employees and teams who have gone above and beyond the call of duty, that take pride in their work and share and support Monash Health values. The program is based on the Monash Health iCare values and associated behaviours. These values and behaviours define the way we work together and support each other to deliver quality healthcare to our customers.

In 2016, we recognised a number of valuable staff, in particular Mark Wooden, a support services staff member at Monash Medical Centre. Chris’s outstanding abilities were expressed in his nomination: “I watch Mark clean regularly. I have never seen someone take such pride in their work or even work as hard. He is truly passionate about what he does and he does a great job. He is always smiling, courteous and helpful. I cannot think of a more suitable person for such an award. I regularly see him vacuuming (with the big machine) in the main corridors from the front entrance up to the corporate area. He is extremely thorough and focused in his cleaning. He is also extremely friendly which I feel is great for staff but also for our patient and visitor experience. We need to clone Mark across the organisation!”

Chief executive Andrew Stripp presented the award at the Reward and Recognition quarterly awards.

“Mark is truly passionate about what he does and he does a

great job. Mark is always smiling, courteous and

helpful.”


Collaborative research on mental health

Southern Synergy is a research centre within the Faculty of Medicine, Nursing and Health Sciences at Monash University. The centre sits within the School of Clinical Science’s Department of Psychiatry, and is located at Dandenong Hospital.

In collaboration with Monash Health, Southern Synergy is leading the study “Working together with shared values towards recovery-oriented practice: Principles Unite Local Services Assisting Recovery – the PULSAR project.”

The PULSAR project is a $2.3 million project, funded by the State Government through the Mental Illness Research Fund, and is led by Professor Graham Meadows. Research partners include Monash Health, Mind Australia, Eastern Region Mental Health Association, the University of Melbourne, La Trobe University, Victoria University and the University of London. The PULSAR project has developed a practical approach to address how different types of services, within a defined geographical area, can be refocused to support personal recovery for people with mental illness. Through an extensive and innovative evaluative framework, it is shedding light on how clinical mental health, primary care and community support services can collaborate effectively.

The research project is well advanced, moving into its final year; to date the study has involved more than 1000 practitioners and consumers in primary and secondary care across the Southern Melbourne Region, and trained more than 200 practitioners across a wide range of service sectors. Analyses and findings will be shared formally in the next year.

Southern Synergy administers the Mental Health Research Seeding Grants, which are intended to encourage mental health research and small-scale projects in preparation for external funding applications. Up to five small grants are available each year ranging from $2,000 to $5,000. The Mental Health Research Seeding Grants have been awarded for 2016, including for:

• David Moseley’s project “Developing an integrated research framework for the new Statewide Neuropsychiatry Unit.”

• Anthea Raju’s project “Pilot and Evaluation of a Mother-Infant Music Therapy Program.”

Recognising and celebrating Monash Health women

Monash Health staff, Dr Anjali Dhulia and Faye Angel, were recognised at the Women’s Health in the South East International Women’s Day award ceremony in March 2016. The awards celebrate the achievements and contributions of women in the Southern Metropolitan region of Melbourne.

Director of Medical Services, Dr Anjali Dhulia, was recognised for her “outstanding leadership in developing and implementing the Women in Medicine initiative at Monash Health”.

Faye Angel, a volunteer at Dandenong Hospital was nominated in the Community Contributor award category. In addition to volunteering with Dandenong Hospital’s transit lounge and cancer day treatment unit, Faye also fosters and supports the rehousing of greyhounds within Victoria.

Monash Health congratulates these two inspiring women on their awards.

Staff recognised for dedication

Our longest serving employees and volunteers were honoured in a ceremony at the Robert Blackwood Hall at Monash University.

The Length of Service Awards is one of the highlights of Monash Celebrates, the month-long acknowledgement of the wonderful contribution of staff at Monash Health.

Board Chair Barbara Yeoh presented Domenica Davies, Kevin Ericksen and Cheryl Abbott with awards the for an incredible 40 years of loyal service.


We are committed to improving patient experience by providing quality training for staff and consumers.

Institute of Healthcare Improvement in practice

In the past year, the Institute for Healthcare Improvement (IHI) has provided training and education to increase improvement capability across all levels and areas of the organisation through an accessible online platform. This initiative has culminated in intensive programs being delivered across the organisation.

More than 100 executive, senior leaders, consumer advisors, and 70 managers and front line staff have taken part in IHI programs, providing a foundation of learning essential to drive and improve healthcare across the organisation.

In 2015-16, 200 Monash Health staff registered for the IHI Open School, strengthening the approach to quality improvement and capability building across all levels and areas of the organisation.

Partnering with consumers at Monash Health

We provide training for staff in partnering with consumers. The training focuses on consumer participation at Monash Health and the important role of consumer advisors across our organisation. Included in the training are approaches to consumer

participation, levels of partnership, applying project management principles and utilising consumer participation at the local level or point of care for improvement. More than 210 staff have completed the training in the past 12 months and have reflected that this will assist them in utilising their patients, family and carer feedback to improve experience, quality and safety outcomes in their local areas.

We empower consumers in their role and ensure they are as equally equipped to contribute alongside our staff.

Multidisciplinary orientation

A patient experience focused training session is being delivered through the Monash Health multidisciplinary orientation. The session includes stories told by patients and carers and reflects on their experience and how, as an organisation, we can improve.

Mental health training

Consumer and carer relations consultants provide a range of regular education and training sessions across the mental health program, including patient-centred care; clinical risk; family inclusive practice and staff orientation for graduate nurses, registrars and clinical staff. In the past 12 months, more than 60 education and training sessions have been delivered to staff, consumers and carers. Staff report the importance of having lived experience perspective in training as it

broadens their understanding and influences their practice.

Monash Doctors Education

Monash Doctors Education (MDE) is responsible for providing and coordinating education and training activity for Monash Doctors. MDE focuses on teaching and learning for interns and Hospital Medical Officers, and works closely with vocational training providers to support their education programs and senior medical staff in their professional development. The purpose of MDE is to facilitate and deliver high quality teaching and learning that is focused on the development of doctors’ clinical knowledge, skills and professional development.

Nursing and Midwifery Education and Strategy

Our Nursing and Midwifery Education and Strategy delivers educational opportunities, enabling a skilled nursing and midwifery workforce to provide excellence in evidence-based patient-centred care. This education encompasses patient care standards, professional growth and identity for all levels of our nursing and midwifery workforce. In the past 12 months, the Nursing and Midwifery Education Strategy team has:

• Supported more than 200 new nurses and midwives to commence their careers at Monash Health.

• Assisted 150 nurses to develop recognised specialist nursing skills in areas such as

Education and training


emergency, intensive care, newborn services, cardiac, neuro, renal and perioperative services.

• Provided more than 20,000 inservice interactions.

• Supported on-line learning for all nursing and midwifery staff.

• Contributed to a range of inter-professional learning activities with other health professionals.

• Provided development opportunities for senior nurses through interactive leadership programs.

Foundations of Care

The Monash Health Nursing and Midwifery Foundations of Care represent ten fundamental care requirements that are applicable across all clinical settings. They provide a system to ensure every patient receives good care and are a cornerstone of the nursing and midwifery clinical governance system.

This year, the Foundations of Care were reviewed and refreshed to ensure they remain contemporary, evidence-based and relevant to all nursing and midwifery practice. As complexity of care and demand for services increases, the process of applying the foundations grounds nursing and midwifery practice in a fully patient-centred approach and delivers robust mechanism to ensure nurses and midwives deliver safe and effective nursing and midwifery care across all clinical settings.

Growing through learning – enhancing education quality in allied health

The Allied Health team has implemented an education and training framework that aims to support allied health practitioners with planning, delivery and evaluation of education and training programs provided in the workplace.

“I enjoy time spent with diverse people and the opportunity to see the inner workings of the health system.” - Alison, Emergency Department volunteer

“Volunteering enables me to help in a small way.” - Nan, Outpatients Department volunteer

“I enjoy the variety of people I meet and the interesting things they have done through their life.” - Colin, Transit Lounge and Concierge Service volunteer

Why do I enjoy being a volunteer at Dandenong Hospital?

The framework ensures workplace learning programs meet practitioners needs and the needs of the patient population and broader community, and ultimately results in improved patient care.

Organisational development, culture and learning

Organisational Development, Culture and Learning design, develop and implement strategic tools, processes and frameworks to support effective people management such as performance enhancement and leadership development. It is also responsible for developing and coordinating our professional development calendar for non-clinical training which is administered through our Learning Management System.

“I enjoy helping the patients and interacting with them.” - Jan, Day Treatment Unit volunteer

“Volunteering keeps my mind occupied and I enjoy the break from everyday drudgery.” - Jim, Emergency Department volunteer

“I enjoy helping others, it gives me great pleasure and is very satisfying.” - Glenda, Birth Unit and Maternity volunteer

“I enjoy spending time with patients as some don’t have many visitors.” - Carlene, Patient Library Service volunteer


Performance against national standards

The National Safety and Quality Health Service Standards, developed by the Australian Commission for Safety and Quality in Health Care, are designed to provide a nationally consistent standard of care for consumers attending any health service organisation across Australia.

National Safety and Quality Health Service Standards

In July 2014, Monash Health successfully underwent inaugural assessment against the National Safety and Quality Health Service Standards. Surveyors noted the strong commitment by staff to both patients and the organisation. The processes established in 2014 continue to be embedded and strengthened, putting us in a strong position for our second survey in August 2017. Going forward, Monash Health will be required to undertake annual self-assessments and three yearly external reviews against both sets of standards. Self-assessment and external consultant review in 2015 showed we continue to provide quality care to our community. Our next external review is scheduled for November 2017.

National Standards for Mental Health Services

In 2014, Monash Health was also successful in our first accreditation to the National Standards for Mental Health Services. The standards are an additional set of measures required of mental health services and apply across the broad range of mental health services, including bed-based services, Indigenous health services, alcohol, tobacco and other drug services, community mental health and aged care services.

Aged Care Accreditation Standards

In 2015, our five residential facilities were successfully accredited against the Aged Care Accreditation Standards.

Human Services Standards

Our Disability and Child, Youth and Family Services underwent evaluation against the Department of Health and Human Services Standards, the service was assessed as “exemplary” with clients interviewed praising the services.

Audit

In order to provide our patients with exceptional care, we first need to understand how we are currently performing.

We have implemented a robust and reputable audit framework to ensure patient safety and the quality of care is measured and that practice improvement opportunities are identified.

Audits are conducted both at an organisational level and locally within clinical areas. Many audits contain questions to the patients to assess understanding of critical information and to capture observations of their care. Examples of patient questions include:

• “Do you understand your rights as a patient at Monash Health?”

• “Do you know which nurse is looking after you today?”

• “Did your doctor wash their hands before they last cared for you?”

• “One of our requirements when people come to Monash Health is that we ask if they are Aboriginal or Torres Strait Islander. Has anyone asked you this question?”

We now report results in real time to enable staff to act on audit results immediately.

All unit leaders can demonstrate improvements in their areas using this audit data as evidence.


A strong clinical governance framework ensures the quality and safety of our care is monitored and constantly improved.

The clinical governance structure is built on the four pillars of:

• Patient-centred care – ensuring that the care we provide is compassionate, respectful and meets the needs of our diverse community.

• Clinical effectiveness – ensuring the care we provide is based on the best available evidence and whenever possible contributing to that body of evidence.

• Risk management – identifying the risks for every patient and implementing strategies to reduce or eliminate the risk of harm.

• Effective workforce – ensuring our staff are qualified, and working well together in multidisciplinary teams.

Leadership

Leadership objectives and responsibilities are clearly defined in the position descriptions of each manager, service director and executive at Monash Health. Individually, they are expected to lead innovative initiatives that aim to achieve the strategic objectives.

Enterprise risk management

Enterprise risk management encompasses all areas of risk across Monash Health including those related to people, safety,

assets, finance, property and reputation. The Board of Directors are responsible for the governance of the risk management system and own the enterprise risk register.

In March 2016, following extensive collaboration with key stakeholders, we implemented a revised risk management framework. The framework aims to develop a sound system of risk oversight, management and internal control processes and structures to support the achievement of our strategic and organisational objectives.

Effective risk management is the responsibility of all employees and supports Monash Health to provide the safest possible healthcare experience to our community.

Clinical risk management

Monash Health has a number of processes for the identification and minimisation of clinical risks. This involves processes to ensure compliance with legislation, reporting and investigation of incidents and near misses, and the implementation of improvement strategies to reduce recurrence. Ultimately, these processes improve the safety of our patients.

Regular reporting of incident and near miss data allows for monitoring of variations in the data, which may indicate an emerging risk for future focus. This occurs at all sites and levels of organisation, including medical and surgical programs.

Complex clinical incidents undergo

rigorous investigation via in-depth reviews, or presentations to a clinical review panel. These investigations ensure any possible gaps in care are identified and rectified through recommendations for improvement in the treating areas. The review panels are comprised of senior clinicians, from varied clinical areas and disciplines, and consumer advisors.

Workplace health and safety

Monash Health continues to develop and implement innovative health and safety programs to prevent and reduce the severity of injury in the workplace.

We have focused on reducing both occupational violence and aggression (OVA) and manual handling incidents in the workplace.

An analysis of OVA incidents resulted in the development of a strategy to reduce these occurrences and seek out the causal factors of violence and aggression in the workplace.

The strategy included the development of a staff behavioural change video titled ‘We’re not going to take it’. The video highlights how healthcare workers are subjected to acts of violence and aggression. It aims to encourage staff to report all incidents. The video was recognised with two significant industry awards. It was named Best Occupational Health and Safety video by the Australian Video Producers Association and won a silver medal in the International

Governance


The safety of patients and staff is pivotal to our decision making.

Horizon Interactive Awards in the USA which recognise excellence in interactive media production. Monash Health has embarked on the DorsaVi Project to reduce manual handling injuries in the workplace. Baseline studies for the project were completed which involved attaching wearable sensor technology to staff in order to track muscle activity and posture throughout the working shift. The bank of data produced provides the relevant knowledge to target the specific movements that cause injury. Training packages and feedback sessions have been developed for current employees and for personnel moving into at-risk roles.

Monash Health’s Workplace Health and Safety team has introduced an early injury intervention program. Injured staff are immediately reviewed by experienced occupational health consultants and a return-to-work program is developed. This early injury intervention program has resulted in a decrease in lost time injuries and will also contribute to a reduction in our workers compensation premium.

Patient-centred care

Patient-centred care at Monash Health is how we focus on patients, families, carers and consumers to deliver exceptional care and outstanding outcomes.

This occurs at all levels of Monash Health and includes:

• Informed consent and shared decision making about care.

• Consumer partnership in service planning.

• Consumer partnership in designing care.

• Consumer partnership in service measurement and evaluation.

We ensure the interests of our stakeholders are incorporated into the organisational strategic objectives through the Monash Health Patient Experience and Consumer Participation Plan, Community Advisory Committee, Primary Care and Population Health Committees, Consumers on Committees Framework and feedback processes.

Performance improvement

Performance of individuals, operational teams and the organisation as a whole are monitored by key performance indicators. The performance improvement strategy implemented at Monash Health incorporates these key performance indicators, enabling identification of performance leaders and their innovative practices.

Credentialing

To support the our strategic goal “We put our patients first”, we must ensure staff are appropriately skilled, trained and credentialed. The objectives include meeting the requirements of the National Registration for Health Professionals legislation and Department of Health and Human Services requirements for Credentialing and Scope of Practice for Medical Practitioners in Victorian Health Services. Monash Health has a long-standing and robust Credentialing and Scope of Practice framework. The framework identifies the different requirements of various health professional groups about credentialing and scope of practice.


Providing safe and quality care is at the core of what we do every day at Monash Health. Through reviewing our processes, use of data and training of our staff, we improve care outcomes, better meeting the needs of our diverse community.

Below are highlights from our National Safety and Quality Health Service Standards assessment.

Quality and safety

continually strive for improvements to enhance patient safety. Even though we know it is difficult to achieve 100% compliance with the audit process, we are always striving to achieve improved hand hygiene rates.

Influenza vaccination

In 2015, Monash Health successfully vaccinated more than 80% of staff against influenza. More than 11,000 staff were vaccinated. Improvements have been made to assist staff complete their declaration forms, including access to the form online. In 2016, it is anticipated this will capture detailed information, make it easier for staff to declare where they have been vaccinated and improve our monitoring system.

Monash Health aims to have 100% of staff complete a declaration form.The 5 moments are:

1. Before touching a patient.

2. Before performing an aseptic procedure.

3. After exposure to body fluids.

4. After touching the patient.

5. After touching the patient’s surroundings.

The 5 moments of hand hygiene

Preventing and controlling healthcare associated infections

Hand hygiene

Hand hygiene is one of the most important methods of preventing spread of resistant organisms in hospitals and the most important step in preventing hospital acquired infections.

Our staff follow the “5 moments” of hand hygiene. These moments were developed by the World Health Organization and are a means of teaching and auditing hand hygiene.

We have made a lot of progress with Hand Hygiene compliance. In 2007, hand hygiene was performed less than 50% of the time. Current audits show hand hygiene compliance consistently approaches 80%. More than 500 nurses have been trained as hand hygiene auditors across all clinical settings. The results of these audits are used to

of staff were vaccinated against

influenza = more than 11,000

staff

80%


amounts of antibiotics that may contribute to development of bacterial resistance. We constantly benchmark our findings against similar organisations.

Improving the quality of clinical care into the future

At Monash Health an infection control clinical risk assessment is conducted for each clinical area. This assessment reviews the status of staff immunisation, the hand hygiene rate for the area, the level of cleaning, adherence to procedures such as sterile technique and use of invasive devices and storage of sterile stock.

The outcome of each assessment is provided to the site operations team to assist in making safety improvements related to infection control. These assessments have highlighted where capital equipment and resources are required and will continue to create opportunities to improve patient safety and quality of care.

Cleaning

Environmental cleaning plays a vital role in ensuring a safe environment for our patients. All our sites are audited both internally and externally against the cleaning standards for Victorian health facilities.

The development and implementation of superior cleaning procedures, using microfibre and steam, has provided an added level of safety. This ensures that cleaning is undertaken at the highest level every time a patient is discharged, even where there are patients with an unknown multi-resistant organism.

Monash Health has completed a major review of both patient and public bathrooms and toilets to ensure we continue to meet the required standards for cleaning. As a result, a number of improvements have been made to our bathroom and toilet facilities including the renovation of a number of patient bathrooms, replacement of bathroom and toilet fittings and an increase in cleaning frequency in high use public toilet areas. The renovation of bathrooms across our sites continues.

Monitoring infection

Our intensive care units closely monitor their central line associated blood stream infections through auditing of clinical practice and feedback. The implementation of chlorhexidine impregnated dressings have seen the reduction of infections to zero. Staphylococcus aureus bacteraemia (SAB) is also constantly monitored and strategies have been implemented to reduce line related SABs to zero. Monash Health has consistently had a SAB rate below the State target of 2 per 10,000 bed days, and work continues to reduce this rate to zero.

Improving care outcomes – antibiotic resistance

Resistance to antibiotics contributes to poor patient outcomes.

Our antimicrobial stewardship team consistently measures the appropriateness of antibiotic use across our health service and provides guidance and education on the safest antibiotic prescribing for our patients.

We have established surveillance systems in our laboratory where results are constantly monitored and reported, and strategies are introduced if resistance trends are identified. We also conduct specific screening of patients from high risk settings (such as overseas hospitals) or when patients have needed to be treated with large

Monash Health consistently

delivers above the state requirement for cleaning across

all of its sites.


Patientjourneys

Guillian-Barre syndrome is a form of nerve

inflammation resulting in a spreading paralysis.

Most people recover from it over time but there is

no known cure.

Guillain-Barré syndrome is a rare but serious autoimmune disorder in which the immune system attacks healthy nerve cells in the peripheral nervous system. A personal experience of Guillain-Barré syndrome

A recent case study presented at an allied health seminar series was a patient’s journey of Guillian-Barré syn-drome. The case study provided an opportunity for the allied health team to reflect on the experiences of both the patient, their family and the care team. Kerry May, Monash Medical Centre’s Director of Acute Allied Health recalls; “Dan came to Monash Medical Centre with symptoms including difficulty swallowing, double-vision, difficulty speaking, a persistent cough and altered feeling in his tongue...Prior to becoming unwell, Dan had no medical concerns, was working full time, a key mem-ber of his family and an avid Hawthorn supporter.”

Guillain-Barré syndrome is a form of nerve inflammation resulting in a spreading paralysis. Most people recover from it over time but there is no known cure.

Dan faced significant time in intensive care, an acute medical ward and rehabilitation.

“The allied health, nursing and medical team caring for Dan showed exceptional patient-centred care – going so far as to ensure his favourite strawberry milk formed part of his speech pathology treatment,” said Ms May.

Dan said throughout his experience, he felt staff listened to him and developed therapy programs to ensure his needs were met.

The team also provided Dan with the opportunity to attend a fundraising event by removing a tracheostomy. This allowed Dan and his family to remain connected to their friends, family and community.


Each January, more than 310 new medical, nursing, midwifery and pharmacy graduates commence their career at Monash Health. The Medication Safety Committee runs interprofessional education sessions for new staff during their three-day orientation.

Interprofessional medication safety education

The sessions highlight key messages related to the safe administration and prescription of medicines, common medication errors and how to avoid them and resources available at Monash Health. Medical and pharmacy graduates then receive a case study for a fictitious patient and complete a medication chart, a fluid chart and discharge prescription. Pharmacists review these completed forms to ensure all medicines have been prescribed safely and provide feedback if improvement is required. Feedback from medical interns indicate the sessions are particularly valuable, and give them an opportunity to apply their prescribing skills prior to commencing their first rotation as a medical officer.

Nursing and midwifery graduates participate in an interactive session highlighting common administration errors, calculations and documentation.94% of participants agreed or strongly agreed that the information was useful and 92% agreed or

Medication safety

strongly agreed the session was relevant to their practice.

Feedback from participants included:

• “The workshop was very useful and it was particularly helpful to run through writing discharge scripts and medication charts.”

• “A brilliant exercise.”

Feedback from young doctors included:

• “A useful way of preparing us for when we actually begin prescribing.”

• “It was good having the pharmacist to assist us in our practice in medication prescribing.”

Allergies and adverse drug reactions

The Medication Safety Committee worked with the Consumer Advisory Committee to introduce a patient information leaflet about medication allergies. The leaflet defines adverse drug reaction, allergy and what to do if a patient experiences an allergic reaction. Many people who believe they are allergic to medicines may actually have suffered from a side effect. The leaflet aims to improve patients’ understanding of allergies and adverse drug reactions, and inform them what information is important for hospital health professionals to know.

Documenting a patient’s allergy and adverse drug reaction details is important to ensure all health

Medication safety data

125,000 patients now have their allergy and adverse drug reaction details recorded in our

electronic records.

professionals caring for a patient have the same information. Our electronic prescribing system requires a prescriber to enter or confirm these details every time they prescribe medicines for a patient. This information is then automatically transferred to the pharmacy dispensing program and to the Scanned Medical Record. More than 125,000 patients now have their allergy and adverse drug reaction details recorded in our electronic records.


Medication Safety Standards Committee

Medication safety is an important part of patient safety. Understanding medication, its risks, dosage, side effects and many other issues, is part of the role of our pharmacy and nursing teams who operate across all of our sites. Partnering with consumers provides a way to improve information and education for everyone.

The past year on the Medication Safety Standards Committee has provided me with an ongoing opportunity to be part of some of the hospital decision making. I have been able to provide unique consumer insights from both my professional background and from a community perspective.

Through the current development of “my Medication Rights” in partnership with the Community Advisory Committee, the pharmacy and nursing research staff have provided another way in which we can all play a role in improving the patient experience.

Warren Fricke Consumer AdvisorMedication Safety Standards Committee


Our patients may require an emergency life-saving transfusion for major bleeding after surgery or having a baby, or they may have a medical condition such as thalassaemia where blood products are required regularly to stay alive or maintain good health.

We transfuse more than 28,721 units of fresh blood components annually across our major sites.

Monash Health has an organisational-wide approach to safe and appropriate transfusion practice in line with national clinical guidelines and standards.

The dedicated Monash Health Transfusion Committee meets quarterly, oversees transfusion governance and practice and has broad discipline, program and site representation including two consumer representatives.

The Transfusion Working Group, also a multidisciplinary team, meets weekly and is an essential part of transfusion governance and service activities.

There is a focus on quality improvement, such as adverse event and incident evaluation, transfusion policy and procedure development, and audit planning and analysis. Blood transfusion audits assist in updating and improving policies and procedures to ensure best practice.Our staff participate in the Victorian Blood Matters transfusion practice improvement program, with

Safe use of blood and blood products

representation on the Blood Matters Advisory Committee and the Serious Transfusion Incident Report Expert Group.

In 2015-16, an audit of red cell use was performed in one of the three emergency department to review the rates of “elective red cell transfusion” and assess the management of anaemia in this group of patients. This audit was used to provide information to the clinical area to improve practice related to assessment and management of transfusion considered to be ‘elective’ or non-emergency. Further audits will be conducted to monitor trends.

Monash Health is one of nine Victorian health services that has been given financial accountability for blood use by devolved funding for the financial year 2015-16. We are monitoring monthly utilisation and wastage against the budget and reporting to the Transfusion Committee meetings.

28,721 units of fresh blood components

were transfused annually across all of Monash Health’s major sites.


At Monash Health, we recognise pressure injuries (also known as pressure ulcers or bedsores) are a cause of significant harm to patients. Patients who are poorly nourished, have impaired mobility and/or reduced sensation are particularly at risk.

Prevention of pressure injuries requires the appropriate knowledge, skill and experience to identify risk factors and implement appropriate prevention strategies. It requires constant vigilance and is a collaborative effort between our clinicians, patients and carers to ensure the highest quality of care and best outcomes.

Preventing and managing pressure injuries

Recently, our wound resource nurses have been working with our frontline nursing and midwifery teams to improve clinical assessment skills and knowledge of pressure injury prevention. The wound resource nurses are working one-on-one with ward nurses to complete daily skin assessments on our high risk patients.

By sharing expertise, our goal is to improve early detection and identification of potential injuries. Initial results indicate we have improved the accuracy of skin assessments and the consistency of our assessment documentation and the early implementation of prevention strategies.We are always looking at new

ways to partner with our patients and carers. This year we are working with our consumers to gain feedback on new and more engaging ways of communicating pressure injury prevention strategies with our patients.

Monash Health is committed to using the latest evidence, providing access to the right equipment and making pressure injury prevention part of every clinician’s responsibility.

With much work having been now developed to ensure the correct policies, procedures and tools are in place, from July onwards, our patient focus on Falls Prevention and maintaining the integrity of the patients’ skin will start to gain momentum. Whilst it seems there is no ‘magic bullet’ to falls prevention, or problems with the skin, it is clear that patient engagement is one key strategy to help combat the problem. Staff education and training will also be ramped up as we all gain an understanding of what a pressure injury really looks like, how it should be managed and definitely how to help prevent them from occurring. Patients and their families and carers will play a key role in assisting staff to be made aware of and identify any special risks the patient might face so that everyone involved can help to improve the health and safety of all Monash Health patients.

Pamela Sloss Consumer Advisor Falls and Pressure Injuries Standards Committee

Falls and Pressure Injuries Standards Committee


We recognise falls as a significant risk to the patients in our care. Despite our very best efforts some patients do fall. Thankfully, the vast majority do not sustain serious injuries, however we understand the negative impact even a seemingly minor fall can have on their confidence and wellbeing.

The prevention and management of falls is a key concern in health services across the world. We partner closely with other Victorian health services and universities to share knowledge and work together on reducing falls.

The number of falls across Monash Health continues to be variable (see below graph). We regularly monitor our performance against others and while our falls rate is comparatively low, reducing the rate of patient

Preventing falls and harm from falls

falls and associated injuries is a continuing priority.

Monash Health is currently in the process of evaluating an initiative to identify patients at risk of falling.Developed by The Kingston Physiotherapy Department in collaboration with the Kingston and Satellites Falls and Skin Integrity Action Group, it provides a framework to identify at risk patients and modify their walking aids using a traffic-light tag system. The modifications incorporate a colour system to identify patients that: require assistance (red); require supervision (yellow); and are independent (green). If the pilot is successful, the initiative will be rolled out on other wards across Monash Health.This year, we have been working with our clinicians to ensure patients and their families are

provided clear information on falls prevention strategies. We have increased the level of education of nursing and medical staff. Our latest audit results indicate 76% of patients recall receiving falls prevention information and 98% of patients found the information helpful.

Rate of falls per 1000 bed days

1.0

Jul Aug Sep Oct Nov

0

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3.0

4.0

3.2

2.8 3.

0

2.6

2.6

Month

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of f

alls

per

1000

bed

day

s

The rate of falls across Monash Health continues to be variable.

3.5

2.5

1.5

0.5

Dec Jan Feb Mar Apr

2.3

2.9

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2.6

May Jun

3.3 3.

4


Each quarter, Dental Health Services Victoria provides Monash Health Dental Services with the Quality Clinical Indicators report. The clinical indicators are data sets which may highlight potential problems which need addressing.

Examples of the quality clinical indicators reported include:

Dental Health Services

• Restorative re-treatment within six months.

• Unplanned return within seven days subsequent to routine and surgical extractions.

• Denture remakes within 12 months.

• Extraction within 12 months of commencement of endodontic treatment.

The Dental Clinical Governance Committee uses the data to compare performance and implement changes if required. Any outliers or variants are investigated and the reports are used to change and improve clinical practice and staff training and recruitment.

Denture remakes within 12 months of initial treatment

We are continuously looking at improving the quality of care provided by our clinicians.

To improve our restorative re-treatment results, we constantly review new dental products and materials and provide education and training, including hands-on workshops, in order to achieve and deliver quality clinical care.

0.0%

0.5%

1.0%

1.5%

2.0%

2.5%

3.0%

Jul-Sep 14

Monash Health State

Oct-Dec 14 Jan-Mar 15

KEY:

Perc

enta

ge o

f den

ture

s re

quiri

ng re

mak

es

Initial treatment period

Regular reviews of new dental products and increased education and training means the percentage of our dentures requiring remakes is below the state level.

Apr-Jun 15


Dental Service marks 25 years

A celebration for Monash Health Dental Service’s 25 year silver anniversary drew a large crowd at 122 Thomas Street Dandenong in November 2015. The event attracted members of Parliament, local councillors and representatives from Dental Health Services Victoria and the Department of Health and Human Services. They joined past and present clients and staff to reflect on the incredible development and growth achieved throughout the years.

The growth of Monash Health Dental Services over its 25 years has been extraordinary —the service has moved from a single-chair clinic in Springvale to a four-chair clinic in Dandenong and the high-tech 10 chair facility at 122 Thomas Street Dandenong.


Our residential aged care facilities provide low and high levels of care, and specialise in aged persons mental health services.

We were successful in achieving accreditation with the Australia Aged Care Quality Agency. The five facilities met all 44 outcomes over 4 standards. A highlight identified was the dining experience project for the residents.

The project included modifications to the dining environment, meal presentation, taste and smell of food, flexibility in ordering meals and meal choices and availability of mid meals. Hydration stations were placed at multiple points in each facility with a range of refreshments including juices and frozen yoghurt.

Residential aged care services

Residents now make their own choices on a daily basis, and are able to change their choice at short notice.

Staff feedback indicated communication with residents was improved. There was a noticeable reduction in wastage as the food was served according to the residents’ preferences, and

Care on the move – supporting our staff and patients in an emergency

In February 2016, more than 50 patients were moved from the Kingston Centre after the hot water supply at two rehabilitation wards was interrupted due to a burst pipe. Over the course of the day, patients were relocated to Casey Hospital, Moorabbin Hospital, Monash Medical Centre and Dandenong Hospital.

Our engineering team determined that fixing the supply was complex and would take several weeks. Consequently, it was decided that patients would need to be transferred to another Monash Health facility. Many of our staff worked late into the night to discuss plans with patients, make contact

feedback from staff and family members has indicated that increasing nutritional intake is helping to improve residents’ health status.

The resident satisfaction survey 2015 recorded an increase in 16% for the quality of food and 10% in relation to meeting residents’ food preferences.

with patient families and make the necessary arrangements to ensure we could continue to provide patients with appropriate care.


Our residential facilities are committed to the safe and effective care of residents and provide quarterly reports to the Department of Health and Human Services that include pressure injuries (ulcers), use of physical restraint, multiple medication use (more than nine), unplanned weight loss, and falls and fractures.

The table below shows the rate of pressure injuries per 1000 bed days at Monash Health.

Intent to restrainWhile all efforts to achieve an environment free of restraints is made, sometimes residents require restraint to ensure their own safety. In these instances there has been full consultation with the family, staff and treating general practitioner and a full risk assessment completed to identify any possible alternate risk mitigation strategies. All residents affected are closely monitored to minimise the impact of the restraint.

Multiple medicationDue to the often complex comorbidities of the resident group, we expect residents to be on multiple medications. Through the process of specialist involvement and regular medication reviews all attempts are made to reduce the use of multiple medications.

Falls resulting in fracturesWe actively promote resident activity to prevent functional decline.

per 1000 bed days Pressure injuries

Stage 1Actual

State Range

Stage 2Actual

State Range

Stage 3Actual

State Range

Stage 4Actual

State Range

Allambee Nursing Home 0.00 0.35 0.48 0.38 0.00 0.07 0.00 0.02

Chestnut Nursing Home 0.00 0.35 0.45 0.38 0.00 0.07 0.00 0.02

Eastwood Nursing Home 0.00 0.35 0.19 0.38 0.00 0.07 0.00 0.02

Mooraleigh Nursing Home 0.28 0.35 0.00 0.38 0.00 0.07 0.00 0.02

Yarraman Nursing Home 0.00 0.35 0.28 0.38 0.00 0.07 0.00 0.02

per 1000 bed days Intent to restrainMultiple medication use (>9)

Unplanned weight loss (cons. 3mths)

FallsFalls related fractures

ActualState Range

Actual Range ActualState Range

Actual

State Range

Actual State Range

Allambee Nursing Home 0.16 0.34 4.39 4.44 1.76 0.76 5.99 7.21 0.00 0.15Chestnut Nursing Home 0.11 0.34 5.78 4.44 0.76 0.76 3.73 7.21 0.06 0.15

Eastwood Nursing Home 0.00 0.34 2.19 4.44 0.32 0.76 4.39 7.21 0.00 0.15

Mooraleigh Nursing Home 0.00 0.34 5.90 4.44 0.42 0.76 7.45 7.21 0.28 0.15

Yarraman Nursing Home 0.00 0.34 4.21 4.44 0.19 0.76 2.24 7.21 0.19 0.15

Delivering safe care in our residential aged care services

The table below shows the rate per 1000 bed days at Monash Health of intent to restrain, multiple medication use, unplanned weight loss, falls and falls related fractures.


The Victorian perinatal services performance indicators report aims to help improve outcomes for Victorian women and their babies by providing a focus for performance improvement in Victorian health services.

Health services are required to review their performance across the ten performance indicators in the report to recognise their strengths, identify opportunities to learn, share outcomes and plan for performance improvement within a continuous quality framework. The report provides data for each of Monash Health’s maternity sites; Monash Medical Centre, Dandenong Hospital and Casey Hospital.

Maternity services

Perinatal Mortality (death of a baby before or soon after birth)

A multidisciplinary, cross site committee reviews all aspects of healthcare that may influence perinatal mortality. This includes staff education, training and rostering, foetal monitoring capabilities and access to public pregnancy care. Improvements have been made in all identified areas with key targets achieved. Significantly, Dandenong Hospital is now able to provide 80% of women public pregnancy outpatient care, a vast improvement from the previous 20% of women. All birth rooms at each site have full foetal monitoring capabilities.

Foetal growth restriction at 40 weeks gestation

The foetal growth restriction is an important indicator because of the strong association between foetal growth and perinatal mortality. Detection of reduced or slow growth should ideally be detected and managed prior to 40 weeks gestation. Casey Hospital implemented a program which has subsequently been implemented at Monash Medical Centre and Dandenong Hospital. Actions included staff re-education, weekly team meetings to discuss women with suspected slow foetal growth and review of any “missed” cases. Posters of abdominal growth during pregnancy are now in every antenatal clinic to prompt clinical examination.


Each year, health services are required to provide reporting against the Victorian Audit of Surgical Mortality, which reviews information and data related to all deaths associated with surgical care.

Monash Health convenes a panel of leading experts to review consolidated organisational data related to surgical mortality and provides each hospital with an individual report for review by the relevant quality and safety committees.

The major clinical themes that have been identified for review, including case study presentations, include:

• Prevention of pressure injuries.• Use of intensive care units (ICU)

and high dependency units (HDU) capability.

• Perioperative fluid management (use of intravenous fluids before and after surgery).

In each case, the numbers are small and represent better performance than other Victorian health services, however each case is reviewed to ensure continuous improvement.

Surgery

Prevention of pressure injuries

• Audit compliance with existing procedures in pre and post-operative period.

• Reporting pressure injury rates compared to reported surgical deaths.

Use of ICU and HDU capability

• More robust and direct measures of missed Medical Emergency Team (MET) call in surgical death cases.

Perioperative fluid measurement

• A focus on fluid management related to paediatric patients.

• Review of current literature to understand practice implemented in other health services.

End of life care

Monash Health has implemented an organisational wide policy and accompanying procedures for providing safe, high quality end of life care. When put into practice, these policies and procedures enable staff to meet the needs of patients and carers. The guidelines cover palliative care inpatient and consultancy services, advance care planning, pastoral care, issues of cultural diversity, patient-centred care and end of life care.


“It was a relief to have this discussion, we

asked many questions and explanations were

clearly given to the family; this assisted

enormously.”

“It was interesting to discuss my plans for the future as it

was not something I had thought of before.

Great to finally talk about it.”

The Advance Care Planning Program at Monash Health commenced in 2006 and supports the principles of person centred care, autonomy and self-determination.

Advance care planning is the process of planning for future health and personal care whereby a person’s values, beliefs and preferences are made known to guide clinical decision making at a future time when the person cannot make or communicate preferences due to lack of capacity.

In 2014, the Department of Health and Human Services released Advance Care Planning: Have the conversation Strategy for Victorian Health Services 2014-16. We have since committed executive sponsorship and governance to implementing the strategy.

Advance care planning

The Advance Care Planning Program aims to embed a sustainable approach to advanced care plans that supports person-centred, shared and supported decision making principles. Key tasks for the program include:

• The provision of information sessions and clinical services to our consumers to discuss and document future health and personal care preferences.

• Nominating an agent for healthcare decision making.

• Providing education, training, mentoring and consultancy services to a range of healthcare professionals.

• Policy and procedure development.

• Using best practice information, healthcare standards and frameworks to continue to improve and develop services.

Our diverse community has embraced the opportunity to understand more about the options available to communicate future health care preference by participating in community information sessions, inservices and workshop education sessions delivered.

The awareness raising campaign has resulted in an 824% increase in referrals to the service from 2012-13 to 2015-16, and the upward trend is expected to continue.

0

50

100

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‘09-10 ‘10-11 ‘11-12 ‘12-13 ‘13-14 ‘14-15 ‘115-16

Referrals to Advance Care Planning Program

Referrals to Advance Care Planning Program have increased.

Year

Num

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f ref

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ls

From the program:


The Victorian Healthcare Experience Survey (VHES) includes four questions relating to leaving hospital. From these questions an adult inpatient transitions index has been developed. The Index provides an overview of how health services and hospitals are performing in the discharge process with the aim of improving discharge planning processes. VHES results are reported quarterly from 1 July to 30 June. Providing the best care for home birth

A world first program has been helping Casey women who want to give birth at home do so as safely as possible. The simulation program uses realistic role play to help midwives and paramedical staff deal with homebirth emergencies. Training involves three scenarios role-played over a day, and includes situations where the baby has to be resuscitated. Monash Health obstetrician and gynaecologist Dr Arunaz Kumar, who took part in this month’s training, said only 2% of women chose to give birth at home.

Dr Kumar said it was usually only healthy women with low-risk pregnancies who chose homebirths. The Monash Health simulation training was unique because it took place in a real house where limitations were more realistic than if it were done in a hospital.We partner with a

Access and discharge

Monash health adult inpatient discharge performance indicator

Q1 Q2 Q3 Q4Monash Health

State average

Monash Health

State average

Monash Health

State average

Monash Health

State average

66% 75% 70% 75% 66% 74% 72% 75%

In an effort to address our performance, discharge planning improvement is a high priority. Initiatives underway include:

• Improved discharge information for patients.• Improving discharge information in hospital.• Criteria-led discharge.• Assessing the effectiveness of expected discharge dates.• Assessing the model of discharge - Kingston Centre South 5 and South 6.• Assessing after hospital patient follow up at Moorabbin Hospital Radiology, Dandenong Hospital General

Medicine and the Acute Assessment Unit.• Inter and Intra-hospital transfers.• Use of media in discharge planning.

The adult inpatient transitions index is measured as a score out of 100, expressed as a percentage. This table illustrates how Monash Health compares to the state average according to the index.


Minister for Health opens life-saving clinic

A Victorian-first specialist clinic to treat patients allergic to the sting of Jack Jumper ants was established at Monash Medical Centre and launched by the Minister for Health, Jill Hennessy on Thursday 2 June 2016. The clinic delivers a lifesaving Jack Jumper ant venom immunotherapy program. This program desensitises those with a Jack Jumper allergy.

Jack Jumper ants are found across southern Australia, most commonly in Tasmania, Victoria and South Australia. It is the most dangerous ant native to Australia with its venom one of the most powerful in the insect world. In areas where Jack Jumper ants are common, 2-3% of people are allergic to their sting. An allergic reaction to its sting can be life-threatening for about half of these people. Several deaths from Jack Jumper ant stings and anaphylaxis have occurred in Australia, with a number of recorded cases in recent years. Jack Jumper ant venom immunotherapy treatment changes how the immune system responds to insect venom, with evidence showing it can prevent severe reactions and death. Until now, the closest clinic providing a Jack Jumper ant venom immunotherapy desensitisation

program was in Tasmania, where the ant is responsible for more severe allergic reactions than bee stings. Our new clinic will means Victorians who suffer Jack Jumper ant allergies no longer have to travel to Tasmania to get the treatment they need.

clinical lead, Medical Director Emergency Services Dr Neil Goldie. “Given the size of Monash Health in staff numbers and clinical sites this is obviously a challenge, but the response and engagement from everyone so far gives me great hope that we can make this a major success.” A series of real patient stories highlighted that even when a full recovery is made, the fear and anxiety of an extended hospital stay or the need for specialist care is significant for the patient as well as their family and friends.

It has been recognised globally that there is a significant problem in the recognition and timely management of sepsis, and so this program will help Monash Health, and all individual staff members to take a lead and reduce patient harm.

“When we talk about medical conditions like sepsis, we often talk about numbers, but it is worth remembering that each one of those statistics is a real person and their battle with sepsis has a significant impact on many people.”

Professor Erwin LohChief Medical Officer

All together to tackle sepsis

‘REACT,’ the Monash Health Sepsis Initiative was officially launched in September 2015 with a presentation at Monash Medical Centre broadcast to other Monash Health sites.

Timed to coincide with World Sepsis Day, the launch demonstrated the need for action.

“In order to tackle sepsis we really need an organisational-wide approach,” said the initiative’s


New online youth services directory

Monash Health recognises the value of strong partnerships with other health providers, universities, community organisations, philanthropic supporters and our consumers. With the support of government, non-government and community grassroots organisations, we continue to deliver the best possible care to our community.

New online youth services directory

In December 2015, the Monash Health Community’s Youth and Family Team announced the launch of a new web-based youth services directory – the Positive Pathways Youth Services Directory youthpositivepathways.com.au

The Positive Pathways Project is a School Focused Youth Service initiative funded by the Victorian Government through the Department of Education and Training, in partnership with Connections, UnitingCare and Monash Health. The project aims to make it easier for schools and community services to link young people and their families to the most appropriate support services. The website provides an easily navigable, up-to-date online directory for youth health and other services, particularly useful for those adolescents at risk due to chronic illness.

Building self-esteem for young people

A world-first study that included teenage girls from Casey and Dandenong has found that group-based therapy helps build self-esteem and could protect against eating disorders.

The study which has been published in the American Journal of Health Promotion, used group-based interventions to help girls at risk of developing eating disorders and mental illness. Professor Helen Truby, Head of the Department of Nutrition and Dietetics at Monash University and Laura Tirlea from Monash Health led the 10-week ‘Girls on the Go’ study.

Professor Truby said the study proved to effectively boost self-esteem. “This is the first large trial of a gender-specific community-based program that has shown to effectively increase self-esteem,” Professor Truby said. The program included interactive activities and discussions

Partnerships

about goal setting, body image, self-esteem, personal safety and assertiveness, healthy eating and physical activities.

Ms Tirlea said the findings were important given the study sample included a large number of girls from culturally and linguistically diverse backgrounds who were often under-represented in this type of research.

The ‘Girls on the Go’ research was funded by the Butterfly Foundation, a philanthropic trust committed to the prevention of eating disorders.

“Girls on the Go provides girls with a range

of issues with supports to improve eating habits,

in both primary and secondary schools.”


Researchers improving dementia care

Monash Health’s Chief Nursing and Midwifery Officer Cheyne Chalmers, and Director of General Medicine Associate Professor Don Campbell joined forces with Deakin School of Nursing and Midwifery in a study that aims to improve the hospital experience of patients with neurocognitive disorders, such as dementia and delirium.

The project, “Reducing harm, in the acute hospital setting, to people displaying symptoms associated with a neurocognitive disorder,” aims to co-produce a knowledge translation strategy to promote acute care nurses’ use of best practice.

The team is working with nurses and consumer advisors to develop a strategy, including a mobile app that will provide clinicians with ready access to information that will help them to manage patients with behaviours such as confusion and aggression.

$1.1 million to improve healthcare for refugees

Monash Health has joined forces with academics and researchers from universities and other healthcare organisations to improve primary healthcare delivery to refugees living in Australia. Monash University’s Professor Grant Russell successfully led a multi-national team of academics and partner organisations in securing a National Health and Medical Research Council (NHMRC) partnership grant valued at $1.1 million. Their work will be supported by a further $1.1 million in cash and in-kind contributions from partner organisations.

Refugees have complex health needs arising from past trauma and sub-optimal care prior to arrival that may not have been addressed due to system-wide inefficiencies and limited workforce capacity.

The Optimise Partnership Project is a unique opportunity for researchers to work together with health and social welfare sector partners to systematically address these gaps.

More than 75,000 people fleeing dangerous circumstances in their home countries were granted protection in Australia between 2010 and 2015. Many of these

refugees and asylum seekers have significant ongoing health challenges – from pre-migration trauma, disrupted healthcare prior to arrival and the demands of settling in a new country.

The vision of the Optimise Partnership Project is to build health system capacity for ensuring that people of refugee background receive the primary care they need when they need it. Not only will this reduce inappropriate use of hospital emergency departments, but will increase the ability of general practices to deliver high-quality care to refugees.


We are proud to be a patient-centred organisation. Listening to our patients is vital to improving their care experience.

Supporting our community through heart failure research

The ‘Journey of people with Heart Failure’ report was a partnership between consumers, Monash Health and the Victorian Cardiac Clinical Network on behalf of the Health Innovation Reform Council.The initiative tracked the journey of 1057 people with heart failure across health services over a 12 month period. This report is a platform to build historical data, illustrate trends in performance over time, enable ongoing measurement of heart failure care and identify opportunities for quality improvement. The approach taken is also transferrable across other chronic conditions.

This report and ongoing improvements in people living with heart failure provides the community with information, support and communication tools, so that they can make meaningful and informed decisions about their ongoing care.

Lacey brings a smile to residents

Our Doveton Community Care Unit (CCU) participated in a qualitative study exploring the benefits for

Responding to the needs of consumers

residents of owning a pet dog. Lacey the dog resides at Doveton CCU, a 20-bed facility providing 24-hour clinical support to adults experiencing a mental illness living within the areas of Greater Dandenong and the City of Casey and Cardinia. She is cared for by all of the staff and residents at the CCU.

Residents have become very attached to Lacey who is a friendly, sociable dog who loves to be active. She has learnt many tricks, from jumping through hula-hoops to giving high fives, and has been able to show off her skills at the Dandenong-based mental health services including Unit 2, Unit 4 and Youth Prevention And Recovery Care Services.

Although not a trained pet therapy dog, Lacey plays a significant part in the rehabilitation of the patients of these services and they look forward to her visiting them on a fortnightly basis.

The healing power of natural imagery

The Monash Health Art Space at Monash Medical Centre highlighted the healing power of natural imagery with a special exhibition of photography by local artist Kieran Stone. The images enabled patients, staff and visitors to experience amazing natural environment from Australia, Asia and New Zealand.

After the exhibition, the photographs were installed in

wards at Kingston Centre to provide comfort and relaxation for patients with delirium or dementia.

A day in the life of those with severe dysphagia

Dysphagia is a swallowing impairment that affects around one million Australians. Staff undertook a challenge as part of Swallowing Awareness Day, a day marked by Speech Pathology Australia to raise awareness of dysphagia and the difficulties it can present to those with the impairment.

Speech Pathologist Ben Smith decided to sample the diet of a patient with severe dysphagia.Eating nothing but pureed foods and extremely thickened fluids for a whole day, Ben gained significant insight into what it’s like for those with a significant swallowing impairment.


We are proud to highlight a selection of winners from this year’s Monash Health Innovation Awards which showcase the outstanding activities our staff have undertaken demonstrating leadership and excellence in the provision of health services to our community.

Engage, educate and improve oral health for patients and staff at Monash Health

(Winning award category: Excellence in person, family and community-centred care)

As part of World Oral Health Day in March 2016, Monash Health Dental Services provided free dental check-up and oral health education sessions to patients on the waiting list. The main objective of the day was to educate patients, help them improve their oral health, assess their oral health risk status, and ensure timely provision of the services for the high risk group.

The initiative was a great success - 468 patients were given an oral health assessment, advice and removed from the waiting list. Fluoride application was done for 24% of the total patients, with 21% of the patients screened having more than four to six decayed teeth.

Patient feedback of the day was very positive with 99% stating the staff were helpful and assisted with their needs.

Monash Health Innovation Awards

Engaging clinicians with our patients’ experience

(Winning award category: Improving healthcare through clinical research)

Understanding the experience of patients with both medical and mental health comorbidities can be a challenge. One reason for this is patients engage with many parts of the service and many clinicians.

Survey results capture a patient’s experience after a unique episode of care – however the patient’s experience of the service is built upon the sum of experiences they have had with the service overtime.

‘The patient interactive’ changes this allowing the clinician to understand the patient’s clinical journey over time.

Co-located physiotherapist and sonographer-led hip dysplasia clinic

(Winning award category: Innovative models of care)

Children under the age of six months diagnosed with developmental hip dysplasia are required to attend multiple appointments for investigation and treatments.

This co-located physiotherapist and sonographer-led hip dysplasia clinic aligned initial care for patients to a single day. Families stated that they found the new service a more efficient use of their time and found it helpful to find out the results and treatment decisions immediately.

The outcome for clinicians was equally positive with 80% of sonographers and 94% of physiotherapists stating the professional discussion helped to classify the degree of hip dysplasia and subsequent clinical decision making.


Feedback and consultation

The Monash Health Quality of Care Report is compiled by the our Patient Experience office in conjunction with our consumer advisors and our staff. Prior to production, feedback on our previous report was sought from our staff, community and consumers of our health services.

Distribution

Hard copies of Monash Health’s Quality of Care Report are provided to the Department of Health and Human Services (Victoria), local government and service providers within Monash Health’s catchment, the Community Advisory Committee (CAC), Board of Directors and upon request. The report is also available on the Monash Health website www.monashhealth.org so that it can be accessed by the wider community.

Help us improve, tell us what you think

We welcome your feedback about the value and relevance of this report and all aspects of the services we provide at Monash Health.

Please contact us:

Patient Experience OfficeMonash HealthLocked Bag 29Clayton South Victoria 3169t: 03 9594 4019w: www.monashhealth.org

Are you interested in bringing a community perspective to decisions that are made in your local health service?

We are always interested in hearing from consumers, carers and community members who might want to provide feedback to our organisation or to join the Monash Health Consumer Adviser Register.

Being a member of the Consumer Adviser Register creates opportunities for individuals interested in quality and safety, patient experience or health issues to participate in our health service.

If you are interested in providing feedback to Monash Health or becoming a consumer adviser, please email [email protected] or phone 03 9594 6230.

Feedback and distribution


Monash Health sites and contact details

Monash Health Corporate OfficeMonash Medical Centre246 Clayton RoadClaytont: 03 9594 6666

Casey Hospital62-70 Kangan DriveBerwickt: 03 9594 6666 Cranbourne Centre140-154 Sladen StreetCranbournet: 03 9594 6666

Dandenong Hospital135 David StreetDandenongt: 03 9594 6666

Kingston CentreCnr Kingston and Warrigal RoadsCheltenhamt: 03 9594 6666

Monash Medical Centre246 Clayton RoadClaytont: 03 9594 6666

Moorabbin Hospital 823-865 Centre RoadEast Bentleight: 03 9594 6666

Monash Health Community

Berwick28 Parkhill DriveBerwickt: 03 8768 5100

Cockatoo7-17 McBride StreetCockatoot: 03 5968 7000

Cranbourne140-154 Sladen StreetCranbournet: 03 5990 6789

Dandenong 122 Thomas StreetDandenongt: 03 8792 8100

PakenhamCnr Deveney Street and Princes HighwayPakenhamt: 03 5941 0500

Springvale55 Buckingham AvenueSpringvalet: 03 8558 9000

Monash Health Corporate Office

ABN 82 142 080 338 246 Clayton Road, Claytont: 03 9594 6666 e: [email protected] w: www.monashhealth.org

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