Hospital Healthcare Autumn 2022

AUTUMN 2022
SAFETY
ISSUE
PP100022780
THE SAFETY
FALLOUT OF
REDUCING CODE BLACKS
AGED CARE AND THE SILENT KILLER
PATHWAY OUT OF THE PANDEMIC

WORKER
IMPROVING ORGANISATIONAL
PERFORMANCE FATIGUE
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CONTENTS
©stock.adobe.com/au/Inna
SAFETY ISSUE
SAFETY
16 18 22 26
How this hospital halved its VPR reforms will restrict The safety fallout of worker Safe management of COVID-19
code blacks equitable access to health care fatigue treatments
INFECTION CONTROL TECHNOLOGY
32 34 36 44
Pathway out of the pandemic Four actions for influenza PPE, HEPA filters and virus Digital ‘twins’ for paediatric
control aerosol protection hip surgery
AGED CARE
47 58 77 79
Cybersecurity is everyone’s The road to net zero Toward the great reset Malnutrition: the silent killer in
responsibility emissions in health care aged care
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4 HOSPITAL + HEALTHCARE AUTUMN 2022 hospitalhealth.com.au

CONTENTS
MANAGEMENT
8
Editor’s Welcome
Mansi Gandhi
16, 22
Contributing Editor
Amy Sarcevic
40 64
How to alleviate the shortage The rising cost of patient care
of critical care nurses
10
The Rounds A DAY IN THE LIFE
Breaking news and
latest medical research
26
Pharmacy
Kristin Michaels, SHPA Chief
Executive
50 60
Improving organisational A Day in the Life: Leanne
performance in health care Northrop, an Aged Care Nurse
47 Practitioner
Technology
Australasian Institute of DESIGN IN HEALTH
Digital Health
77
Aged Care
Sean Rooney,
CEO, LASA
66 74
Recovery and mental health Meeting growing regional
needs
DAILY NEWS
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A nxiety. Exhaustion. Depression.
Burnout. Post-traumatic stress
disorder (PTSD). More than two years
Elsevier Health’s recently published ‘Clinician
of the Future’ global report reveals how one in
three clinicians are considering leaving their
[email protected] into the pandemic and we often hear current role by 2024. To ensure a positive shift
these words associated with workers in moving into the future — and to fill current
Advertising Sales:
the healthcare industry. gaps — clinicians highlight the following
Nikki Edwards
priority areas for greater support: enhancing
+61 431 107 407 COVID-19’s impact on the wellbeing health technology skills; a greater focus on
[email protected] of health workers is staggering. Latest the patient–provider relationship; and an
research by Professor Marie Bismark, expanded healthcare workforce.
PUBLISHED BY a public health physician and health
Westwick-Farrow Media lawyer who leads the Law and Public But it’s not all doom and gloom in the sector
A.B.N. 22 152 305 336 Health Group at the University of that’s going through a massive transformation.
Melbourne, and colleagues suggests This issue also features a range of exciting
that one in 10 Australian healthcare projects and initiatives on a variety of topics
workers reported thoughts of suicide and themes — a program that helped a local
or self-harm during the pandemic, hospital halve its code blacks; how digital
CELEBRATING
YEARS with certain groups being more ‘twins’ could transform paediatric hip surgery;
vulnerable. Not surprisingly, and rather the impact of shift work on impulse control;
unfortunately, most of these workers aged care and malnutrition; and an Australian-
with thoughts of suicide or self-harm did first pilot aimed at providing equitable access
not seek professional help. to clinical trials for patients in regional areas.
www.wfmedia.com.au
Researchers suggest that strong and Also, make sure you check out the exciting
sustained action is urgently needed to new projects featured in this issue’s ‘Design
Head Office
Unit 7, 6-8 Byfield Street, North Ryde protect the safety of healthcare workers in Health’ section — one on the 339-bed
Locked Bag 2226 and provide meaningful support. Maitland hospital in the Lower Hunter Valley
North Ryde BC NSW 1670 The challenges facing the healthcare of New South Wales and another on a
AUSTRALIA workforce don’t just impact their and new dedicated adult mental health unit at
ph: +61 2 9168 2500 their family’s wellbeing, they also Blacktown Hospital.
present safety risks. The article on page
If you have any queries regarding our Happy reading!
privacy policy please email 22, featuring Consultant Emergency
[email protected] Physician Dr Stephen Parnis, discusses
the safety fallout of worker fatigue in
Subscriptions for unregistered readers - health care. Dr Parnis reminds us how
price on application extended hours, exhaustion and mental
fatigue increase the risk of clinical errors,
and shares what is needed to change Mansi Gandhi
Printed and bound by Bluestar Print the status quo and improve outcomes
Print Post Approved PP100022780 for both staff and patients. Of course, Editor, H+H
ISSN 2204-3438 PRINT these aren’t the only challenges facing [email protected]
ISSN 2204-3446 DIGITAL
the healthcare sector.
NOTICE:
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The Rounds
Updates in health care
Funding boost for local nurse’s
tech startup
Amelio Health, a provider of chronic pain management
programs, has received the federal government’s Boosting
Female Founder Initiative grant.
The company is one of 51 recipients from over 2200
applicants vying for $12m in funding. Applications were
©stock.adobe.com/au/Daniel Vincek
assessed by an Independent Assessment Committee made
up of women entrepreneurs, which was led by Professor Jana
Matthews, ANZ Chair in Business Growth and Director of the
Australian Centre for Business Growth at the University of
South Australia.
CEO, Nurse and Founder of Amelio Health Kathy Hubble said
the grant will allow her company to accelerate global growth
and develop technical enhancements that will be essential for
scaling purposes. “Being a recipient of this grant is a fantastic
SA Health, Flinders test new dietary tool way to shine the light on the problem of chronic pain and
for cancer patients how we are helping thousands of people manage their pain
A new dietary tool to quickly and accurately assess micronutrient levels and get their lives back, ” Hubble said.
aims to help cancer patients fight disease, according to Flinders University The Amelio Health program has an 85% completion rate,
researchers. with 95% of those participants increasing their capacity and
“Dietary intake, specifically consumption of anti-inflammatory micronutrients, getting their life back. Pain coaching alone does not address
can play a role in both cancer initiation as well as the treatment-related the complex nature of chronic pain, especially when it comes
outcomes experienced by patients receiving systemic cancer therapy,” said to medication rationalisation. The company also provides
Flinders University PhD candidate Mitali Mukherjee, an accredited practising learning for rehabilitation consultants.
dietitian at Flinders Medical Centre. Amelio Health also uses data to drive behaviour change and
“Tested by 112 cancer patients, our 21-item food frequency questionnaire for 14 assist live health coaching and nudging. We can see the
common micronutrients can be done in about 10 minutes and could be used emotional impact on physical function as it is happening, and
to screen patients having suboptimal micronutrient intakes. gently nudge people in the right direction.
“We hope it will pave a pathway for provision of dietary advice in clinical Hubble launched Amelio Health in January 2020 with the
practice and future observational research with chemotherapy and support of rehabilitation company Recovre. My team and
immunotherapy cancer treatments.” I offer education and medication management for people
suffering with chronic pain, and practise decision support for
Mukherjee, with other SA Health and Flinders University experts including
rehabilitation consultants, Hubble said.
Professor Michelle Miller and medical oncologist Dr Shawgi Sukumaran, hopes
to expand the study to use the tool to test the validity of anti-inflammatory “Amelio Health helps clients overcome the challenges of
nutrients among oncology patients receiving systemic treatment. resource deficiencies and disruptive processes to create
innovative and operational excellence in an ever-changing
The tool tested adequacy of a patient’s micronutrients for 12 nutrients include
environment. Having long been a burning platform in life
copper, iron, vitamins A, E and D, alpha linolenic acid, long-chain omega 3 fatty
insurance, chronic pain is now being viewed and treated
acids (LC n3-FA), arginine, glutamic acid, isoleucine, leucine and valine.
through an entirely new, holistic lens. It’s paying powerful
“Further research could help to determine whether micronutrient intakes and dividends for customers and life insurers alike,” Hubble said.
an anti-inflammatory diet can aid in altering the tumour microenvironment,
reduce inflammatory side effects and immune-related adverse events,” said
senior author Dr Sukumaran.
Dietary factors have been associated with risk of developing cancers,
especially breast, colorectal, head or neck, lung and prostate. Dietary factors
also play a role in side effects and chemotherapy and other treatment options
for cancers. Previous studies have confirmed the benefits of a lower dietary
©stock.adobe.com/au/peterschreiber.media
inflammatory index score associated with a Mediterranean diet or less

processed or refined foods comprising large amounts of fruits and vegetables,
lean meats, fish, wholegrains and healthy fats.
Mukherjee said there is currently no validated tool to measure micronutrient
intakes in a clinical setting.
“Collecting comprehensive dietary information from a diet history and
analysing it with Foodworks software can take up to two hours to assess
micronutrient intakes, which is generally not feasible in clinical practice,”
she said.

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The Rounds
How antimicrobial resistance spreads
inside the human gut
A collaboration between the Hudson Institute of Medical Research and
the Wellcome Sanger Institute, Cambridge UK, explores how antimicrobial
resistance (AMR) spreads inside the human gut.
Lead researcher Dr Samuel Forster said resistance occurs when bacteria
Nurse researcher recognised by acquire changes and no longer respond to antibiotics. This makes
international society infections harder to treat and increases the risk of disease spread, severe
illness and death.
Australian College of Nursing (ACN) President Emeritus
Professor Christine Duffield FACN has been announced as “Antibiotic resistance is emerging
one of 32 new inductees into the Sigma International Nurse at an alarming level, rendering
Researcher Hall of Fame. some bacterial infections
untreatable and increasing
Professor Duffield is an internationally renowned and passionate dependence on last line
nurse who has worked across direct care, consultancy, antibiotics,” Dr Forster said.
academia, research and leadership roles to spearhead the
advancement of the nursing profession in Canada, New “The gut microbiome contains
Zealand, the UK and Australia for over 40 years. She has thousands of beneficial bacterial
published over 200 research papers and is Associate Editor species, each of which may carry
for the International Journal of Nursing Studies, the most highly antibiotic resistance genes and
ranked international nursing journal. share these with disease-causing
bacteria,” he said. “This work
“I am humbled to receive such a prestigious recognition in the provides a new tool in the toolkit
international nursing community. I would like to acknowledge Dr Sam Forster in his lab at the
for managing the emerging threat Hudson Institute, where he studies
all the other inductees for this year, including my Australian of antimicrobial resistance.” antimicrobial resistance.
colleagues Professor Jeroen Hendriks MACN, Professor Tracy
Levett-Jones and Professor Lisa McKenna FACN. It is an honour Bacteria can develop resistance
to be in such elite company,” she said. either through changes in their genetic sequence or by acquiring
resistance genes from other bacteria. But resistance in pathogens is just
ACN CEO Adjunct Professor Kylie Ward FACN said, “Nurses one side of the story — the beneficial bacteria in our microbiomes also
working in research roles play a leading role in advancing need ways to protect themselves, otherwise they will be destroyed every
our profession and ensuring we are at the cutting edge of time we take antibiotics.
healthcare innovation and professional practice,” she said.
Understanding the diversity of resistance in the microbiome and
“The achievements of Professor Duffield and her fellow which ones can be spread to pathogens allows us to be prepared and
Australian nurse researchers highlight the respect and influence take actions to prevent this occurring.
our nurses have on the world’s biggest health profession.
“Our research provides world-first experimental identification of the
key mediators of this transfer from the microbiome to pathogens,” said
Dr Emily Gulliver, a postdoctoral researcher also working on the project.
“Of most concern, bacteria carrying these elements were also detected
in other body sites including the vagina, skin and nasal cavity, with some
also found across diverse environmental samples. This suggests how
©stock.adobe.com/au/eskay lim
widespread these elements may be,” Dr Gulliver said.

Dr Forster said, “In this case we are discovering the rules that allow bacteria
to share key functions between them and using this knowledge to reduce
and prevent potentially deadly infections.”
This research was published in Nature Communications.
©stock.adobe.com/au/Andrea Danti
Alzheimer’s: disease cost expected to rise by
70% to $26.6bn
The cost of Alzheimer’s disease is projected to rise by more than 70% to around
$26.6 billion over the next 20 years, according to a new report by the University of
Canberra’s National Centre for Social and Economic Modelling (NATSEM).
Dementia Australia CEO Maree McCabe AM said with almost half a million
Australians living with dementia — and Alzheimer’s disease the most common form
— this report reinforces the likelihood that dementia will have a staggering future
economic cost without urgent action.
“Dementia is the second leading cause of death and the leading cause of death of
women in Australia. It is the major chronic disease of this century,” McCabe said.
The report, titled ‘The Economic and Societal Cost of Alzheimer’s Disease in Australia, 2021–2041’ and commissioned by Biogen Australia and
New Zealand, builds on NATSEM and Dementia Australia’s ‘Economic Cost of Dementia in Australia 2016–2056 Report’, released in 2017.
In order to reduce costs in the longer term, there needs to be a bi-partisan long-term commitment to improved services, research and
increasing our understanding about dementia risk reduction, according to McCabe.
The report indicated costs could significantly be reduced if a disease modifying therapy for Alzheimer’s disease was to become available. The
result would mean fewer people having moderate to severe symptoms which would in turn, over time, reduce the impact on the health, aged
care and disability systems.
“The introduction of a disease modifying therapy has the potential to lower the economic impact but is only part of the solution.
“The time for a holistic, sustained and coordinated approach is now,” McCabe said.

It’s time to fight
antimicrobial resistance
Appropriate wound care for infection prevention and infection management

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1 Fleming-Dutra, K., et al. (2016). “Prevalence of Inappropriate Antibiotic Prescriptions Among US Ambulatory Care
Visits, 2010-2011.” JAMA: The Journal of the American Medical Association 315(17): 1864-1873
2 Tackling drug-resistant infections globally: Final Report and Recommendations – The Review on Antimicrobial
Resistance chaired by Jim O’Neill, May 2016
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The Rounds
©stock.adobe.com/au/Kateryna_Kon
Breast cancer: how often
©stock.adobe.com/au/Tyler Olson
does overdiagnosis occur?
A new modelling study from the US found that
previous estimates of breast cancer overdiagnosis
may have been overestimated. The study, based
on data from the Breast Cancer Screening
Consortium, suggests that overdiagnosis, or
the finding of tumours that may never have
progressed or caused harm in a woman’s lifetime,
occurs in about 15% of screen-detected cancers.
The US Preventive Services Task Force (USPSTF) cites overdiagnosis as one of the chief New drug study hopes
potential harms associated with mammography screening because of the burden and adverse
consequences of unnecessary treatments. Therefore, knowledge about overdiagnosis is critical
to help kids with severe
for supporting shared decision-making about screening. However, the risk for breast cancer epilepsy
overdiagnosis in contemporary screening programs remains uncertain, with the most widely cited Researchers from the University of South
estimates reaching about 30%. Australia, in association with European
Researchers from Duke University and the Fred Hutchinson Cancer Research Center studied researchers, are investigating a range of
data from Breast Cancer Surveillance Consortium facilities to estimate the rate of breast cancer FDA-approved drugs with the aim of helping
overdiagnosis in contemporary mammography practice for a cohort including 35,986 women, kids with severe epilepsy.
82,677 mammograms and 718 breast cancer diagnoses. To estimate overdiagnosis. Malignant migrating partial seizures in
In a program of biennial screening of women aged 50 to 74 years, which corresponds to USPSTF infancy (MMPSI) is a childhood epilepsy
recommendations for average risk women, approximately 1 in 7 screen-detected cases would be most commonly caused by mutations in
overdiagnosed, the research found. Increasing the screening interval to annual screening did not the KCNT1 gene — a gene responsible for
seem to affect this number. regulating neuron activity in the central
neural system. Children with this genetic
An editorial from Massachusetts General Hospital says that these findings may help women who
condition are very unwell and can suffer up
are considering having mammography screening better understand the risk of overdiagnosis.
to 100 epileptic seizures a day.
There is no cure or current therapy to relieve
the condition and the research aims to
change this.
Music for stem cells: how soundwaves could help The researchers, funded by the Channel
regrow bones 7 Children’s Research Foundation, will
Researchers from the RMIT University have used high-frequency soundwaves to turn stem investigate a range of drugs flagged as
cells into bone cells, in a tissue engineering development that could one day help patients possible options for children with MMPSI,
regrow bone lost to cancer or degenerative disease. testing their effectiveness on reducing
seizures.
To date, experimental processes to change adult stem cells into bone cells have struggled
with mass production, making widespread clinical application unrealistic, according to RMIT Chief investigator Professor Leanne
researchers. Additionally, the few clinical trials attempting to regrow bone have largely used Dibbens (UniSA) is an expert in the genetics
stem cells extracted from a patient’s bone marrow. of childhood epilepsy and was involved in
the first discovery of the genetic mutations
RMIT research team have showed that stem cells treated with high-frequency soundwaves
that cause epilepsies, including MMPSI. She
turned into bone cells quickly and efficiently. Importantly, the treatment was effective on
said that this research could deliver life-
multiple types of cells including fat-derived stem cells, which are far less painful to extract
changing outcomes for affected children
from a patient.
and their families.
Dr Amy Gelmi, Co-lead researcher and a Vice-Chancellor’s Research Fellow at RMIT, said,
“The non-seizure drug Quinidine has been
“The soundwaves cut the treatment time usually required to get stem cells to begin to turn
trialled in a number of children, but with
into bone cells by several days.
little improvement, so there’s an acute
“This method also doesn’t require any special ‘bone-inducing’ drugs and it’s very easy to need for new drugs to treat children with
apply to the stem cells. KCNT1 mutations.
“Our study found this new approach has “We will be investigating a range of FDA-
Credit: RMIT University
strong potential to be used for treating the approved drugs that have been identified
stem cells, before we either coat them onto to limit the effects of the potassium gene
an implant or inject them directly into the mutation, and in this way, we hope to
body for tissue engineering.” identify a high potential drug to treat this
The high-frequency soundwaves used in the type of severe epilepsy,” Dibbens said.
stem cell treatment were generated on a low- A significant advantage of the study is that
cost microchip device developed by RMIT. the eight drugs within the study are already
The soundwave-generating device the FDA-approved, which means the need for
researchers have developed can be used to lengthy and costly clinical trials to prove the
precisely manipulate cells, fluids or materials. drugs’ safety and efficacy is eliminated.
Magnified image showing adult stem cells in The next stage in the research is Positive results from this study will make a
the process of turning into bone cells after investigating methods to upscale the strong case for trialling the drugs in people
treatment with high-frequency soundwaves. platform, working towards the development with KCNT1-epilepsy, with children suffering
Green colouring shows the presence of of practical bioreactors to drive efficient from this severe form of epilepsy having
collagen, which the cells produce as they
stem cell differentiation. immediate access to successful drugs.
become bone cells.

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SAFETY
How this hospital halved its

code blacks
Amy Sarcevic
I t used to be a familiar scene for Emergency

Department Director Prof. Paul Preisz. A
psychiatric or drug-affected patient being
ferried to and from departments. Too
behaviour-disturbed to be treated by medics.
Too physically unwell to be in the sole care
of psychiatrists. Often left to sit for hours in
a crowded waiting room, or in the back of a
police wagon, the patient’s condition would
worsen, agitation would breed and violence
would typically ensue.
In fact, scenarios like this are said to account
for a large portion of Australia’s hospital
violence statistics. In some metropolitan
hospitals, up to 10,000 code blacks are
reported every year; and across the sector, up
to 38% of workers have experienced physical
assault at least once in their careers.
Witnessing too many patients with
comorbidities falling through the cracks in
the system, Prof. Preisz founded Australia’s
first ever PANDA (Psychiatric, Alcohol and
Non-prescription Drug Assessment) unit at
St. Vincent’s Hospital in November 2020 —
a holistic pit stop where people could have
their complex needs addressed at once.
Never turned away, patients presenting at
the PANDA unit are immediately granted
a quiet personal space where a team of
toxicologists, psychiatrists, doctors and other
specialists provide a unique blend of acute complex comorbidities, it wasn’t what we “The man was immediately given a private
and social care. set out to achieve. However, given the bed away from the commotion of the
current rates of violence among this emergency department, where staff were
The result: a 50% reduction in ‘code blacks’
patient cohort, it is certainly something able to diffuse his temperament and provide
since the unit’s inception, amongst a cohort
to be celebrated.” tailored care. Shortly after admitting him, we
that would typically present the highest risk
placed him on a fairly strong detox program
group for security threats. In fact, Preisz recalls receiving a heartfelt
and provided the necessary social supports.
thank you note from one of his most
Today, Prof. Preisz — whose unit has treated It turned out the patient had a significant
challenging patients. Recently out of jail,
upwards of 3000 people to date — spends background of post-traumatic stress disorder
the man was homeless, had a significant
more of his time poring over thank you and a range of medical issues, including high
drug history and was experiencing
cards from patients, than security incidents blood lipids and prediabetes. We arranged
methamphetamine-induced psychosis
from staff. housing for him and enrolled him as an
when he presented at the PANDA unit. In
outpatient to provide longer-term medical
“The reduction in patient violence is quite a traditional healthcare setting, he would
care,” Preisz said.
a remarkable side effect of the PANDA likely have become aggressive or violent.
initiative,” he told Hospital + Healthcare. At PANDA, he remained cooperative and Not long after his admission, Preisz and
“With our main goal to adequately treat amenable to treatment. team were surprised to receive the man’s

SAFETY
“Never turned away, patients

presenting at the PANDA unit are
immediately granted a quiet personal
space where a team of toxicologists,
psychiatrists, doctors and other
specialists provide a unique blend of
acute and social care.”
©stock.adobe.com/au/Khunatorn
letter in the mail — a level of gratitude not Staff experiences on the PANDA ward or are met with violence instead. At PANDA,
often seen amongst people presenting to are positive too, with many relishing the the environment fosters better patient/staff
ED in such circumstances. experience they gain at the facility. relationships, giving workers a better sense
of having made a meaningful difference.”
“It’s quite different to how things could have “A junior doctor of mine once said
unfolded in a traditional healthcare setting. I something lovely,” Preisz recalled. “He The PANDA model is already being
recall seeing patients of a similar nature being told me the experience of working at the considered in other major hospitals and
sent to and from the very same wards in an PANDA unit had made him not only a better there is increasing talk about expanding the
ambulance because none of the staff felt doctor, but a better person. It’s wonderful model, in light of its success. Preisz hopes
they had the right specialty to take care of the to hear feedback like that, because it shows it will be the start of a growing trend — for
person. When they are finally admitted, the harmony between people’s expectations the sake of patients and staff.
patient is rightly frustrated and often becomes and the reality of working in health care.
threatening towards staff, or physically lashes People often go into the field because they “Every patient has the right to receive
out. Providing tailored care and placing them want to help people and have a rewarding the care they need; and every healthcare
in a low stimulation environment sees patients experience in doing so. In traditional wards, worker has the right to a safe working
with complex comorbidities behaving quite workers can grow disheartened when they environment. Thankfully the PANDA unit
differently,” Preisz said. don’t get the appreciation they deserve — provides both.”
hospitalhealth.com.au AUTUMN 2022 HOSPITAL + HEALTHCARE 17

TELEHEALTH
VPR reforms will restrict

equitable
access to
health care
Dr Margaret Faux* & Dr Silvia Pfeiffer**
F rom July this year, Australia’s MBS

telehealth system is going to change
once again, and this comes after two years
will be unable to access a doctor or seek
medical treatment via telehealth unless
they’re registered with the practice.
Australia to create the VPR mandate. The
scheme will be open for registration from
July and MBS telehealth for general practice
of constantly evolving rules and regulations would be contingent on the patient being
This leaves patients with no other option
regarding the delivery of healthcare services registered from 1 July 2023.
but to register, leading to industry concerns
in this country. In a few short months, the
about practical compulsion in Australia’s To be eligible for registration, patients
controversial new voluntary patient registration
healthcare system. must visit a practice at least three times
(VPR) laws will come into effect.
during a two-year period, followed by one
Here, we explore why Australia’s misleading
According to the 10 Year Health Plan, visit every two years thereafter to preserve
new VPR reforms will restrict equitable access
MBS telehealth will not be available to a registration. Once these reforms come
to healthcare and how this will hinder our
patient unless they’re registered with the into effect, only registered patients will
nation’s healthcare outcomes.
GP practice. In application, the reforms be able to access MBS-funded telehealth.
will extend the “existing relationship rule” Voluntary patient reforms and Whereas, currently for patients to access
GPs currently experience with telehealth MBS subsidised telehealth with a GP, they
consultations and a number of other the MBS must have had at least one fact-to-face
healthcare arrangements. Although the new In line with the 10 Year Health Plan, the consultation in the last 12 months with a
laws are described as ‘voluntary’, patients government will invest $69 million in Services treating doctor or practice.

TELEHEALTH
©stock.adobe.com/au/nito
“The VPR scheme
won’t just affect MBS care, is out of touch with the modern
telehealth, but will digital healthcare system and ultimately

feels paternalistic. The VPR scheme will
compel patients into a relationship with the
also impact chronic practitioner and into an environment where
the practice can still charge what they want.
disease management For example, Aussies will no longer be able
plans and to visit their local bulk billing clinic on the
weekend to get a last-minute script renewed
medication reviews when their regular GP has a lengthy waiting
list, and will instead only be able to see
such as the simple their registered GP where they may still be
charged $90.
act of requesting a From a telehealth perspective, any
administrative obstacles introduced to limit
script refill.” patients’ access to health care will be the
cause of a return to pre-pandemic clinician
and patient behaviour, including a reduction
and the practitioner. But ultimately for in enabling fair and equitable healthcare.
Australians to be able to access a doctor for People in rural and remote areas will be
MBS items like telehealth, they have no other particularly disadvantaged as they won’t have
option than to be registered and must meet the ability to see their practitioners or avoid
registration criteria, which has the feeling and out-of-pocket costs.
characteristics of practical compulsion. As we approach July and the rollout of the
The High Court has confirmed that doctors new VPR scheme, we’re left feeling uncertain
and patients enter private contracts. This about how this will affect the future of
means that doctors can charge what they Australia’s healthcare system. What we do
want and patients have a reciprocal legal know is that access and equitability to critical
right to choose their doctors. In the case healthcare services such as telehealth,
of VPR, the sanctity of this contractual chronic disease management and medication
relationship appears breached by a type reviews will become restricted under the new
of third line forcing, whereby patients will reforms. The Australian Government must
essentially be forced to deal exclusively reassess the VPR scheme and consider how
with one doctor or medical practice. In any putting these reforms into effect will restrict
other area of law, businesses who forced equitable access to health care and ultimately
customers into exclusive relationships, or hinder Australia’s healthcare outcomes.
marketed their offering as voluntary when
it is really mandatory, would come to the
attention of the Australian Competition and
Consumer Commission (ACCC) for engaging
in misleading and deceptive conduct. **Dr Silvia Pfeiffer, CEO and Co-
Founder, Coviu. Pfeiffer has more
However, in the healthcare system we seem
than 15 years’ experience with web
to be turning a blind eye and the reality is that
video and has worked for Accenture,
patients’ health outcomes will be restricted
as a result of the new VPR scheme. Already, Google, Mozilla, NICTA and CSIRO.
it seems the government has invested some Coviu is her second start-up. She has
of the $69 million in taxpayer money into a PhD in computer science, a masters
building the technological infrastructure in business management and has
required to support the new controversial published two books on HTML5 video
reform. Yet, this approach to primary care and one on video consultations for
does not seem to be focused on improving
healthcare businesses.
The VPR scheme won’t just affect MBS patient outcomes, rather accelerating
telehealth, but will also impact chronic disease bureaucratic control with red tape.
management plans and medication reviews
such as the simple act of requesting a script A new era of healthcare
refill. As part of the 10 Year Health Plan, the reform and coercion *Dr Margaret Faux, CEO, Synapse
government anticipates that payments related There’s talk of the VPR mandate being Medical. Faux is a Solicitor of the
to ‘quality and outcome measures’ will drive modelled on Britain’s National Health Service Supreme Court of NSW and the High
40% of primary care funding, rather than fee- (NHS). The key difference is that under the Court of Australia, having practised
for-service payments. NHS, no money changes hands. In fact,
law for over two decades. She is also
healthcare consultation is free at the point of
Understandably, there’s significant concerns an academic scholar of Medicare and
need and it’s completely illegal for patients to
about the reforms, including how the scheme health insurance law, who recently
pay when seeing a GP. In Australia, payment
will act as a barrier for the fair access to health
schemes are the polar opposite, and GPs can completed her PhD on the topic of
care in Australia.
charge whatever they want. Medicare claiming and compliance, and
What this means for patients The concern is that the Australian has published in peer reviewed journals
It’s suggested that VPR will strengthen the Government is forcing patients to register, on the topic of Medicare compliance.
relationship between the patient, the practice which goes against the right to health

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SAFETY
The safety
fallout of
worker fatigue
in health care
Amy Sarcevic
For as long as Consultant Emergency Physician

Dr Stephen Parnis can remember, he has begun each
T understaffing
he fallout of understaff ing has been
huge, Parnis says, with workers across
the sector collectively burnt out. Forced to
shift on his various emergency wards wondering how take on longer hours and stretch themselves
thinner during shifts, it is little wonder that
many workers will be present. Absenteeism — due to 56% are “exhausted” and 86% under stress.
COVID-19 infections and isolation orders — has been
With mental fatigue at an all-time high, so too,
so rife through parts of the pandemic that some teams Parnis believes, are clinical errors.
©stock.adobe.com/au/Yingyaipumi
have regularly had to operate at half capacity. Cognitive impairment

“Worker fatigue is something that all health
systems need to be very mindful of at
present,” Dr Parnis told Hospital + Healthcare.
“In emergency medicine, it is fair to say
that whether you are a doctor, nurse, allied

SAFETY
“In terms of procedures, a fatigued

person might take longer, or be less
likely to get optimal outcomes. They
could miss an injury that they might
otherwise have picked up.”
employees are 70% more likely to be involved skills isn’t what it used to be. I was acutely
in a workplace accident. aware of the need to avoid making errors at
every step,” Parnis said.
Within health care, this reduction in cognitive
ability can manifest itself in a variety of Compassion fatigue
dangerous ways, Parnis warned.
The mental fatigue epidemic is taking its
“In terms of the cognitive side of practice, toll on workers, with 42% of 600 frontline
tired workers could miss important details healthcare staff surveyed “less willing”
on a chest X-ray or a CT scan. They might to work than before the pandemic. A
not be thorough enough in their history- consequence of this is ‘compassion fatigue’,
taking, or as sharp in their decision-making, Parnis warned — where a person’s ability to
leading to an incorrect diagnosis or poor feel empathy declines.
management plan.
“Personally, I know I am showing early signs
“In terms of procedures, a fatigued person of burnout when I lose my ability to care
might take longer, or be less likely to get properly about a patient’s circumstances.
optimal outcomes. They could miss an injury Compassion in healthcare is very important —
that they might otherwise have picked up.” especially in times where workers are required
to ‘go the extra mile’ during shifts. It’s what
Tired workers may also struggle to manage motivates us to do our jobs well and perform
situations with varying urgency, where quick tasks to the highest degree. No doubt, rafts of
decision-making is vital. “Often in health care, (rightfully) unwilling workers will have safety
workers have to make the call on things that
consequences for the sector.”
can wait for hours versus things that need to
happen instantly. Getting this wrong could be Training
a life or death scenario,” Parnis said. The impact of worker burnout could even
Communication and listening skills could also interfere with medical training and present
take a hit from mental fatigue, with further longer-term safety issues for healthcare.
consequences for patient safety. “There
“There are medical students in the system
are enormous levels of noise in healthcare
now that have never known clinical medicine
health professional, administrative worker, settings at the best of times. Add to that
outside of pandemic times. This has
or support person, you are rarely — if ever mental fatigue — and mandates for wearing
interfered with their access to patients, and
— coming to work feeling rested in these masks or shields — and clarity on what is said
I’m wondering how this will play out in their
pandemic times. When you’re tired to this is not always easy. This could present itself as
careers. It may also impact their decisions
degree, you are at real risk of making critical a significant safety hazard,” Parnis said.
about working in medicine long-term, adding
mistakes — whether that’s an error of clinical
Stretching roles fuel to the chronic understaffing problem that
judgement, an oversight, or a physical slip-
already exists within health care,” Parnis said.
up involving a fine instrument.” The understaffing has also seen some workers
being delegated duties that pertain to their The solution?
Indeed, a federal investigation in 2019 former experience, but sit outside of their
revealed that working while tired is no less While Dr Parnis appreciates the gesture from
current responsibilities.
dangerous than working under the influence hospital administrators, he would like to see
of alcohol. Academia agrees, with prolonged “I needed to re-learn how to perform ECGs fewer emails referring psychological support,
periods of demanding cognitive activity recently, something I haven’t done for and more encouraging annual leave. “There
linked to reduced alertness and a decline several decades. At this stage in my career, is no substitute for time away, doing different
in mental functioning. As a result, tired my ability to master new or long-disused things, or doing nothing at all.”

MATERNITY
New
this model really responds to what parents are
wanting and improves the health care on offer
to patients,” Macpherson said.
“Our pilots in public and private settings
obstetric
have been an overwhelming success.
Sonographers are on the frontline
conducting these scans and parents are
telling us delayed communication from the
guidelines
day of the scan until the next time they see a
doctor concerns them.
“This is not only about communicating
findings with parents but also equipping
sonographers to share their communication
with the reporting doctor so there is a clear
promote parent-centred understanding of the information being shared

across all professionals in the care team.
communication
“Ongoing management of a complicated
diagnosis will of course sit with the doctor–
patient relationship, but our new guidelines
can support sonographers to start a clear,
unambiguous, compassionate and judgement-
free communication process that is sensitive
The Australasian Society for Ultrasound in Medicine (ASUM) to the parent journey.”
has released new guidelines mapping a way forward for Parent-centred communication in obstetric
sonographers to open dialogue and be more transparent with ultrasound has trialled in Fiona Stanley Public
Hospital, Perth, and PRP Diagnostic Imaging —
obstetric patients about the results of their scans. Eastwood, NSW, with a high rate of parent and
clinician satisfaction.
A SUM Chief Executive Lyndal Macpherson

said the guidelines were the result of
broad collaboration with a multidisciplinary
communication in Australian obstetric settings
— and feedback from expectant parents who
were keen to have reassurance from their
“When forming organisational policies — public
facilities and private radiology and obstetric
practices may refer to ASUM’s Parent-Centred
team including parent groups, patient sonographer the baby was developing well Communication in Obstetric Ultrasound
advocates, sonographers, radiologists rather than waiting for their next specialist or Guidelines to consider implementing new
and obstetricians, and had a clear priority midwife appointment. ways of working with sonographers and
to improve care for expectant parents by Macpherson said the guidelines were not parents,” Macpherson said.
improving communication between them mandatory but rather were a first step in The Pink Elephants Support Network consulted
and health professionals, particularly when opening parent-centred communication closely on the guidelines and board member
there are unexpected or ambiguous fetal or in obstetric ultrasound with a focus also Dr Melanie Keep said after the loss of her own
maternal findings. on collaboration and continuity of care baby at 11 weeks in 2019, she was moved to
between sonographers, reporting specialists ensure other women experienced more open
The guidelines build on PhD research and referrers. “Opening up clear lines of and supportive communication when faced
by sonographer Dr Samantha Thomas communication with a set of guidelines that with unexpected and sometimes traumatic
— Sonographers’ level of autonomy in will help public and private settings consider pregnancy news.
©stock.adobe.com/au/serhiibobyk

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PHARMACY
Hospital pharmacists’ role in

safe management
of COVID-19
treatments
Kristin Michaels, SHPA Chief Executive
The recent introduction of oral antiviral treatments has shaken up the COVID-19 healthcare
landscape, once again calling on the expertise and services of Australian hospital pharmacists as
we progress towards the endemic stage of this pandemic.
M edicine information centres led by

clinical pharmacists are key hubs
in this knowledge network and must be
to 89%; while this data pertains to earlier
variants, there is demonstrated efficacy
with Omicron.
these new treatments. A recent 3-year
(unpublished) review of over 11,000
immunocompromised patients from
supported to ensure accurate and timely Melbourne’s Alfred Hospital found a third
A recently published article in SHPA’s of patients would not have been able to
information reaches pharmacists and their
flagship peer-reviewed journal has outlined receive PaxlovidR due to such interactions.
healthcare colleagues handling novel
the ‘Pandora’s box’ relating to oral COVID-19 A similar review of COVID-19 positive
COVID-19 treatments.
treatments, authored by expert pharmacist patients found 37% of patients would have
Secured by the Australian Government representatives from the National COVID-19 also been excluded from PaxlovidR therapy,
at the end of 2021, nirmatrelvir/ritonavir Clinical Evidence Taskforce. highlighting the significant extent to which
(PaxlovidR) and molnupiravir (LagevrioR) expert input is required in key patient
The safe use of PaxlovidR requires a
were recently distributed via the National populations.
thorough medication history and individual
Medical Stockpile to public hospitals,
patient assessment of all medications, It is into this breach that medicine
residential aged-care facilities and
including those bought over the counter. information centres, led by expert
Aboriginal Community Controlled Health
Careful clinical consideration needs to clinical pharmacists, step in. Specialist
Organisations (ACCHOs). On 1 March 2022,
determine if concurrent medicines can be medicines information pharmacists are
molnupiravir (LagevrioR) was listed on the
temporarily withheld, appropriately dose- trained to deal in the complex clinical
Pharmaceutical Benefits Scheme. This has
reduced or avoided altogether in light of assessment of medicines, and therapeutic
broadened treatment accessibility beyond
clinical factors such as significant renal recommendations can be tailored to the
the realms of acute healthcare facilities,
impairment. individual patient and their specific clinical
but has exposed safety gaps which clinical
pharmacy support and services are needed Many medications with narrow-therapeutic factors. Not supporting widespread access
to fill. and high toxicity ranges are known to be to specialist medicine information centres
affected by these interactions including to deal with these newly introduced oral
Throughout this pandemic, hospital treatments leaves wide knowledge gaps
some antipsychotics and anticoagulants,
pharmacists have been essential in that product information and standard
while other interactions render PaxlovidR
overseeing the safe management consensus guidelines are simply unable to
ineffective altogether.
and supply of COVID-19 vaccines and fill. Even one of the most widely shared drug
intravenous medicines. The new oral Clinical assessment of medicine interaction checkers for PaxlovidR among
antivirals mitigate the progression of interactions is a core function of all expert the clinician community, the University
COVID-19 infection, reducing hospital clinical pharmacists who are essential of Liverpool’s COVID-19 Drug Interactions
admission or death from any cause by up to advising on the quality and safety of Checker, currently omits many medicines

PHARMACY
including chemotherapy medicines and

some HIV antivirals.
“Careful clinical
It therefore comes as no surprise that some
jurisdictions are centralising distribution consideration
models within designated public hospitals,
where specialist COVID-19 teams — with needs to determine
expert clinicians and specialist clinical
pharmacists — review and assess individual if concurrent
patients and their medications before
commencing COVID-19 treatments. Many of medicines can be
these specialist teams have been in place
since 2021 for COVID-19-positive inpatients temporarily withheld,
being treated with intravenous remdesivir
and sotrovimab, also accessed from the
National Medical Stockpile.
appropriately dose-
Some states are using this model to reduced or avoided
support GPs and patients in the community.
However, this level of clinical pharmacy altogether in light of
review is not currently embedded in
residential aged care facilities or as part of clinical factors such
ACCHOs, nor are expert clinical pharmacist
reviews or medicines information as significant renal
pharmacists available, meaning GP
prescribers are unable to have their patients impairment.”
access a clinical pharmacist review and
dispensing service.
and they provide a much-needed rapid
Specialist hospital pharmacists are response to COVID-19 infection for those
fundamental to bridge these care gaps, in the wider community. Clinical hospital
©stock.adobe.com/au/Jacob Lund
supporting treating clinicians in the next pharmacy expertise is needed to support

phase of this pandemic to improve patient the safe, timely and quality use of new
outcomes and reducing pressures faced oral COVID-19 therapies to reduce related
by hospitals. hospital admissions.
The new oral COVID-19 therapies are Put simply, hospital pharmacists are crucial
rightly receiving an enthusiastic welcome, to their success.

SPONSORED CONTENT
Traceability in ultrasound infection

prevention: standardisation
through digitisation
U ltrasound probes are used throughout
many hospital departments. During use
ultrasound probes can contact a range of
accreditation purposes. Action 3.17 of the
NSQHS Standards requires health service
organisations have compliant traceability
healthcare departments (e.g. using RFID
technology and printers). This can help
reduce the risk of manual administrative
patient tissues, including sterile tissue, the processes for critical and semi-critical error and incomplete record keeping.
bloodstream, mucous membranes, non-intact devices.1 The Australian Commission on Digital records permit paperless linkage to
and intact skin. Proper probe reprocessing Safety and Quality in Health Care (ACSQHC) the patient record which can be backed
according to the intended use of the device is expects hospitals to be compliant with Action up securely. Digital solutions can also
essential to help protect the next patient from 3.17 by December 2022.4 streamline compliance practices to ensure
infection risk. The Spaulding classification that sensitive patient data is protected from
is adopted in Australian and New Zealand It is important facility policies specify the
unauthorised use.
national standards to determine these information that must be collected to enable
minimum disinfection requirements, based on traceability of ultrasound probes and their Peace of mind with digitised
how the device will be used.1-3 reprocessing information to patients. Read
our Clinical Bulletin on the information that traceability
Tracking or traceability refers to the collection needs to be captured and linked for every In healthcare, a robust traceability system
of medical device identifiers, reprocessing semi-critical or critical ultrasound probe use, can be used as a tool for investigating and
information and then linking this to the according to national standards.1-3 Once identifying the affected patients in the event
patient record.1,2 Traceability in ultrasound policies are in place, education and training of an outbreak or infection prevention breach.
infection prevention forms part of the record for end users is essential so the required Implementing digitisation into traceability
that a facility has met its standard of quality information is consistently documented for workflows can ensure record security,
and safe care for patients undergoing every use of the probe on a patient. accuracy and efficient capture across the
sonographic procedures. The Australian ultrasound infection prevention workflow.
National Safety and Quality Health Service Digitisation supports
References
(NSQHS) Standards, AS/NZS 4187 and standardised ultrasound 1. Australian Commission on Safety and Quality in Health
the ACIPC-ASUM guidelines require full infection prevention Care (ACSQHC). National Safety and Quality Health
traceability to the patient for sterilisation and
AS/NZS 4187 recognises that “HSOs should Service Standards. Action 3.17. Second Edition. 2021.
high level disinfection of semi-critical and
be working towards an electronic tracking/ 2. Standards Australia (AS) and Standards New Zealand
critical medical devices, including ultrasound
process record system.”2 (NZS). AS NZS 4187 2014: Reprocessing of reusable
probes.1-3 medical devices in health service organisations. 2014.
Documentation of the required traceability 3. Australasian College for Infection Prevention and
Why is traceability compliance information can be completed manually Control (ACIPC), Australasian Society for Ultrasound in
required? using logbooks and other paper based Medicine (ASUM). Guidelines for Reprocessing Ultrasound
Transducers. Australasian Journal of Ultrasound in
Traceability is essential in an outbreak systems, however introducing digitisation
Medicine. 2017;20(1):30-40.
investigation to determine the extent of into the workflow can have several benefits.
4. Australian Commission on Safety and Quality in Health
patient notifications and device recalls.1-3 Digitisation ensures information capture
Care (ACSQHC) AS18/07 July 2021. https://www.
In a non-outbreak setting, it allows a and labelling is standardised across the safetyandquality.gov.au/publications-and-resources/
facility to demonstrate they meet their entire ultrasound probe reprocessing resource-library/as1807-reprocessing-reusable-medical-
duty of care to patients and for healthcare workflow for all ultrasound users across devices-health-service-organisations
»
For more information
Nanosonics Limited
www.nanosonics.com.au

INFECTION CONTROL
©stock.adobe.com/au/Destina
renal impairment and pregnant women,
especially with regard to preventing
vertical transmission,” wrote the authors,
led by Associate Professor John Lubel, a
gastroenterologist and hepatologist at Alfred
Health and Monash University.
“The expected benefits of this consensus
statement include a standardised approach
to the management of hepatitis B across
varied health care settings in Australia. At a
community level, the benefits of producing
locally relevant guidance are ultimately to
improve the health care, experience and
outcomes of people living with hepatitis B.”
In 2020 an estimated 222,559 people in
Australia were living with chronic hepatitis
B, representing 0.9% of the population.
In Australia, 46.3% of people with chronic
hepatitis B were born in the Asia–Pacific
region, most frequently in China, Vietnam and
the Philippines. Aboriginal and Torres Strait
Islander peoples also have higher prevalence,
representing 7% of people with chronic
hepatitis B.
“Australia has committed to the National
Hepatitis B Strategy goals, aiming to improve
diagnosis, treatment and care and therefore
reduce attributable mortality,” wrote Lubel
and colleagues.
“We remain well short of reaching targets,
with an estimated 27% of chronic hepatitis
B cases remaining undiagnosed, 22.6%
receiving care (target 50%) and just 10.7% of
people being treated (target 20%).
Hepatitis B:
At that rate, Australia will not reach the Strategy
2022 targets until 2045 for the proportion in
care (target 50%) and 2046 for the proportion
receiving treatment (target 20%).
“Although the threshold of ≥2% prevalence
new recommendations is the commonly accepted cut-off for HBV

screening, there are cost-effectiveness data
for clinicians
from similar settings to Australia (US and
Netherlands) supporting the application of a
threshold below Australia’s average prevalence
of 0.9%,” wrote Lubel and colleagues.
“Consequently, many experts suggest
T
universal screening could be extended to
New recommendations for the he recommendations, published in the
Australian adults (aged 20–79 years) in whom
Medical Journal of Australia, provide
management of hepatitis B in hepatitis B status has not been documented.
guidance to clinicians for managing hepatitis
Australia have been released B and recognising groups at increased risk of “In Australia, all clinicians need to recognise
hepatitis B virus (HBV) infection, and describe groups at increased risk of HBV infection and
in a bid to improve awareness appropriate and timely screening strategies. implement appropriate screening strategies,”
of chronic hepatitis B among Lubel and colleagues concluded.
The Gastroenterological Society of Australia
clinicians and to increase (GESA) initiated the development of the “Once identified, monitoring and timely
detection of cases that new resource, and gastroenterology and commencement of treatment significantly
infectious diseases physicians formulated it reduces complications of chronic hepatitis B.
currently remain undiagnosed. with input from primary care physicians and
consumer representatives. “In addition, it is imperative that clinicians
understand that in chronic hepatitis
“[The statement] covers six main topics B, cirrhosis is not a prerequisite for
that include epidemiology, natural history, development of hepatocellular carcinoma
diagnosis and monitoring, treatment and (HCC), and non-cirrhotic people with chronic
complications, and specific subgroups, hepatitis B require risk evaluation and, where
such as people with viral coinfection, appropriate, should be enrolled into a HCC
immunosuppressed individuals, those with surveillance program.”

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proof of certification. UL/EN/IEC 60601-1 and
CAN/CSA C22.2 No.601.1 M90 are popular
to a generous warranty, 24/7 access to
customer care and technical support from
the actual manufacturer also helps ensure
viability and operational efficiencies. standards that regulate medical electrical accountability.
equipment.
With so many decisions related to features Leading Ergonomics
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users and leaders alike? Rigorous Testing musculoskeletal disorders (MSDs).
Leading manufacturers will exceed even
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confidence that safety is at the foundation of on every product with cycle testing to help
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height and monitor tilt and pan, that promote
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for healthcare, ISO 13485:2016 certification Warranty
points to a robust quality management Product warranties indicate the confidence For 40 years, Ergotron has designed quality,
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INFECTION CONTROL
Pathway out of
the pandemic
In mid-2020, faced with a rising wave of COVID-19 infections
— a previously unknown disease with neither vaccine nor
effective
effective treatment — an urgent, improvised collaboration
between a Melbourne hospital, a primary health network
and a community health organisation created a system that
supported thousands of lives.
T he multidimensional constructed model,

which included financial, social and
mental health supports, resulted in more
“The prototype design took into account the
different resources and specialist knowledge
different
of each Pathway partner — utilising hospitals
than 80% of COVID-19 patients being treated for acute medical care, NWMPHN’s local
successfully in their own homes, monitored knowledge of the primary health landscape
by GPs, leaving hospitals free to care for the within the region, and cohealth and community
seriously ill. health partners’ skills in caring for people
isolating at home,” said lead author Dr Seok Lim,
Dubbed the West Metro COVID-Positive a geriatrician and general medicine physician at
Pathway, the model was quickly adapted by Royal Melbourne Hospital.
other health services and is now the standard
tool for pandemic management across “Design of the prototype was also based on
Victoria. In a paper published online in the meeting the needs of people with COVID-19,
Medical Journal of Australia, a team of experts both in the clinical domain of health
led by its architects say the pathway approach monitoring — especially rapidly detecting
can now be adapted to improve management and responding to deterioration — as well
of other infectious or chronic diseases. as the mental health and practical aspects
associated with home isolation.”
“The Pathway was originally designed by North mental health supports for people in our
Western Melbourne Primary Health Network From its inception, the Pathway model
area,” said co-author, cohealth’s COVID-19
(NWMPHN), the Royal Melbourne Hospital operated as an inclusive, multipronged
clinical lead, Dr Nicole Allard.
(RMH), and community health organisation process. Entry point for patients was a
cohealth, supported by the Victorian positive PCR result, followed by a contact- “We developed a model that supported the
Department of Health,” explained co-author tracing phone call. If the patient consented, complex needs of people who were isolating
Janelle Devereux, NWMPHN’s Executive cohealth community health workers at home for 14 days, valued the expertise
Director for Health System Integration. conducted a standardised risk assessment of GPs in our area and aimed to have
for severe disease and any psychosocial appropriate referral to hospital services. Our
“It went into operation on August 3, 2020, problems that might preclude home-based
as the state government declared a state of teams were able to assist with complex care
isolation. navigation — meeting people’s health needs
disaster. A month later, three more hospitals
joined in — Djerriwarrh Health Services, People with financial problems or other beyond COVID-19, and social support for
Western Health and Werribee Mercy Hospital. challenges such as drug and alcohol them to stay at home safely.”
By that stage the Pathway covered seven dependencies were referred for specialised Following triage, enrolled participants were
municipalities containing more than one support, as was anyone without a Medicare
allocated to low, medium or high tiers of
million people.” card.
care according to their symptoms and
What made the Pathway design eff ective for
effective “In the design and delivery of the program, risk factors for severe disease. Low-risk
patient care and resource allocation was that cohealth and partners recognised the participants were monitored by telehealth
it embraced three clinical skill sets. importance of incorporating social and services (most provided by regular GPs)

INFECTION CONTROL
©stock.adobe.com/au/Krakenimages.com
every second day during the second week

of illness. “As well as being As well as being adopted as the standard
model across Victoria, the model is set to be
People at risk of severe disease and those adopted as the adapted to manage other conditions.
with moderate symptoms were referred to “Heart disease and lung disease are good
hospital outreach services. Those already
seriously ill were placed in wards or ICU.
standard model examples,” Dr Lim said. “Royal Melbourne
Hospital and NWMPHN are currently working
“Despite rapidly rising numbers of across Victoria, together on a project for these conditions that
borrows many principles of the Pathway model
infections, the Pathway ensured all patients
were monitored and provided with best- the model is set of care.”
case care,” said Christopher Carter,
NWMPHN CEO. to be adapted The MJA paper was written by a team of 14
experts, including Royal Melbourne Hospital
“Other countries saw their hospital systems
overwhelmed during coronavirus waves.
to manage other respiratory physician Dr Alistair Miller, Professor
Benjamin Cowie from the Peter Doherty
The Pathway model which we and our
partners devised stopped that happening
conditions.” Institute for Infection and Immunity, and others
from the WHO Collaborating Centre for Viral
here during the first wave of the pandemic, Hepatitis, Djerriwarrh Health Services, Western
while simultaneously ensuring optimal care Health, Werribee Mercy Hospital and Vrije
for all patients.” Universiteit Amsterdam.

INFECTION CONTROL
Four actions for • Invest in subtyping more influenza A viruses
influenza
than we do (Box, B), because being unable
to subtype as H1 or H3 may be the only
indication that an animal virus has infected
a human.
control
• Improve communications between animal
and human public health sectors so that
we can institute active surveillance in
people involved in culling large numbers of
infected animals.
• Work in public–private partnerships to
lower the barriers to surveillance at the
animal–human interface.
W ith the lifting of border restrictions and

quarantine regulations, Australians
can anticipate the reintroduction of influenza,
“Highly pathogenic avian influenza A(H7N7)
and low pathogenicity avian influenza
A(H7N6) and A(H5N2) viruses were reported
“Such efforts will be beneficial beyond
influenza: the COVID-19 pandemic and
recent reports of a new genotype of Hendra
according to the authors of an editorial in Victoria, and swine influenza viruses have
virus in Australian flying foxes are excellent
published by the Medical Journal of Australia. been detected in several states.
reminders that other animal viruses that can
Improving collaboration between animal and “The reason for public health concern is that cross species barriers bear watching,” she
human public health sectors was crucial to novel (eg, animal) influenza viruses to which concluded.
detecting and protecting against influenza the human population lacks immunity could
in 2022, wrote Professor Kanta Subbarao, spread to cause a global pandemic if they
Director of the World Health Organization’s cross the species barrier to cause human
Collaborating Centre for Reference and infections and spread efficiently from person
Research on Influenza at the Doherty Institute to person.
in Melbourne. “Does that sound familiar? We have learnt
“While our
“While our primary focus is on seasonal from COVID-19 that we ignore the animal–
human interface at our own peril.”
primary focus
influenza, we must also remain vigilant about
zoonotic and pandemic influenza viruses,” Professor Subbarao recommended four is on seasonal
she wrote. actions:
“Although seasonal influenza viruses were • Establish surveillance at the animal–human
influenza,
in abeyance in 2020–2021, there was
widespread influenza virus activity in animals
interface, because focusing on viruses that
can cross the species barrier is an excellent
we must also
globally and within our own region. place to start.
remain vigilant
about zoonotic
and pandemic
influenza viruses”
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SPONSORED CONTENT
© Stock.Adobe.com/au/Rawpixel.com
How can air purifiers help aged
care facilities protect residents
and staff from harmful viruses?
Kate Smith, Head of Clinical Solutions, Training and Support — GAMA Healthcare (RN/RM, CRNI, GCertNurs, Cert IV TAE)
A s winter approaches, with its associated colds and flu, many aged
care and long term care facilities will be looking for additional
methods to protect their residents and staff.
• Automatic mode — This means the appropriate speed will be
automatically selected, depending on the current air quality.
• Low light sensors and night mode — In low light conditions (e.g.
A recent Australian study identified that clean surfaces, ventilation and at night), the fan speed will automatically reduce, providing a
air filtration play a key role in preventing the indoor spread of viruses quieter environment for a peaceful sleep. All lights and displays
such as COVID-19. This research demonstrated a 67% reduction in are turned off and the fan runs at its slowest speed.
aerosols compared to environments where there are no air purifiers.1
• Turbo mode — Made to provide maximum decontamination,
The addition of air purifiers is a cost-effective way to improve air quality turbo mode allows the fan to operate at its highest speeds for
and reduce potentially harmful circulating particles such as bacteria, fast, effective purified air.
viruses, fungi, dust, mould, smoke and odours.
Understanding airflow
But how do you choose the right air purifier for your facility? Clean Air Delivery Rate (CADR) is based on how fast air flows
Uncovering the following information from your air purifier through the filters and how effective those filters are. When
manufacturer will ensure you have the correct information required to comparing units, always ask the manufacturer for the CADR, not the
make an informed decision before purchasing. flow rate. The CADR of a machine impacts the size of the room it
can be used in.
Does the air purifier contain true High-
Efficiency Particulate Air (HEPA) filters? Air changes per hour (ACH) are a practical way to estimate
HEPA filters trap very fine particles from air and are classified according ventilation in a space. The CADR of your air purifier and the volume
to the percentage of particles they trap. Medical-grade HEPA 13 filters of your room determines your ACH. Ask your manufacturer for
will reduce 99.95% of airborne particles, whereas HEPA 14 filters will these specifications so you can compare and contrast the differing
remove 99.995%. This means it will be 10 times more efficient, offering versions.
further peace of mind. Robust evidence and supportive documents, which include HEPA
The addition of pre-filters protects and prolongs the HEPA filters’ life, filter capacity, CADR, and ACH specifications provided by your air
and carbon or charcoal filters reduce unwanted odours. Filters must be purifier manufacturers, will aid your decision process.
changed according to each facility’s Infection Prevention policy, but an Understanding these factors is essential when selecting the right
air purifier unit with a change of filter notification system will aid timely air purifier to improve the air quality within your aged care facility,
removal and replacement. protecting your residents and your staff.
Air quality sensors Reference:
Auto-mode makes managing air quality simple. An air purifier that 1. Buising KL, et al. (2021). Use of portable air cleaners to reduce aerosol transmission
senses the air quality and automatically adjusts the speed will ensure on a hospital coronavirus disease 2019 (COVID-19) ward. Infection Control & Hospital
Epidemiology, https://doi.org/10.1017/ice.202284.
the space has optimal air quality. Look for:
»
www.gamahealthcare.com.au

SAFETY
©stock.adobe.com/au/amazing studio
• A healthcare worker in full PPE — surgical
mask, gloves, gown, face shield.
• A healthcare worker in full PPE — but with a
fit-tested N95 mask.
• A healthcare worker in full PPE — with a fit-
tested N95 mask and a HEPA filter system.
Virus exposure was then captured via skin
swabs applied to the face, nostrils, forearms,
neck and forehead.
Studying the interaction of virus aerosol and
PPE, the research found significant infiltration
in scenario one (over 200 virus particles
detected in nostril), slightly less infiltration
in scenario two (between 25 and 200 virus
particles detected in nostrils) and almost
complete prevention in scenario three (zero
to 1 virus particle detected).
While the research is currently under peer
review, the findings, when presented to
hospital management at Monash Health
and Epworth Health, resulted in immediate
impact with Dr Joosten involved in helping
both health services deploy HEPA filter
technology on hospital wards caring for
COVID-19 patients.
Dr Joosten said the findings demonstrate that
standard PPE alone does not protect against
infectious aerosol at high load.
“Among the most important protective
measures are vaccination, personal protective
equipment and ventilation. Here we show that
PPE, HEPA filters personal protective equipment and ventilation

interact to provide added protective benefit
and virus aerosol

against virus-laden aerosol.”
protection
Monash Health’s Chief Medical Officer,
Professor Anjali Dhulia, said Dr Joosten’s
previously published and most recent
HEPA filter data research contributed to the
deployment of HEPA filter technology at
Monash Health.
Dr Lachlan Henderson, Group Chief
Executive, Epworth HealthCare, said keeping
patients, staff and doctors safe has been the
M
priority throughout the pandemic.
onash University researchers used
Full PPE, involving a fit-tested a live virus aerosol model that “We have also regularly reviewed airflows
N95 mask, in conjunction with highlighted the standard PPE strategy that at each of our hospitals. Dr Joosten’s virus
was developed with droplet transmission aerosol research was critical in guiding our
a HEPA filtration system is in mind is not geared to prevent aerosol infection control team to deploy HEPA filter
said to offer health workers transmission and may offer insufficient technology at Epworth as an added layer of
in a hospital setting the best protection in a hospital environment. protection,” Dr Henderson said.
protection against virus The experimental study, led by Dr Simon Dr Joosten was recently awarded a $50,000
Joosten, from the Monash University School grant from the Epworth Medical Foundation
aerosol exposure. of Clinical Sciences, used a nebuliser to pump and will advise on airflow management
bacteriophage PhiX174 into a sealed clinical in the upgraded cancer ward at Epworth
room for 40 minutes testing three scenarios: Freemasons.

SPONSORED CONTENT
The S-Monovette® is the revolution

in blood collection.
The S-Monovette is an innovative enclosed The reduced vacuum pressure in the in approximately one sixth of the sharps
blood collection system that allows the user to S-Monovette drastically reduces the rate volume caused by using a pre-evacuated
draw blood from the patient using the syringe of haemolysis and vein collapse, meaning system, giving significant cost savings.
or vacuum method, uniting the advantages of increased sample quality and reduced
If you would like a visit from one of our
both techniques in a single product. costs associated with repeat collections.
Sales Representatives to demonstrate this
Furthermore, unlike pre-evacuated
When used as a syringe, the phlebotomist has system, please contact us on toll free
tubes, the S-Monovette does not have
full control over the speed at which the blood 1800 803 308.
to hold a vacuum for many months after
is drawn into the tube. This is particularly
manufacture, which allows the membrane
useful for patients with fragile veins, such as
stopper to be thinner and more easily
the very young or elderly, where the use of the
penetrated by the needle sheath. This
aspiration technique prevents even the most
minimises the movement of the needle in
fragile veins from collapsing. When the tube
the vein when attaching the tube, ensuring
has been filled, the plunger is simply snapped Sarstedt Australia
optimum patient comfort.
off to leave a primary sample tube which can
be centrifuged and is compatible with all The S-Monovette needle is ready to use www.sarstedt.com
major analysers. so that there is no need for assembly
to a holder. The needle is of a compact,
The S-Monovette can also be used as an
low profile design, which reduces the
evacuated tube by drawing the plunger fully
chance of haematoma by allowing for a
down and snapping it off immediately
reduced angle of puncture and eliminates
prior to blood collection. This creates a
the possibility of needle stick injury
fresh vacuum and ensures a precise filling
caused by assembly of the needle and
volume, ensuring a correct dilution ratio.
holder. The compact design also results

GUIDELINES
©stock.adobe.com/au/StockPhotoPro
Clinical practice
guidelines for
children
with CMT
Charcot-Marie-Tooth disease (CMT) — a lifelong degenerative Published in the Journal of Neurology,
Neurosurgery and Psychiatry, the
condition that causes damage to the nerves, muscle weakness, new guidelines include evidence and
sensory problems, difficulty walking, foot deformity and consensus-based recommendations for the
management of muscle weakness, balance
associated pain — is the most common childhood inherited and mobility impairment, sensory symptoms,
nerve disorder. Yet until now, there have been no guidelines to muscle cramps, impaired upper limb function,
respiratory impairment, joint movement and
help patients manage their condition. non-surgical management of joint deformity.
Dr Yiu said she hoped the recommendations
T
would be disseminated and implemented
o address this need, Murdoch Children’s CMT usually starts during childhood and across multiple healthcare settings around
Research Institute (MCRI) research progresses over time, and while there is the world to benefit children and young
associate Dr Eppie Yiu, University of Sydney currently no cure, people with CMT can use people with CMT.
Professor Joshua Burns and their team a variety of therapies and strategies to help
formed the Paediatric CMT Best Practice manage their symptoms. “The guidelines are important for a range
Guidelines Consortium, involving clinicians of medical and allied health clinicians who
from Australia, Belgium, Canada, Croatia, the Dr Yiu said the guidelines would promote provide care to children with CMT, including
US, the Czech Republic, Italy and the UK. optimal, standardised care for children neurologists, rehabilitation specialists,
with CMT globally, improve access to physiotherapists, occupational therapists,
Dr Yiu and Professor Burns led the effort multidisciplinary care, such as via the National clinical nurse specialists and genetic
to produce the guidelines, which address Disability Insurance Scheme (NDIS), and were counsellors,” she said.
the management of clinical problems critical for clinical trial readiness.
experienced by children with CMT and Clinicians from The Royal Children’s Hospital,
related neuropathies (weakness, numbness To develop the guidelines, the international University of Melbourne, The Children’s
and pain from nerve damage), and advocate panel of clinicians conducted a series of Hospital at Westmead, Sydney Children’s
for improved access to multidisciplinary systematic reviews covering 10 clinical Hospital Randwick, UNSW Sydney, Macquarie
care. “The aim was to develop evidence questions and evaluated the body of University and Concord Hospital, The
and consensus-based recommendations literature on CMT disease management. The Children’s Hospital of Philadelphia, University
for the clinical management of children and panel then formulated recommendations of Antwerp, Stanford and the University of
adolescents with CMT,” Dr Yiu said. based on these reviews. Pennsylvania also took part in the review.

SPONSORED CONTENT
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‘Scan4Safety’ in Australia —
Preparing for what comes next
G lobal data standards enable greater
visibility, traceability and improved
accuracy within healthcare supply chains
wasteful practices and ensure accuracy
at the intersection with the patient in care
settings. They must also maintain minimum
classifications all have their place but so
too does the accurate and unambiguous
recording of the products identified.
around the world. The unique identification levels of traceability (unambiguous product
and other structures they provide are vital for identification and batch) and visibility for the Is it time for a scaled
healthcare not only in explicitly identifying majority of products so that we can be more ‘Scan4Safety’ program
a product so it can be located or traced responsive and utilise more technology. in Australia to ensure
throughout the supply chain, or by providing
the ability to accurately and unambiguously Many of the health providers around the consistency? Is this part of
identify a patient to ensure that the right country (public and private) have been what comes next?
patient is given the right treatment, but also undertaking digital health programs, Although countries like England have formed
in ensuring that event-based data can be many too have undertaken some supply national programs to ensure that all health
captured and shared consistently throughout. chain improvement programs, but few are providers have the same baseline approach to
considering how the two interconnect within managing identity as part of their standards
The accuracy of identity (people, products, the care setting, in that final step in the frameworks Australia has been less inclined
places) has never been more important as traceability of a product, the one that counts to do so. Granted this is in part because
we continue to digitalise even more of our the most, where products are used as part of of the structure of our health system but
processes to support patients and clinical treatment. the question remains as to whether we are
teams across ever-widening networks. The
missing some enormous opportunities in
work to build an interoperable framework Terminology and coding
of data that can be utilised across the many failing to do so?
versus unambiguous
providers of care and support the patient Across all of the sites that have implemented
themselves remains critical. So too, the
identification — is it a choice
‘Scan4Safety’ across the UK (England,
increased focus on traceability of products to of one or the other? Scotland and Wales) and Ireland the
ensure their authenticity, enabled post-market The utilisation of terminology and codification documented results in improvements to
activities and manage risks that became to normalise data within clinical systems using patient safety, returned clinical hours to care,
obvious within the past two years. global data standards such as Snomed is a reductions in waste and the rich data created
key part of creating interoperable data within to help make management decisions are
Did the tide change in patient records, and we see this in an even astounding.
healthcare thanks to Covid? more pronounced way as work continues
Covid has taught us many things. The to enable internationally recognised patient Some of the details of benefits are contained
intersection between the healthcare supply summaries and data structures. But while within the Scan4Safety evidence report
chain and the patient must ensure accuracy clinically we only need to generically record ‘Improving patient safety and saving money
and safety as well as eliminate the unnecessary that a patient was given a specific type of using point-of-care scanning in the NHS’.
loss of time for clinical staff, this is given. If medicinal product, as one example, there is Locally in Australia, the ACT has been working
nothing else the pandemic highlighted many still a need to record the product itself against towards taking a similar approach as part
of the gaps in the processes and capability of the patient to verify correct product dose but of their digital transformation program, so
health providers around the country and the also to ensure that accurate records related to too NSW Health signalled their intent when
amount of reworking and manual interventions product performance are possible. they developed their state-wide barcoding
that have been needed to be carried out by standard. But what of the rest of the
The changes to medical implants mean system? And how could we further vision
clinical staff to deliver the best care to patients.
that actual products must now be recorded the ’Scan4Safety’ approach not only within
With so much pressure on our amazing clinical
against patient records and information hospital settings but also within our aged care
teams around the country, having them spend
provided to patients. Future changes in
more time than necessary on supply chain- and community care? The opportunities are
regulations to implement Unique Device
related processes is a luxury that the system endless.
Identification (UDI) based on global standards
simply cannot afford.
and replace the use of non-unique supplier Find out more about GS1 standards in
Healthcare supply chains must be well codes will make further significant changes healthcare https://www.gs1au.org/for-your-
managed throughout to ensure we eliminate in this area. The use of terminologies and industry/healthcare/

STAFFING
How to alleviate the shortage of

critical care nurses
Margaret Fry*
different
The spread of diff erent
variants and the COVID-19
T here are several reasons for the shortage
of nurses, including critical care staff
staff..
In recent times, as the Omicron variant has
Yet these numbers need to increase across
the board to meet demand. The federal
government has predicted there will be a
pandemic overall have infected greater and greater numbers of shortfall of approximately 85,000 nurses by
Australians, more people are being hospitalised 2025, and 123,000 nurses by 2030.
contributed dramatically to and going into intensive care units. Shortages
Longer term factors contributing to the
the shortage of nurses in the of critical care and other nurses have emerged
in hospitals around the nation, pushing down shortage of nurses include rising hospital
nation’s hospitals. State and nurse-to-patient ratios to worrying levels. Nurses admissions due to the growing burden of
federal government must are being seconded from the private health chronic disease and improved survival rates.
system into the public system to help alleviate This is linked to the ageing population and
efforts
step up their eff orts to ensure the shortages, which have been exacerbated by increased survival rates for those with chronic
there are enough nurses in COVID-19 and the quick spread of Omicron. disease or co-morbidities. In addition, nurse
workforce planning by governments has been
hospitals to supply quality In recent years, the supply of nurses has not sporadic, poorly integrated and inadequate
health care and avoid poor kept up with the increased demand, and to meet longer term demand. Nurses are
now there is a shortage of nurses predicted providing more health care with fewer
patient outcomes, including for most specialities including critical care resources and the healthcare system is losing
funding postgraduate study areas. Currently, in Australia we have 432,855 nurses due to burnout and dissatisfaction.
practising registered nurses and enrolled
to better equip nurses for nurses. Of those, 48,207 are registered nurses
difficulties
This is also resulting in difficulties in recruiting
and retaining skilled experienced nurses in the
crisis health care. practising in the health system and 3347 are public and private sectors.
non-practising. As of September 2021, there
are 2277 endorsed nurse practitioners, who The labour shortage may result in compromised
are legally entitled to autonomously assess, longer term outcomes, including poorer health
diagnose and manage a range of patient outcomes and near misses in hospitals as
conditions in line with their scope of practice. the quality of care is compromised. This will

STAFFING
“No single policy

will remedy
the projected
shortfall of
nurses able to
meet service
demands.”
career retention should be fostered through

incentivisation and better ongoing education
and training, which should be included in
nurses’ rosters, rather than in their own time.
Separately, greater opportunity and funding for
roles such as nurse practitioners would improve
access to health care. Nurse practitioners
need to be empowered to operate more
independently of other professionals to manage
a range of patient conditions. As an example,
nurses should be able to sign work certificates,
along with doctors. Legislation needs to be
revised and Medicare Benefits Schedule (MBS)
items expanded to broaden nurse practitioners’
scope in public and private practice and
©stock.adobe.com/au/Blue Planet Studio
in rural and regional Australia. This would

improve healthcare access and timeliness
across Australia, including in rural and regional
Australia. Governments too should consider
incentivising rural and regional placements
for nurses, as it does for other medical staff.
The use of unregulated workers in aged-care
settings should be overseen by governments to
improve healthcare outcomes for the aged.
Only by introducing such a combination
of measures at every level can the nursing
inevitably lead to greater patient dissatisfaction. individuals must face the cost of their education shortage be alleviated over the longer term. In
Nursing staff shortages will also diminish the alone, even though the healthcare system the short term, governments should provide
organisational culture of hospitals and push up overall and patients benefit. nurses with whatever support they need to
staff dissatisfaction across all areas as resources help overcome shortages and burnout, which is
Importantly, postgraduate education equips
run thin on the ground. being exacerbated by COVID-19.
nurses with the necessary skills for healthcare
No single policy will remedy the projected management and it can help nurses integrate
shortfall of nurses able to meet service into specialty clinical areas such as critical
demands. To begin, a prolonged and persistent care in ICU units. The gaining of knowledge
effort is needed to address the nursing shortfall and skills can transform healthcare practice *Professor Margaret Fry is a researcher,
and educate people about nursing careers and and support a culture of evidence-based clinician, supervisor and teacher at UTS,
thus to stimulate greater output of trained and practice, which can deliver better healthcare which offers the Master of Advanced
skilled nurses. Governments need to devise outcomes. Furthermore, the online delivery Nursing and Graduate Certificate in
strategies to minimise nursing curriculum creep of courses can provide nurses with greater Critical Care. The focus of her applied
to ensure integration and a coherent relevant access to educational opportunities, including research is on improving the quality
education program. those nurses located in geographically and safety of nursing care and patient
diverse regions.
There needs to be better defined career outcomes. Professor Fry has over 180
pathways for nurses and a greater time for Work security and employment conditions peer reviewed publications and $5.5
transition-to-practice programs that support are also important. Employees of nurses, million in grant or scholarship funding.
an environment of learning, overseen by largely state hospitals systems, should look Professor Fry has worked extensively
experienced senior nursing clinicians. We need at employing more nurses on permanent in critical care areas (intensive and
to encourage postgraduate study too, degrees contracts where possible, and move away from
emergency) for over 20 years and
such as the Master of Advanced Nursing an overly casualised workforce. Governments,
possesses a highly credible reputation
and Graduate Certificate in Critical Care, and healthcare providers and educators too need
postgraduate training more generally should to explore strategies to increase diversity in the industry.
be funded by government. As it is, nursing and the number of men in nursing. Early

SPONSORED CONTENT
Protecting patients from

ransomware attacks
Why healthcare cyber resiliency is
critical as we move beyond recovery
AJ Missaghi Chief Technology Officer — Healthcare & Life Sciences (APJ) Dell Technologies
T he moves made by Australian healthcare

leaders to digitally transform health
services now will directly impact the long-
governments collaborate with healthcare
leaders and tech experts to realise the full
potential of digitally driven service solutions,
The Australian Government’s Ransomware
Action Plan reports that during the height
of the pandemic in 2020, ransomware
term wellbeing of citizens and protect the the progress made in recent times must be campaigns targeted Australia’s aged care and
future economy. protected and enhanced. healthcare sectors. The ‘Maze’ ransomware
encrypted valuable information, such as
However, to realise the potential of a
digitalised healthcare sector and navigate the Healthcare vulnerabilities sensitive personal and medical information,
data era, leaders must prepare for innovative A cyberattack was reported every 8 minutes so it could no longer be used until a ransom
technologies and confront the rise in cyber in Australia over the 2020–2021 financial was paid. Reckless attacks such as these put
and ransomware attacks head-on. year, with an 84 per cent increase in reports patients’ lives at risk.
relating to the health sector in 2020 from Preventative cyber technology is constantly
In the past two years, the healthcare
2019. The financial cost is staggering, but the evolving with innovations to protect data
system has been at the heart of societal
human cost is incalculable. Already straining and keep pace with the bad actors; however,
and economic recovery. Its resiliency
and innovation while facing the ongoing under a backlog of pandemic patient the Australian health sector will continue
pandemic and other everyday medical appointments, health systems are relying on to be a vulnerable target because of its
challenges have been immense; the rapid digital transformations to turbocharge long- access to sensitive data and increased
shift to telehealth services helped reduce term resiliency. But cyberattacks can disrupt reliance on internet-enabled services. And
community transmission and protect patients operations at large hospitals resulting in a alarmingly, according to a 2021 survey by Dell
and healthcare workers while keeping lack of access to patient data and delays and Technologies, 74% of health industry decision-
beds free for COVID-19 patients. Now, as cancellations of time-sensitive procedures. makers say they struggle to find suitable data

protection for their AI and machine learning launched a roadmap with proposed strategies
solutions. A collaborative public and private to cover critical issues in the roll-out of an AI-
sector approach is now needed to maximise enabled Australian healthcare system, with the
©stock.adobe.com/au/Monkey Business
cyber security and resilience. goal being a fully funded national plan by 2025.
Ransomware is everyone’s problem and Given these advancements, it isn’t surprising
could hinder healthcare progress if not that the health sector is a tempting target for
dealt with decisively. As the Australian cybercriminals. Retaining trust in the digital
government mounts more robust defences innovations that underpin Australia’s future
against cyberattacks, national partnerships economy and social wellbeing is critical to
with the brightest cyber experts, CIOs, and sustaining progress, which is why it’s more
public health leaders are necessary to ensure important than ever that our most sensitive
Australia is cyber secure. Cyber is at the core data, health data, is rigorously protected.
of digital healthcare infrastructure and the
As healthcare leaders look to reinforce the
basis for future progress, making it essential
cyber resiliency of their organisations, focusing
for combatting today’s healthcare challenges.
on their most critical data is key — from records
Protecting health data with accompanying images to object data from
Health data is the lifeblood of progress in diagnostic systems and health surveys. Placing
solving healthcare problems. But accelerated this critical data in a vault will help ensure it is
digital transformations have created increasing isolated, can’t be modified and can be quickly
complexities — and data protection must recovered in the event of an attack — enabling
evolve to meet new demands. healthcare services to get up and running
quickly again.
After a tumultuous couple of years, healthcare
waiting lists have grown out-of-hand, placing Better together
pressure on already overwhelmed facilities Protecting these unstructured datasets
and staff. Telehealth services, supported by requires a ‘people, process, and best of breed
always-on digital platforms, initially boosted technology solutions’ approach. While there
accessibility to services and continue to is no antidote or 100% fail-proof approach,
streamline efficiencies. The Australian enlisting a cyber strategy that focuses on all
government has recently committed an three areas is vital. Cyber security is evolving
additional $24 million to support telehealth quickly to keep pace with cybercriminals. That
changes to give GPs and specialists additional means cyber strategies should constantly
flexibility to treat their patients safely as evolve too, with stress tests and ongoing
Omicron case numbers grow. assessments to ensure they are fit for
purpose. So is having the right technology
Meanwhile, the datasphere has grown
and cybersecurity partners. Planning and
increasingly complex. Simplified, agile as-a-
preparation are vital. This is not a journey that
service data management across the hybrid
healthcare providers can travel alone — and
and multi-cloud is now essential for boosting
there is no end in sight.
operational efficiencies. Health records and
mobile devices have streamlined wait times But the risks of not acting now far outweigh
and minimised patients’ time spent in hospitals, the short-term cost of investing in tighter cyber
as IoT and Edge computing have powered strategies. Healthcare progress is at stake. It is
patient monitoring. Behind the frontlines, AI underpinned by technology innovations that
technologies have led the charge on healthcare require patient trust, continuity, and reliability.
research — enabled by High Performance Take the potential for Digital Twin technology,
Computing. In December 2021, the Australian which is transforming the sector and enabling
Alliance for Artificial Intelligence in Healthcare healthcare institutions to meet pressing
challenges — from personalising healthcare to
combatting patient wait times. The powerful
combination of the digital twin, IoT, AI, and
data analytics will boost patient outcomes
and hospital performance. But this must be
supported by stringent cyber security to
evolve with the trust of patients and healthcare
providers — and remain operational in the event
of a ransomware attack.
Ransomware is a national and global challenge;
an open, multistakeholder approach across
sectors will help organisations ramp up
defences. The nature of healthcare makes it
particularly vulnerable, and the stakes are high
© Stock.Adobe.com/au/Cavan Images
as it powers national resilience beyond the

pandemic. Securing the viability of healthcare
innovations with first-class cyber strategies will
benefit everyone everywhere. As we look to a
more equitable, sustainable future that puts
citizens at the forefront of progress, healthcare
cyber security is more than a hot topic — it’s a
lifeline.
»
www.delltechnologies.com

TECHNOLOGY
Digital ‘twins’
for paediatric hip surgery
Dr Martina Barzan and her
team at Griffith University
have created computerised
‘twins’ of child patients that
would enable surgeons to
better plan, test and execute
complex surgeries for severe
hip deformities.
T he development is said to halve surgery

time, which means getting back to
normal walking and sitting sooner.
Dr David Bade from the Queensland
Children’s Hospital has trialled the technique
and agrees that using the 3D-printed guides
they move to understand how their hips will Dr David Bade said that the innovation “helps
reduces his surgical time.
move after the surgery, to make the best me, as a surgeon, get the best result on the
“This is particularly so with very difficult virtual plan. table, and also helps the patient get a more
deformity cases,” he said. “With less surgical accurate result and better outcome long
Dr Barzan designed a system to translate
time, there are less X-rays and radiation doses, term”.
those virtual plans to the operating theatre,
and less blood loss for these young patients.”
using 3D-printed surgical guides individually “This type of pre-planning and patient-specific
Dr Barzan explained that before the digital matched to each patient’s body. The system cutting guides can be used in multiple areas of
twins were created, “surgeons would have to leads to decreased radiation and every the body and in multiple deformities.”
cut out X-rays and move the pieces back and patient recovers back to normal walking.
The only treatment for children with severe
forth”.
“Nine months later, all of the children hip deformities is surgery. Such deformities
Now, surgeons can use computerised replicas could walk normally, sit and play pain-free,” can occur through trauma, infection or being
of the children’s bones, muscles and the way Dr Barzan said. born with them.

TECHNOLOGY
Michael Adams, Griffith University
Dr Barzan won this year’s Fresh Science

Judge’s Choice Award (Southeast
Queensland) for her work. The competition is
national, and helps early-career researchers
find and share their stories of discovery.
The program takes up-and-coming
researchers with no media experience and
turns them into spokespeople for science,
giving them a taste of life in the limelight,
with a day of media training and pitching
experience, and a public event in their
home state.
Dr Barzan was supervised by Associate
Professor Christopher Carty, a Principal
Research Fellow at the Griffith School of SHS
— Allied Health Science.

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TECHNOLOGY
Cybersecurity
is everyone’s responsibility
Deana Scott, Cybersecurity Community of Practice Chair, Australasian Institute of Digital Health
©stock.adobe.com/au/Melinda Nagy
Health care continues to become increasingly digitised with an ever-expanding range of
infrastructure options, technology platforms and devices being implemented and accessed by
hospitals and healthcare organisations. Across the globe, the pandemic has seen the speed
of digitisation in care delivery accelerate, with many organisations being caught off guard
by legacy infrastructure, poor systemisation and a need to rapidly pivot in response to daily
announcements and infection rates.
T he challenge now is how do healthcare

organisations continue to respond with
a secure approach to ensure the sector
Consumer confidence is crucial to the
reputation and sustainability of any
organisation and will become a significant
doesn’t suffer a virtual pandemic due to the metric as health care makes its slow but
opportunistic actions of malicious actors? incremental progress towards value-based
care. This brings us back to the question
Health care has continued to hold first place
of how health care continues to leverage
in the biannual notifiable breach reports and
technology while mitigating the potential
therefore is a top concern for the Office of
for a cyber attack and retain consumer
the Australian Privacy Commissioner (Office
confidence in delivery of care. The answers
of the Australian Information Commissioner,
lie in a two-pronged approach, one that
2022). Of significance, compromised
involves accepting that cybersecurity is at
credentials made up 60% of reported cyber
the intersection of people and technology.
incidents, highlighting the need for greater
It is a symbiotic relationship, like hardware
awareness and responsibility in protecting
and software.
user profiles. Ransomware is in third place
and the impact of such an attack can severely Internal as well as external stakeholders must
disrupt the delivery of care and, consequently, be engaged in any cyber strategy and they
patient safety. are key to mitigating cyber incidents.

TECHNOLOGY
It requires a ‘whole of organisation’ approach media release on 17 March 2021 (Eastern We should all be aware of the risk from emails
with cyber hygiene protocols embedded into Health, 2022), Eastern Health outlined (phishing attacks, attachments with malicious
agreements, contracts and onboarding and their response and ensured that consumer functionality, requests for information)
offboarding activities for staff, contractors and confidence was maintained by confirming or of inserting and/or opening unknown
suppliers. patient safety was not impacted and within storage devices (the USB you find the in
six weeks had returned to normal services. carpark). However, the seemingly innocuous
The OAIC Notifiable Breaches Report July
discussion in the lift, or social media post that
to December 2021 (Office of the Australian Implementing an organisation-wide dedicated
reveals sensitive information about the work
Information Commissioner, 2022) again cyber strategy is a significant undertaking and
environment, the text message about a parcel
highlighted the increase in human error it requires an acceptable level of funding and
delivery or downloading a cat video out of
breaches. It is no longer accepted that cyber dedicated resources. For smaller healthcare
curiosity can all be used by a malicious actor
hygiene protocols be the sole responsibility of organisations, these strategy and response
to breach defences.
the IT department or require a technical ‘fix’. plans don’t need to be onerous, but they do
There is a broader problem embedded across need to be in place, however brief. Not having Stay vigilant inside and outside the workplace
health care of abdicating one’s responsibility a documented plan in place may impact — don’t let curiosity kill your cyber defences.
by proxy. insurance excesses and increase the severity
of fines in the event of a cyber incident. References
The Australian Digital Health Agency
1. Australian Digtial Health Agency. (2022, March 3). Cyber
(Australian Digital Health Agency, 2022) As an individual working in the healthcare Security Awareness. Retrieved from Digital Health for
website states: “Everyone involved in sector with (or without) access to personally healthcare providers: https://www.digitalhealth.gov.au/
providing and supporting healthcare plays identifiable information, any breach in your own healthcare-providers/cyber-security/cyber-security-
a role in maintaining the privacy of people’s infrastructure (smart phone, laptop, etc) is a awareness
information that healthcare provider potential risk to the work environment as well. 2. Eastern Health. (2022, March 3). Latest News . Retrieved
organisations hold. This means making sure from Eastern Health: https://www.easternhealth.org.au/
media-events/latest-news/item/1277-media-statement-
everyone is secure in their online behaviours,
cyber-incident#media-statment-17-march-2021
both at work and at home.”
As a board member, director or individual,
“Implementing an 3. Office of the Australian Information Commissioner. (2019).
Australian Privacy Principles Guidelines. Privacy Act 1988.
organisation-wide
oaic.gov.au.
there are mandatory legislated responsibilities
that must be adhered to in the collection, 4. Office of the Australian Information Commissioner. (2022,
February). https://www.oaic.gov.au/privacy/notifiable-data-
use and disclosure of personally identifiable
information (Office of the Australian dedicated cyber breaches/notifiable-data-breaches-statistics/notifiable-
data-breaches-report-july-december-2021. Retrieved
Information Commissioner, 2019), more so
when it comes to healthcare information. strategy is a significant from https://www.oaic.gov.au/: https://www.oaic.gov.
au/__data/assets/pdf_file/0010/12205/Final-Notifiable-
Federally, and at state level, PII is legally Data-Breaches-Report-Jul-Dec-2021.pdf
protected, and it is therefore essential this undertaking and it 5. Office of the Australian Information Commissioner. (2022).
data have strong governance and controls Notifiable Data Breaches Report July to December 2021.
applied. A documented cyber response requires an acceptable 6. The Australasian Institute of Digital Health works to
support the digital health workforce to implement and
plan (CRP) and business continuity plan
(BCP) can serve an organisation well as was level of funding and understand issues around cybersecurity and ultimately
offers thought leadership on the topic through its Cyber
demonstrated by Eastern Health when it
dedicated resources”
Security Community of Practice. Find out more at www.
became victim of a cyber incident. In its digitalhealth.org.au.
©stock.adobe.com/au/forestgraphic

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For more information call us on 1800 050 999 or email [email protected]
or visit www.boc-healthcare.com.au
BOC is a trading name of BOC Limited, a subsidiary of Linde plc. © BOC Limited 2020. Reproduction without permission is
strictly prohibited. Details given in this document are believed to be correct at the time of printing. Whilst proper care has
been taken in the preparation, no liability for injury or damage resulting from its improper use can be accepted.

MANAGEMENT
Improving
organisational performance
in health care
Lyndal Hughes*, Partner, and Charlie Penny**, Senior Consultant, Q5
Our healthcare systems have operated under enormous

pressure over the past two years — where we have expected
systems to function at a peak level for too long. They have
delivered outstanding care to patients but have damaged their
own organisational health in the process.

MANAGEMENT
©stock.adobe.com/au/lenetsnikolai
Consider how this needs to be reconfigured
for the future, incorporating recent learnings.
For example, ensure that the advances
made in digital health become embedded in
business as usual.
Get all your data together. Don’t go fishing
— you may catch something that throws you
off course. Develop hypotheses to frame
data analytics, such as hypotheses formed
from human experience (your team, the
patients, community). Look for fresh insights.
If the analytics are only reconfirming what
you already know, then perhaps you are not
asking the right questions of the data.
Consider questions such as:
• Have the frequency and nature of
interactions between people and teams
shifted? This may give evidence that staff
need to solve operational problems and
patient outcomes differently.
• What data is sitting under the success or
lack of success of established measures
and targets (in addition to the obvious
impacts of COVID-19)?
• What factors co-exist to drive both positive
outcomes for patient experience and staff
experience?
Straight away we can see that the art of
thinking well is critical to the use of science.
Science alone can take us on the wrong path,
if not given careful consideration.
The art of thinking, sensing and
N ow, more than two years into the

pandemic, it is time to take stock.
Leaders in the health system need to
Reflection and alignment require both art and
science. Science is the evidence and data:
looking at employee surveys, financial bottom
understanding people is critical to re-
establishing organisational health in the
healthcare sector. But where to start? Start at
find the time and space, collectively and lines, patient data and efficiencies with clear both ends of the hierarchy. Leaders need to
individually, to make their departments hypotheses and an analytical precision. start by forcing a practice of reflection. This
healthy again. What makes a healthy Bringing this together against the vision and involves stepping back and looking through
department? It is one where there is a strategy, to make new decisions. Art is the the lens of our people to understand how
clear vision, it is grounded in behaviours judgment and wisdom that leaders bring we can best develop future leaders, as well
and actions for everyone, with a clear to the room. Data mustn’t drive decisions. as listen and actively respond to the needs
strategy or pathway to deliver it. There must It can only inform. The lived experience of of front-line staff. This alone will ensure the
leaders and their teams allows for meaning, long-term health of our health systems and
be alignment between vision, strategy,
prediction and ultimately compassion. the people who work within them.
measures and individual motivations.
Leadership is the pivotal force joining all So where to start? Use science to consider But take care not to fall into the mind trap of
of these. the best clinical service model design. ‘rightness’. In the words of Jennifer Garvey

MANAGEMENT
“The art of thinking, sensing and — including those who have run towards the
understanding people is critical to fire and are ready for their next mission, and
those reaching the end of their careers and
re-establishing organisational health investing in their co-development.
We hope to equip leaders with the skills they
in the healthcare sector.” need to be the next generation of health
system leaders, but also create networks
which they can rely upon and mentors they
can learn from. Investing in ‘pre-retirement
groups’ can not only provide these mentors,
Berger, rightness occurs when our instinct provided exceptional care. Their approach but may also create opportunities to retain
to believe that we are right closes us off to demonstrated the art of looking forward these experts in our services for another few
the ways that we are wrong. Health care by bringing these experiences into months. This will have a significant impact
is filled with examples of leaders believing consciousness — to reflect and learn. There on recovery efforts and retention of their
in the certainty of their own views even as was a natural ‘hot housing’ of innovation in institutional knowledge.
complexity grows. nearly all frontline teams to make a difference.
Using an approach that combines the art
There was trust within a framework.
Stepping back to step forward and science of organisational health has
Yet we have observed the resurgence of the potential to transform the healthcare
To manage operational pressures effectively
anger and frustration in many hospitals, as sector beyond just effective operational
and sustainably in the long term, leaders and
business-as-usual creeps back in. Legacy management. There is a real opportunity
executive teams must create the space to step
systems and practices close back in to restrict to redesign our systems to be sustainable,
back and re-evaluate their system as a whole.
leaders, and untapped potential is left to fade. efficient and fit for the demands of future
While easier said than done, we have seen
healthcare services.
great progress from executive teams who take Some of our most recent work has involved
time out and are willing to refocus on strategy, bringing together cohorts of frontline leaders Now is our moment to change for the better.
as well as shape clear, medium- and long-term
plans for recovery and transformation.
The first step to this is ensuring their
organisation has a powerful ‘organisational
vision’ to work towards, followed up by a clear,
measurable delivery plan that provides staff
and patients with the clarity to move forward.
COVID-19 brought healthcare leaders together
around the single, sometimes bloody-minded
purpose of tackling the pandemic that drove
change at a pace we rarely enjoy. We saw
the building of field-testing centres, creation
of telephone-first triage systems to limit the
spread in hospitals and the rapid deployment
of mass vaccination programs.
Beyond the current crisis, it is now vital for
leaders and staff to harness the same clarity
of purpose and planning as efforts shift to the
recovery and redesign of our clinical services.
*Lyndal Hughes leads the health sector **Charlie Penny was Q5’s first ‘boots
Creating capacity and practice in Australia for Q5, with over on the ground’ when work to support
capability 25 years’ experience in implementing the building of the Dragon’s Heart
During the pandemic, we witnessed health effective transformation and leadership Hospital (DHH) commenced. The
and social care leaders, both young and old, strategies for blue-chip companies DHH was a surge hospital with 2000
‘run towards the fire’ to deliver the world- and government departments in beds for COVID patients, built in 30
class performance we needed to care for our Australia, New Zealand, the UK and days in the Principality Stadium —
populations.
the USA. As a former London-based the home of Welsh Rugby. Building
Now it’s time to capture all these learnings Accenture executive, Lyndal offers the DHH formed the foundation for
and better ways of doing, and use this to rigour and insight to all the projects the past two years for Charlie, who
invest in our leaders so that they have the skills she works on. She has been the Head has subsequently led a series of
and networks needed to lead change. The
of Culture and Change for Woolworths projects in the NHS. His recent work
opportunity is now to transform, re-create and
Food Group and founder of the highly has included supporting executives
realign our healthcare systems and capabilities
for tomorrow. regarded change consultancy Treacle. to refocus on their strategy and
This consultancy was rolled into Q5 in longer-term transformation plans
Currently, health services are experiencing a 2021, bringing with it deep expertise following the intensely operational,
wave of retirements, workers exhausted and
in working with leaders to shape and fire-fighting period experienced
exasperated by the pandemic. Now is the time
implement integrated change programs during the pandemic. He has also
to capture that loss of organisational memory
and reflect on the internal networks which are that align with strategy. Lyndal delivers supported a number of service
so often relied upon to get things done. measurable differences in workplace improvement programs, including
behaviours, wellbeing, organisational accelerating efforts to vaccinate the
Managers have started to lead in different
culture and leadership impact. Welsh Population.
ways. They harnessed the need, naturally
co-designed with their teams and

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compare outcomes and identify areas for • Integrated search and full-text retrieval
improvement. It’s also the basis for reporting 67% (609) • Artificial intelligence-driven literature
to patients, carers and consumers, with met all core actions at initial assessment at appraisal
results of hospital assessments available first accreditation cycle
online2. • Automated evidence synthesis and project
74% (672) reporting
More efficient quality met all core actions at second
Together, these capabilities can help hospitals
improvement needed accreditation cycle
transform your safety and quality improvement
Quality improvements can propel ongoing processes into a finely tuned engine that
upgrades in healthcare provision and supports compliance with the NSQHS
strengthen compliance to the NSQHS Second edition Standards.
Standards — as long as they’re launched, Hospitals and day procedure services
completed, and disseminated efficiently. January 2019 - December 20215 Ovid® Synthesis Clinical Evidence Manager
offers a single, cohesive view of projects
Hospital teams may find they duplicate efforts and reduces duplication while also fostering
60%
and experience roadblocks to collaboration. collaboration within projects by streamlining
completed assessments
There’s no simple way for projects to be the literature search, appraisal process,
prioritised, for new people to join a team, 74% implementation, and dissemination.
or for team members to document and of assessments met requirements at initial
track a project’s evolution. Teams may have assessment This solution will take clinical practice
no standard workflow and no way to easily improvement projects to the next level to
communicate or get feedback on a specific 1 ensure high quality based on the latest research
stage of a quality improvement project. not accredited insights and evidence, and support hospitals
with your NSQHS Standards compliance.
According to the NSQHS Standards User
20 1 Consumer fact sheet 2: Accreditation of health service organisations. ACSQHC.
Guide for Governing Bodies: “There is
required mandatory re-assessment 2 www.safetyandquality.gov.au/consumers/public-reporting-hospital-
increasing recognition that paper-based performance-nsqhs-standards
reporting is limiting, and that governing 7 3 www.safetyandquality.gov.au/sites/default/files/2019-11/nsqhs_standards_user_
bodies should use a blend of soft and hard with significant risks identified
guide_for_governing_bodies.pdf
4 The state of patient safety and quality in Australian hospitals 2019. Sydney;
intelligence. A mix of information and data
ACSQHC, 2019.
sources are needed to support quality 5 www.safetyandquality.gov.au/standards/nsqhs-standards/implementation-
improvement and monitoring.”3 nsqhs-standards/nsqhs-standards-lessons-learnt
»
Wolters Kluwer Health Australia Pty Ltd
Visit wltrsklwr.com/ovid-synthesis

SPONSORED CONTENT
© Stock.Adobe.com/au/krumanop
Healthcare Transformation
Enabled with LTE and 5G
H ealthcare today is marked by its
technology-enabled reach, with providers
extending coverage to more locations and
pandemic. LTE and 5G routers for pop-up
locations allow healthcare groups to quickly
set up temporary sites such as testing and
Clinic Within a Store
Many clinics and pharmacies are located
within a larger store or a nursing facility or
in a wider variety of ways than ever before. vaccination facilities anywhere, without hospital. To keep patient information secure,
Advancements such as telehealth, Bluetooth- needing a wired connection or even an onsite most of these in-store offices have to bring
connected devices, live streaming from IT professional. However, the IT team can their own network. An all-in-one Wireless WAN
ambulances, and pop-up temporary care sites still monitor and fine-tune connectivity and solution with enterprise-grade security can
help deliver services to people where they need security centrally through a cloud-based provide secure cellular-based connectivity
it, when they need it. network management platform. that is completely separate from the host
Western Health in Victoria provides a site’s network.
IoT in Healthcare
comprehensive, integrated range of services
Whether in a fixed or temporary location,
from its various sites; ranging from acute Ambulances and Medical
medical experts use devices and applications Vehicles
tertiary services in areas of emergency
to monitor environmental and patient data from
medicine, intensive care, medical and Communication of an incoming patient’s
connected medical devices, which helps them
surgical services, through to subacute care status between medical vehicles and
provide the appropriate care. A wireless edge
and specialist ambulatory clinics. Western hospitals is crucial for treating injuries and
solution that supports Bluetooth can safely send
Health provides a combination of hospital and other emergencies correctly and quickly —
information from these IoT devices and sensors
community-based services to aged, adult and especially for time-sensitive scenarios such
directly to the cloud, allowing off-site specialists
pediatric patients and newborn babies. as a person sustaining a life-threatening
to analyse and respond to real-time data.
event like a stroke. High-performance, always-
As Australia’s COVID vaccine requirements
With over 50 years of experience and 50,000- available connectivity supports on-board
increased during the pandemic, Western
plus babies delivered, Monash IVF is a leader in video communication and data transfer en-
Health needed to establish a temporary
reproductive care. Opening its newest facility in route to the nearest care facility.
COVID Vaccination Centre staffed by 100
Albury, Monash IVF needed day-1 connectivity
employees out of the Melton Vaccination Telehealth
for its 20 clinical and corporate staff on-site.
Hub. The healthcare provider needed Telehealth visits are commonplace today
Working with Cradlepoint technology partner,
day-one cellular connectivity to meet staff for all types of care. LTE and 5G routers can
Sparx Solutions, Monash IVF deployed a
requirements. be sent home with doctors and/or used
Cradlepoint 5G solution to provide primary
connectivity on the site, enabling connectivity Western Health implemented Cradlepoint in a clinic, enabling high-bandwidth, low-
for its medical and corporate devices. With 4G and 5G wireless networking solutions latency video streaming on either end of a
secure and reliable wireless connectivity, these to enable primary connectivity at the telemedicine appointment.
devices are able to transfer patient data to and temporary site. This gave 100 on-site staff Cradlepoint’s NetCloud Service and cellular-
from the organisation’s centralised data centre. secure access to patient vaccination and enabled wireless edge routers and adapters
health records and enabled clinical staff to use LTE and 5G to reliably connect medical
Pop-Up Clinics increase capacity from administering 50,000 professionals anywhere.
Pop-Up clinics have become ubiquitous vaccines per month to 50,000 vaccines
across Australia and globally over the every 10 days.
»
Cradlepoint Australia Pty Ltd
https://resources.cradlepoint.com/healthcare

TECHNOLOGY
©stock.adobe.com/au/Mikko Lemola
Precision
oncology
and patient Patients may be able to avoid treatment that
is unlikely to work, and have an increased
likelihood of more effective treatment, which
care
has the potential to reduce healthcare costs
and improve patient outcomes.
Optimising treatment
Precision medicine using genomic tools is
the future for all cancer treatment. As with
all cancer treatments, precision oncology
Professor David Thomas, Director of the Kinghorn Cancer Centre and will be initially used in advanced cancers,
Lab Head of Genomic Cancer Medicine at the Garvan Institute of Medical with the greatest impact in rare and high-
Research Australia mortality cancers like sarcomas and cancers
of unknown primary1,2. In these settings,
genomic medicine could be a game changer.
Rare cancers are often misdiagnosed, and
suffer from a lower priority in cancer research,
Cancer is fundamentally a
genetic disease, driven by
P recision oncology uses knowledge of the
genomic profile of each patient’s cancer
to guide accurate and personalised therapy.
leading to a paucity of standard treatments
and new therapies.
The future for precision oncology is illustrated
mutations that drive cancer Rapid developments in two related fields have
by lung cancer. Lung cancer is a leading
enabled precision oncology. First, the robust
growth. Just as each person and affordable access to genomic tools cause of cancer death in most higher income
countries. Lung cancers are both common,
is genetically unique, so the in the clinic. Second, the development of
biomarker-dependent drugs that can exploit and often diagnosed very late in the illness.
genomic profile of no two the genomic vulnerabilities identified. Each year, about 12,000 Australians are
cancers is the same. diagnosed with lung cancer3. It is the fifth
The effects of these innovations are most common cancer in Australia, accounting
transformative. for 9% of all cancers diagnosed and is

TECHNOLOGY
responsible for almost one in five cancer in Australia, we have developed a large-scale By 2023, assuming the current success rates
deaths in the country.2 genomic screening program focused on lung in clinical trials, we expect that number to
cancer called ‘ASPiRATION’. go up to 25 druggable targets. Lung cancer
Lung cancers are highly mutated, with
is a poster child for the ongoing success
>100,000 mutations found in some cases4. In In a partnership between Roche Australia, the
of precision oncology, but the principles of
the 1990s, conventional chemotherapy was Thoracis Oncology Group of Australia, and
precision apply to all cancers.
relatively ineffective, leading to few treatment the Australian Government, ASPiRATION aims
options for those in whom the cancer was no to assess the impact of personalised health Given that cancer is now the leading cause
longer curable. care in lung cancer — potentially transforming of death in high income countries, it is
the way cancer care is administered in critical for health systems to understand the
The development of tumour genomic
this country. A first-of-its-kind in Australia, value proposition of precision oncology, to
profiling combined with new treatments has
ASPiRATION will generate high quality, real- affordably and equitably introduce these into
transformed treatment options for patients
world clinical and medical data about the the care of cancer patients.
with lung cancer.
impact and value of comprehensive genomic
profiling (CGP), precision medicine and I also predict that genomics-based precision
By 2021, we have identified more than 11
personalised health care (PHC). medicine will be implemented earlier in the
different drug targets in lung cancer. The
cancer journey, moving from the incurable
use of the right drug in the right patient has
We hope to show that comprehensive setting to adjuvant treatment, diagnosis,
transformed outcomes, leading to extension
genomic profiling — when implemented and even to the pre-diagnostics space —
of survival by years in many cases. More
at scale along with tools and processes to where we might be able to identify people at
than half of all patients with lung cancer will
support personalised care plans, rapid access differential risk and screen for them.
carry one of these 11 drug targets. A single
to innovative medicines and systematic
comprehensive genomic panel can now Prevention, early detection, accurate
tracking of clinico-genomic data — enables
identify all 11 drug targets at one go, rather diagnosis, curative therapy and personalised
the promise of truly personalised health care
than gene by gene. The challenge in Australia treatment of advanced cancers will all be
by identifying the right treatment for the right
today is to transition from single gene tests to influenced and affected by genomics and
patient, at the right time.
comprehensive genomic panels. targeted therapies. I cannot think of an area
The 11 approved drug targets are present in of cancer care which will not be changed by
The question then is how can genomics and
almost 50% of all lung cancer patients today. the use of genomics, in Australia and beyond.
precision oncology play a vital role in the shift
The future is coming: we should be preparing
towards value-based healthcare?
for it today.
Precision oncology and value-
based healthcare References
1. About | Garvan Institute of Medical Research. (2019).
With these advances in genomics and
matched therapies, and also a deeper
understanding of the molecular biology of
“Lung cancer Garvan Institute of Medical Research. Retrieved from
https://w ww.garvan.org.au/research/genomic-cancer-
medicine-program/about
cancers, we can now deliver better value by
moving away from a one-size-fits-all model for
is a poster 2. About | Garvan Institute of Medical Research. (2019).
Garvan Institute of Medical Research. Retrieved from
cancer treatment. child for the https://www.garvan.org.au/research/genomic-cancer-
medicine-program/about
In the example of lung cancer, moving
towards testing all drug targets at one go in ongoing success 3. Australian Institute of Health and Welfare (AIHW). Cancer
Data in Australia, AIHW, Canberra. (2020). Retrived from
order to find out what is present in a patient’s
tumour, enables the use of that information of precision https://www.aihw.gov.au/reports/cancer/cancer-data-in-
australia/contents/about
as early as possible in the patient’s journey
to guide the choice of best treatment. To oncology, but 4. Strachan, T., Goodship, J., & Chinnery, P. (2015). Genetics
and Genomics in Medicine. European Journal of Human
show the potential benefits of this approach
the principles of
Genetics, 23(5). https://doi.org/10.1038/ejhg.2015.18
precision apply
to all cancers”
©stock.adobe.com/au/catalin

SPONSORED CONTENT
© Stock.Adobe.com/au/Monkey Business
Smart electrification
for smart hospitals
Ian Richardson, Building Solutions Technical Specialist, ABB Australia
F lorence Nightingale is regarded as the

founder of modern nursing, gaining
prominence as a manager and trainer of
importance is delivering the most effective
outcomes for patients. To achieve this, a
modern healthcare facility must maintain an
The smarter hospital can help manage
the quality of the air we breathe by
measuring the CO2 in the atmosphere
nurses during the Crimean War. One of environment where power resource-intensive or creating positive pressure rooms for
her notable quotes was “The very first medical treatments can be provided with immunocompromised patients. The HVAC
requirement in a hospital is that it should do efficiency and reliability, yet still meet the system can account for up to 50% of
the sick no harm”. sustainability goals of the facility. the operational costs of the building, so
energy efficiency measures in this area
Hospitals are complex installations utilising Meeting these specific demands requires a
are paramount. Using high efficiency
multiple applications that must work flawlessly holistic approach to understand the facility’s
drives in the HVAC system combined
24 hours a day, 365 days a year. Electrical individual needs, as well as providing the
with ABB i-bus KNX building automation
supply availability supports operational right mix of technology working seamlessly
controls to manage the area environment
continuity, and this is especially crucial in together to deliver the required outcomes.
according to occupancy, specific use, and
emergency rooms, intensive care units and The building infrastructure needs to be smart.
comfort requirements, can all contribute to
operating theatres, where supply interruptions A smart building has become a widespread
increased cost savings.
can be a matter of life and death. phrase used to define the needs of a modern
building. In this context we could say a Digital solutions can provide healthcare
The ability to ensure supply continuity in hospital or healthcare facility needs to be a facilities with new levels of energy
hospitals can be a big challenge, requiring smarter building, due to the critical nature of management. Systems such as ABB Ability
deep knowledge of correct installation the use of the building. Energy and Asset Manager offer a state-
practices and devices that can ensure
of-the-art solution that can integrate
uninterrupted service and a healthy Smart solutions combine energy and asset management in a single
environment. Guidance can be found in reliability, efficiency and safety intuitive dashboard. This tool allows
standards such as AS/NZS 3003, Electrical
The first aspect of the smart hospital seen building managers to view, manage and
installations – Patient areas, IEC 60364-
by staff, patients and visitors can be the optimise building systems from anywhere,
7-710, Electrical installations of buildings
building automation system. While automated at any time. Predictive, condition-based
– Requirements for special installations
to the needs of the hospital, an automation maintenance can be implemented to ensure
or locations – Medical locations, and in
system such as ABB i-bus KNX can reduce reliability and availability of the healthcare
publications such as the Australasian Health
staff workload through the automation of facility’s power system and equipment. In
Facilities Guidelines produced by the
core functions such as lighting, shutter and addition, real-time monitoring of energy
Australasian Health Infrastructure Alliance, as
blind control, heating, ventilation, security, usage can achieve maximum energy
well as the state-based guidelines published
and energy management. Patient rooms efficiency and lower costs.
by the respective health departments of New
can be automatically configured to respond
South Wales, Victoria and Western Australia. The smarter hospital can have an active
to individual needs such as light intensity,
role in improving patient health. Patients
A modern hospital or healthcare facility is not sunshine glare and optimal climate.
can enjoy a more personalised experience
an ordinary building environment, it is a place
A smarter hospital can become an active with greater comfort. The often complex
of healing, where care is provided to patients
player in optimising the health of those in and high-risk procedures undertaken
to improve their health. The building must
its care. The automatic adjusting of lighting can be performed in safer, more reliable
not only provide the security of a reliable
intensity can assist staff working overnight surroundings protecting both patients
electrical supply ensuring service continuity,
to stay more alert. Lighting in pharmacies and staff. For the business side of the
but it also has a role to play in the care of the
can be optimised for colour discrimination, hospital, improved asset management is
patients, staff, and visitors.
a crucial aspect for dispensing medicines. achieved through predictive maintenance,
The central nervous system for Emergency lighting luminaires and systems reducing catastrophic failures and down-
provide clear instruction and help minimise time. Network resilience can be seen from
the most resilient healthcare injuries in high-risk and emergency evacuation power supplies that are uninterrupted
facilities situations. Periodic maintenance and testing of even during power grid outages. Finally,
The electrical system of a hospital or health emergency luminaires according to Australian intelligent data analysis delivers efficiencies
care facility could be described as the central standards can be performed remotely without and cost savings, confirming the return on
nervous system of the building. Of paramount interruption to the safe operation of the facility. investment of the facility.
»
ABB Australia Pty Ltd
https://campaign.abb.com/ABB_Hospitals_Healthcare

TECHNOLOGY
©stock.adobe.com/au/khanchit
The road to net zero

emissions in
health care
Abe Fitzsimons, Healthcare Segment Lead, Pacific Zone at Schneider Electric
Health care will face substantial challenges transitioning to a aggregate data to create a digital model of
the facility and its assets.
net zero future, but those challenges must be faced sooner
In practice, this will translate into streamlined
rather than later. solution design that is based on real-time
A
monitoring and data-driven decision-making,
ustralia’s healthcare industry contributes ahead of the curve and keep global warming
enabling more efficient energy management.
about 7% of total greenhouse gas below 1.5 degrees.
emissions — representing 35,772 kilotonnes of As a result, a multitude of benefits can be
CO2 — with the majority embedded in supply Core to the solution are digitalisation and expected: lower energy and maintenance
chains. With this significant impact, we need a electrification. Decisions to digitise and move costs, less downtime, better patient
concerted and collective sector-wide effort to away from fossil fuels should be embraced experiences, and improved staff safety and
abate emissions. now by every healthcare organisation. satisfaction. Ultimately, we will see reduced
These decisions can result in immediate wins energy consumption and fewer carbon
Embracing an energy transition means
for the climate. Technology exists today to emissions.
change, but adapting will have a myriad of
advantages, creating more efficient, digitised, facilitate them, with solar PV, increasingly These processes can easily be embedded
greener facilities with benefits for both clients advanced batteries, electric vehicles and into plans for new facilities, but quick gains
and climate. digital monitoring. can be made today by retrofitting existing
Our ability to reduce energy consumption is ones. A digitally controlled and connected
I recently hosted an industry webinar,
limited by a lack of information, which can energy system can reduce energy usage in
‘Harnessing innovation: the road to net zero
be addressed by digital technology. The most facilities by around 20%.
emissions in Australian healthcare facilities’.
I was heartened that half the participants internet-enabled interconnectivity of our I see the future of health care built in a
had set net zero by 2050 targets, and we power systems, heating and cooling systems, system that is driven by data, with proactive,
heard how the Climate and Health Alliance appliances and machinery can now be actionable insights key to improving
is building collaboration across the sector monitored and controlled. operational efficiencies and patient care.
towards eliminating emissions. This data is also crucial to improving our
Gas use in hospitals must be supplanted by
contribution to combating climate change.
As the Alliance’s Fiona Armstrong said, the electricity, renewably generated electricity.
sector must recognise that climate change Shifting away from fossil fuel-driven electrical Knowledge must be shared across the sector,
is the biggest current threat to global health, sources, smart facilities can find alternative, encouraging and educating suppliers to join
threatening our existence as a species. cleaner ways to procure electricity needed to the journey to net zero.
However, the fact the other half of the power healthcare facilities. They can generate
their own solar power or enter into power The healthcare industry as a whole must
webinar audience was yet to set net zero
purchasing agreements for renewable energy. become even more client and climate
targets demonstrates that many in the sector
conscious, collectively striving for net zero
must begin moving more quickly.
Electrification will also facilitate digitalisation, emissions, not just within a facility but across
Setting 2050 targets is a good start, but it allowing facilities to leverage the Internet its supply chain, and play its part in abating
is the trajectory that counts if we are to get of Things to connect multiple systems and the biggest global health crisis of this century.

A DAY IN THE LIFE
A day in the life of

Leanne
Northrop,
an Aged Care
Nurse Practitioner
5:30: I’m up and 08:00: I arrive at the Nurse
at ’em. Nothing of Practitioner clinic. This is a telling
importance can moment.
be considered 09:00: Time for the COVID-19 meeting for Senior Leadership.
If clinicians are at the door, charts
before a cup of Lately this has been as serious as chest pain. The meeting
in hand, their resident may have
tea. Lately I have takes on a sombre atmosphere as we brace for latest statistics
a pressing need to be seen. It
©stock.adobe.com/au/ArthaDesignStudio
this while I listen to the in the state, our region, amongst our staff, their close people,
could be something like pain relief,
news since aged care is our residents and their close people. There is a mutual goal
deterioration or both.
so prominent, and often is to keep residents safe. We discuss how to care for residents
linked with COVID-19 data If it is a resident waiting at the clinic who are deconditioning due to isolation, who don’t want to
and directives. door, this is usually a good sign as go to hospital, whose doctors can’t always come in and who
they are up and about and motivated. are missing chair Tai Chi and Bingo. Covering shifts when our
Since so much can turn on
colleagues are sick is a grim challenge too, as we all adapt to
a dime these days, it feels Whatever the need is, nothing can fill their boots. There is also the sourcing of RATs, PPE, food
better to be prepared! happen before I have stuck a delivery, keeping families in touch and coaching to ensure PPE
This is also why I make swab up my own nose. is worn carefully.
©stock.adobe.com/au/amin268
my lunch. It is usually (Rapid antigen testing

something that can be must be the It’s a relief to know the team understand and sympathise with
eaten quickly and won’t residents’ revenge how stifling summertime PPE can be, and how it turns us into
make a mess while I type to know the staff drooping, pruney, drippy clones with fogged up glasses that
or read. enduring this residents can’t recognise or understand, and who we can’t see.
regularly too.)
Then off to work.
05:30
08:00
08:30
09:00
09:45
10:30
10:30: Independent Living Unit rounds commence after discussion

with the team about their feedback, priorities and concerns. Clinical,
08:30: It only takes a 09:45: A resident from our
care and support staff know the residents so well that they notice
little while to bring my key Independent Living Unit is waiting
small, but significant changes; for example, a person who is unusually
resources to hand for the for me. He told me he had a terrible
pale, or green around the gills, or has blue, cool fingers. When
day. The computer gifts me toothache, could not eat and wondered
these observations are communicated, we can get underway with
with Therapeutic Guidelines if I could pull the tooth out. Tempting
assessment and interventions that tie in with the GP visit, and can
for currently endorsed as it was, dentistry is not in my scope
hopefully keep residents at home and well.
guidance, PBS to check of practice. Without health cover, or
medications, pathology when funds are limited, treatment I took my kit to a gentleman who has a wound on his lower leg that
results and the program for options are limited, so NP referral was has not reduced by the required 25% in one month or healed in three
Medicare billing. NPs can written, a dental service identified and, months despite the clinician’s best efforts. The wound was swabbed to
©stock.adobe.com/au/tanyastock
prescribe, diagnose, send with advocacy, and an appointment rule out infection, photographed, plans made for biopsy and referral to
off for pathology and claim made. With pain relief a dermatologist. Skin is so tough but so fragile, tells a million stories and
from Medicare and I want and a modified diet can heal in the most arid health landscape so is always deserving of our
to ensure I’m looking at the in the meantime, the best efforts. I also did a Doppler Test to check his lower leg circulation. A
latest evidence base for gentleman was able to healthy Ankle Brachial Index will ensure the man had enough effective
all I do. manage. circulation to heal skin after any pending interventions.

A DAY IN THE LIFE
©stock.adobe.com/au/Zarina Lukash
L eanne Northrop is a Nurse Practitioner (NP) at Peninsula
Villages, an aged-care facility on the Central Coast, New
South Wales. She recently relocated from Western Australia
to the Central Coast aged-care facility, and has worked in
rural and remote areas, supporting elders and working within
various healthcare settings.
Peninsula Villages is said to be one of the few aged-care

facilities to have a full-time NP on-site. After experiencing two
extended lockdowns during the COVID-19 pandemic, the
aged-care facility considers the role of an NP to be the way of
the future in aged care.
13:50–13:55: A socially distanced group of five

nurses sang “happy birthday” loudly to one of the
team between the first and ground floor. It was
quite fun. I’ve never done that before.
13:00: High care rounds commence after

©stock.adobe.com/au/Photographee.eu
discussion with the team. They are worried

14:00–15:00: High Care
about a resident who is unusually agitated.
12:15: Our current Quality Meeting. With the
The lady is not allowing interventions or
group of student multidisciplinary team,
assessment. It was beginning to look like
nurses had a short trends in skin tears, pressure
delirium was causing her agitation. Her
NP-led toolbox session injuries and falls are
Advanced Care Directive was for active
by watching the reviewed, and preventative
management and transfer if unwell, so a
Doppler procedure, interventions considered
transfer to ED was initiated.
and then discussing and implemented. We were
contemporary wound I went on to review a gentleman who had pleased to know there are
care products, and the been suffering frequent falls. The most recent occurred when he bent forward new tracksuit pants and
rationale for their use. to pick up his binoculars from the floor. He tells me he has taken to birdwatching shorts in all sizes, with
It feels good to teach since he’s been in lockdown. He sustained a laceration to his hand that I was able built-in hip protectors now
new nurses setting to suture. This prevented a hospital visit, which is one of our KPIs. It’s been a while available. When falls can’t
out and introducing since he had a blood test and a medication review to check for anything that may be prevented at least we
them to the complex also contribute to a fall, so I, in partnership with the GP, initiated these things. can try to reduce the ‘harm’
specialty of aged care. from falls; and there would
In all areas, there are medications to be charted, ceased, checked, crushed, be the added benefit of not
injected and explained. Like all nurses my day is full of little parcels of resident and trying to keep track of hip
©stock.adobe.com/au/chrupka
family education. As an NP this often relates to medications no longer in favour protector pads!
(think Valium), or why research recommends a supplement (think vitamin D for
bone health and to minimise secondary fractures). It can be challenging (think of
inventive ways to explain antibiotic stewardship in full PPE to a person who is hard
of hearing and has the right to ask).
12:15
13:00
13:50
14:00
15:45
17:30
15:45: Time for a cuppa and the paperwork… (although

©stock.adobe.com/au/ Soloviova Liudmyla
paper actually features less and less, which I’m still getting
used to). 17:30: Done for the
day. Home to play
Progress notes underpin a person’s condition and care, with my daughter’s
and our communication and accountability, so I’m keen to new puppy and go
contribute. for a walk.
NPs can also submit a Medicare claim for each visit,
which raises funds for the organisation and contributes to
sustaining the role, so I’m also keen to ensure this is done!
Finally, there is preparation for a case conference
tomorrow with the family of a resident approaching
end of life.
It’s a privilege to be part of a person’s journey. A Day in the Life is a regular column opening the door into the life of a
person working in their field of health care. If you would like to share a
We all want to contribute since it is understood, if not
day in your working life, please write to: [email protected].
spoken, that we only get one opportunity to make a
person’s end of life right.

TECHNOLOGY
Transforming
lung
©stock.adobe.com/au/Sergey Nivens
health
The world’s first dedicated
lung scanner, XV Scanner, has
T he scanner uses an automated scanning
process to produce detailed lung
function information in real time, and will
Minister for Health and Aged Care Greg Hunt
said, “The development of the XV Scanner
is a wonderful example of Australia again
been installed at the Prince of help people living with lung conditions such punching above its weight in the world of
as chronic obstructive pulmonary disease, health and medical research.”
Wales Hospital in Sydney.
cystic fibrosis and asthma. It is said to help
4D Medical received $28.9 millio through
with early disease detection and accurate the Medical Research Future Fund’s (MRFF)
monitoring of chronic respiratory conditions. Frontier Health and Medical Research Initiative
The XV Scanner will be used by researchers to develop and commercialise the scanner.
and clinicians from the University of New Dr Fouras said the XV Scanner would not
South Wales (UNSW) and the Sydney have been possible without the MRFF
Children’s Hospital, including lung health investment. The XV Technology software
expert Professor Adam Jaffe, who is is already being commercialised, while
currently the John Beveridge Professor of the scanner remains on track for clinical
Paediatrics at UNSW. deployment in late calendar 2023.
Dr Fouras, Founder and Chief Executive Coupled with 4DMedical’s XV Technology,
Officer of 4DMedical, described its the device provides detailed quantitative
development as a “transformative moment data on respiratory function via an
in lung health history”. automated process, which delivers

TECHNOLOGY
4DMedical CEO & Founder Dr Andreas Fouras and Federal Minister for
Health and Aged Care Greg Hunt MP at the Prince of Wales Hospital in
Sydney, for the unveiling of 4DMedical’s XV Scanner (pictured).
important advantages in other areas as market at the time. Importantly, engineering

well, including: rapid scan times, which research and development has been
improve patient experience and also deliver completed in-house and within budget,
Digital rendering of 4D Medical’s increased throughput, thereby improving resulting in the creation of a significant
XV Scanner installed at Prince of the economics for healthcare providers; body of intellectual property.
Wales Hospital and increased access to XV Technology
4DMedical is now working with leading
for more patients, including children, the
medical researchers to progress a series of
elderly and the very unwell.
clinical trials that will take the XV Scanner
The successful placement of the scanner towards regulatory clearance by late 2023.
at the Prince of Wales Hospital means Success here will give 4DMedical a superior
4DMedical has designed, built and deployed product offering accelerating penetration
the first XV Scanner in an Australian hospital of the global respiratory diagnostic market
within 12 months of MRFF funding, meeting currently valued at more than US$31 billion
the ambitious target communicated to the a year.
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TECHNOLOGY
Unaffordable
innovation?
The rising cost of patient care
Richard Gerdis, Vice President & General Manager, Asia Pacific & Japan at LogicMonitor
The past two years have seen

Australia’s medical industry
undergo significant changes,
with e-health and telehealth
quickly becoming the norm.
The industry has already
seen the implementation of
ePrescriptions and new MBS
items to support remote
care as more practices adopt
telehealth services to reach
and treat patients effectively.
However, as digital care
©stock.adobe.com/au/metamorworks
becomes more prevalent,

practitioners are faced with
fragmented and, at times,
difficult-to-obtain patient
records. They also face growing
compliance challenges around
the transfer, storage and
management of sensitive prioritise accordingly? And what challenges what kind and how it’s handled, make the
does the industry need to overcome to see implementation of machine learning difficult
patient information. the right platforms implemented at scale? unless highly restricted. Further, supporting
such complex systems will require the use
AI and patient care of foundational tools that help monitor and
AI has been breaking ground in the healthcare
I
support the performance of and access
n response, the government has begun sector by assisting practitioners in tackling to critical data. Fortunately, AI-enabled
exploring methods of connecting and practical challenges. However, the most monitoring already exists and is used by
consolidating patient data to offer complete exciting application for specialists and many companies to keep existing databases
record visibility. With the application of AI, general practitioners is ‘hyper individualised up and running efficiently. The technology
there is also the potential to aid practitioners treatment’. Hyper individualised treatment is there but to evolve the industry will need
in delivering hyper individualised treatment. develops patient-specific tailored treatments to reassess its approaches to consolidated
Still, the rapid adoption of multiple new based on more than a diagnosis. In record keeping, compliance and privacy.
technologies comes at a cost, with private combination with AI, the level of depth this
practitioners within the industry facing approach provides reduces diagnosis time, Continuity of care in a
mounting tech expenses driven by the need improves treatment accuracy and provides fragmented system
to innovate faster to stay competitive. practitioners with insights that may have
‘Continuity of care’ is the holistic management
otherwise gone unnoticed.
With so many new technologies out there, of a patient by a single practitioner or within
how does a practice discern which are Despite numerous benefits, privacy issues, a network of providers. Substantial bodies
truly shaping the future of patient care and such as how much data access is given, of literature outline the benefits of continuity

TECHNOLOGY
“Larger practices
that house sizable
amounts of patient
data spend excessive
time and resources
switching between
tools to gain insight
into issues and spot
problems”
single platform, and this approach can be

applied to every system: from security to
data storage. It can cut down on costs, and
make collaboration across teams, offices and
practices easier.
Making innovation affordable

Amidst fragmented systems and complex
privacy requirements, practitioners are
spread thin, and with data sprawled
across on-premises and digital, costs can
easily compound. For example, like many
healthcare organisations, Bupa Australia
relies on a vast network infrastructure to
support its operations. Following a series of
acquisitions in 2017, its IT team noted that
the large number of different tools Bupa
used for IT monitoring was neither efficient
nor cost-saving. As a result, the organisation
made the decision to modernise. They
deployed a cloud-based observability and
monitoring solution across two main data
centres. Doing so allowed the team to
quickly eliminate extraneous monitoring
of care, from improved patient satisfaction The cost of compliance tools to streamline operations. Their new
to reduced avoidable hospitalisation. Record platform also helped the team automate
All healthcare providers in Australia have
visibility is a crucial aspect of continuity of time-consuming processes.
professional and legal obligations to protect
care, due to the fact that having a complete their patients’ health information. Different COVID-19 has pushed the healthcare
understanding of a patient’s medical history specialisations have different requirements; industry forward in many ways; however,
is essential to prescribing the best treatment. however, the new challenge is managing fragmented patient data and costly and
While initiatives such as My Health Record patient data compliance across hybrid complex systems are still holding the industry
have had success addressing record visibility physical and digital environments. In the back. Furthermore, healthcare institutions
issues within the public space, the adoption past, patient record regulations focused employ a vast array of technologies to
of these systems remains low amongst on the physical storing of information, but operate on a daily basis, and if one part of
private practitioners. The challenge is not as digital records expand, practitioners that technological ecosystem goes down, it
the concept itself but the numerous services face a slew of additional criteria. Moreover, can have a huge knock-on effect. To advance,
and rising costs that underpin the program today larger practices that house sizable the industry must address the urgent need
and managing these in an efficient fashion. amounts of patient data spend excessive for better IT management of the critical
Affordability must be a primary consideration, time and resources switching between technologies that form the foundation of
and what practitioners require are streamlined tools to gain insight into issues and spot patient care such as observability. It’s time to
digital solutions, particularly concerning problems. Consolidating systems and tools start practising essential ‘technology self-care’
unified observability and record keeping, that through a unified observability platform will for the platforms that power modern
remove unnecessary complexity from what allow healthcare IT specialists to view the health care and establish the foundation for
should be a straightforward process. performance of these systems through a future innovation.

DESIGN IN HEALTH
Recovery
and mental
health

DESIGN IN HEALTH
T he Acute Adult Mental Health Inpatient

Service, with a modern therapeutic
space ensuring people can recover in a
calm, healing environment, has officially
opened at Blacktown Hospital.
The 30-bed unit has been designed to
support recovery-orientated contemporary
models of care, with locals with lived
experience and the wider community
playing a key role in its design and delivery,
said Minister for Mental Health Bronnie
Taylor at the opening.
“There is an abundance of natural light,
beautifully designed outdoor areas, sensory
and de-escalation spaces and stunning
artwork throughout the new facility.
“Importantly, people with lived experience
were involved in every step of the
development process, to ensure delivery of
the best outcome for consumers, staff and
the western Sydney community.
“All of this contributes to a therapeutic
space that promotes cultural, emotional,
psychological and physical safety and
empowerment.”

DESIGN IN HEALTH
The new unit features: 30 single-bed

rooms each with unique artwork; two
spacious dining and recreation rooms
filled with natural light; a dedicated room
for art therapy and other therapeutic
activities; sensory modulation rooms
including comfortable chairs and lounges,
TV and skyview ceiling panel; indoor and
outdoor exercise and fitness facilities; and
landscaped gardens.
Western Sydney Local Health District
(WSLHD) Chief Executive Graeme Loy said
feedback on the new facility has been
fantastic. “I am excited for ongoing mental
health redevelopment work across our
District as we continue to provide the best
possible care for the people of western
Sydney and support their recovery.”
The purpose-built unit is part of the
$700 million state-wide Mental Health
Infrastructure Program to support the
delivery of mental health care reform in NSW.
Consumers and staff transitioned from
Bungarribee House at Blacktown Hospital
into the new unit in February following a
smoking ceremony.
The relocation also complements the
$700 million Blacktown and Mount Druitt
Hospitals Expansion Project and makes way
for Bungarribee House to be demolished
and work to begin on an additional new
purpose-built mental health facility at
Blacktown Hospital.

SAFETY
©stock.adobe.com/au/ Pixel-Shot
Reducing
medicine-related mishaps
The Royal Victorian Eye and Ear According to Australian research by the Agency CEO Amanda Cattermole said, “The
Quality Use of Medicines and Pharmacy Victorian Department of Health and the
Hospital (Eye and Ear) is said to Research Centre, UniSA, an estimated Royal Victorian Eye and Ear Hospital are to
be the first hospital in Australia 250,000 hospital admissions are medicine- be commended for their support for the
related and two-thirds are potentially Pharmacist Shared Medicines List initiative.
to implement the Pharmacist preventable.
Shared Medicines List (PSML) “Now this Victorian hospital has led the way in
The Australian Digital Health Agency (Agency) implementing this initiative, the Agency and
medicine safety initiative. and the Victorian Department of Health have the Department are working to extend PSML
worked closely with The Royal Victorian Eye to other health services in Victoria.”
P
and Ear Hospital in East Melbourne to deliver
roduced only by pharmacists and PSML at the hospital. The Chief Digital Health Officer at the
uploaded to My Health Record, it is a Victorian Department of Health, Neville Board,
consolidated list that includes information The Director of Pharmacy at Eye and Ear, said Victoria’s digital health roadmap centred
about prescription and non-prescription Catherine Rokahr, explained that pharmacists on the secure sharing of critical health
medicines such as over-the-counter and highlight changes to a patient’s regular information between clinical settings, making
complementary medicines, including vitamins medicines made during a hospital stay. each patient’s care journey safer.
and herbal remedies. It also includes the
“This is detailed in the discharge medicines’ “I thank all the staff at the Eye and Ear for
health practitioner’s reasons for prescribing
list uploaded to My Health Record which taking the lead and getting essential patient
each medicine and how and when patients
becomes part of the PSML and shows GPs medicines information into My Health
should take them.
and community pharmacists any medicines Record,” Board said.
The PSML helps patients and healthcare that have been stopped, directions and
providers manage medicines safely doses that have changed, new prescriptions A Pharmacist Shared Medicines List (PSML)
throughout a patient’s healthcare journey, and the reasons for each medicine use and contains information about the medicines a
including when they are discharged from medication changes,” she said. patient was known to be taking at the time
hospital and go home or into a residential the list was created.
Jeanette Anderson, the Director of Digital
aged care facility.
Health at Eye and Ear, added, “PSML is part of The list includes medicines that have been
When this information is available in My the hospital’s commitment to an outstanding prescribed to the patient by their doctors and
Health Record it can help patients and patient experience and there is real interest in other non-prescription medicines that they
healthcare providers avoid medicine-related adopting this medicine safety initiative across may be taking (such as paracetamol) and
mishaps and ensure continuity of care. the state’s health system.” other known over-the-counter medicines.

AGED CARE
©stock.adobe.com/au/Kawee
What
do older
people want 2. Choices to be built into their health care.
3. Support to identify, navigate, access and use
healthcare services.
from their health care?

4. Effective communication with service
providers.
5. Health care that is integrated and responsive
to their needs.
N
More than 1 million Victorians are aged over
ew research by the National Ageing living independently in their own home for as
60. Carers are also feeling the strain from a
Research Institute has found that trust in long as possibly was a top priority.
lack of confidence in the system. Less than
the aged-care system is particularly low, with
“The Royal Commission into Aged Care half of carers felt that caring was a fulfilling
almost 50% of older people revealing they do
Quality and Safety highlighted that older experience, and only 16% felt well supported
not trust that they would receive good care in
Australians want to remain at home. This by other carers and services to help share the
residential aged care. And that’s not all — 41%
research reaffirms this, but also shows there load. With more than 60% of carers surveyed
consider residential aged-care facilities to be
is a lack of faith in our health- and aged-care aged over 65 themselves, there is increased
depressing places.
systems’ ability to provide adequate support,” likeliness that they will have increasing health
The report, titled ‘What do older people said NARI Acting Executive Director, Associate needs of their own.
want from their healthcare?’, conducted on Professor Frances Batchelor.
“Older people and their carers want and
behalf of the Victorian Department of Health,
“One of the key things older people want is deserve support that is informed by their needs,
has revealed older Victorians have a lack of
to be heard, and this report is an important priorities and expectations,” Associate Professor
trust in, and understanding of, the health-
avenue for their voices. If we listen, the Batchelor said.
and aged-care systems. Less than 50% of
challenges older people and their carers are
respondents were aware of the healthcare “We hope this report, and the important findings
facing can be planned for and addressed,”
services available to them. Around 22% of within it, will help inform government and create
Associate Professor Batchelor said.
older people surveyed do not understand the a starting point for much needed change within
My Aged Care system. Based on this research, NARI has identified the system.”
the core priorities of older people as being:
However, taking an active role in management The research included a survey of almost 300
of health was deemed to be very important by 1. For their opinions regarding health and older people across Victoria, between April 2019
82% of older people, and more than 75% said wellbeing to be heard. and February 2020.

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DESIGN IN HEALTH
Meeting growing
regional needs
L ocated on a greenfield site in the Lower
Hunter Valley of New South Wales, the
new Maitland Hospital features clinical and
sixth hospital Multiplex has delivered for the
NSW Government in recent years.
“The new hospital delivers key services to
emergency services, spanning over seven
increase clinical capability in the form of
floors. The 50,000 m2 space, developed
beds and treatment spaces to meet the
by construction company Multiplex,
health care needs of the growing Lower
offers a range of adult and paediatric
Hunter Valley community.”
services including emergency, paediatric,
maternity, chemotherapy and contemporary Multiplex’s new build includes the delivery of
operating suites. clinical support services including central sterile
services department, pharmacy, pathology,
The ground floor, spanning 11,000 m2,
isolation rooms where required, plaster
accommodates the main entrance, retail
rooms and gyms to support both general and
space and key clinical departments that
mental health services for residents. As well
require direct public access. The 339-bed,
as upgrades to clinical spaces, the project
$470 million hospital also includes a rooftop
included roadwork upgrades to the intersection
plant room and helipad.
at Chelmsford Drive and Metford Road as well
Multiplex Regional Managing Director David as internal roadworks to create two separate
Ghannoum said this hospital represents the hospital entrances.

DESIGN IN HEALTH

DESIGN IN HEALTH
Works spanned a two-and-a-half-year period,

with Multiplex commencing main works early
in 2019. Significantly, a total of 3465 jobs
were generated by the project, and at peak
construction, some 600 people worked onsite
per day.
Ghannoum said that as well as well as the
successful delivery of the hospital, the project
had generated some significant social and
environmental outcomes for the Maitland
community.
Social value outcomes were underpinned
by the Maitland Connectivity Centre, a
Multiplex initiative linking local job seekers
with job opportunities on the project and
beyond. The centre delivered over 50
Indigenous candidate placements as well as
15 traineeships.
The project also delivered environmental
benefits following the HI framework based on
GreenStar criteria and targeting a minimum
of 45 points. This included a waste reduction
and recycling scheme that generated only
3.6 kg of waste per square metre, and enabled
over 90% of that waste to be recycled.
More than 2500 photovoltaic solar panels
were also installed as part of a new
1.16-megawatt solar system on the roof of the
hospital’s northern car park.

AGED CARE
©stock.adobe.com/au/VectorMine
Toward the • Funding for an immediate wage rise for the
aged-care workforce as recommended by
great reset
the Royal Commission and a commitment
to fund the outcome of the Fair Work
Commission work value case.
• Increase subsidies paid to providers so they
can pay for higher costs incurred for COVID
infection prevention and protection.
Sean Rooney, CEO, LASA
• Build resilience by agreeing to set up
the proposed National Aged Care Covid
Coordination Centre (NAT-CCC) in
T
partnership with states and territories to
he aged-care sector has begun seriously hampered in their daily routines
ensure aged-care services are effectively
to emerge from the challenges by the lack of adequate PPE and RAT resourced, enabled and supported to deal
encountered over the summer from the supplies, which continued until nearly the with future waves.
COVID-19 Omicron wave. end of January.
The NAT-CCC would resource and coordinate
The impact on the sector has been profound It is now a year since the release of the final COVID prevention and preparation, response
and tragic, with more than 700 deaths in report by the Royal Commission into Aged and recovery for aged-care services across
residential aged care since 1 January 2022, Care Quality and Safety, and the structural Australia. The centre would have ‘nodes’ or
more than double the number for all of 2021. deficiencies in aged care identified by sites in each state and territory connecting with
the Royal Commission have been vastly existing local structures.
The wild spread of infection in the wider
community led to a significant reduction of magnified by the pandemic, particularly over
the summer. In the meantime, providers will continue to
the aged-care workforce as staff became
face workforce challenges with vacant shifts
infected or were forced to isolate due to Our own Commonwealth Chief Medical and a lack of available agency staff to fill the
being a close contact. This resulted in Officer noted in early February concerns in gaps. We need to ensure that they are properly
prolonged bouts of isolation for aged-care the Northern Hemisphere of the potential resourced to effectively care for and protect
residents and a disruption of services to for further COVID variants and the potential older Australians and we look to government to
home-care clients, all signs that providers for a new wave of infection combined with step up and provide that support.
and their staff were under severe pressure the flu. The message is that there could be
just to keep delivering essential services more waves of infection ahead of us. This The rollout in February of teams of Australian
every day. means we must be learning from the past Defence Force personnel has been welcome
and preparing for the future. And we must as a way of addressing immediate critical staff
During the second half of December and
bring a sense of urgency to this task if we are and skills shortages, but it is not a long-term
for most of January, Omicron infections
to avoid the challenges experienced and the solution.
and close contacts among the aged-care
workforce meant that when local surge devastating outcomes realised during the The new interim visitation guidelines have also
workforce capacity was exhausted, many Omicron wave. eased the way for providers and families to
providers were forced to leave shifts unfilled support older people in residential care who
Leading Age Services Australia (LASA) and
on a regular basis. This meant those staff have missed visits from loved ones.
other industry representative bodies through
remaining shouldered the workload, doing
the Australian Aged Care Collaboration The aged-care sector will now be seeking a
double and sometimes triple shifts to care
(AACC) and aged-care sector unions have ‘reset’ of the proposed aged-care reforms
for and protect older Australians.
been advocating for urgent action by resulting from the Royal Commission in the light
On top of the staff shortage, providers government to prepare for more outbreaks of the immediate priorities for the sector during
in both residential and home care were singling out three key areas: the pandemic.

AGED CARE
Malnutrition:
the silent killer in aged care
Robert Hunt – Chief Executive Officer, Dietitians Australia
©stock.adobe.com/au/agneskantaruk
It’s been one year since for increased risk of falls, pressure injuries, Dietitians Australia has already indicated
hospital admissions, symptoms of COVID-19 to the federal government that to elevate
the Royal Commission into and adverse outcomes on mortality. This in the health and wellbeing of people in
Aged Care Quality and turn increases costs in the aged-care sector aged care, malnutrition must be included
and broader healthcare system to the tune in the Quality Indicator Program for both
Safety handed down its of $10.7 million in Victoria alone. residential and in-home aged care. The
report identifying ‘food To put that into plain text, we’re spending framework for screening of malnutrition risk
and nutrition’ as an area money for people to be sick rather than would include initial and ongoing training
saving money for people to be healthy. of all care staff and support workers using
for immediate attention in Where’s the sense in that? a validated malnutrition screening tool.
the ailing industry. With This would enable anyone the capability
Despite the government’s $10 supplement to identify, and immediately respond to, all
research showing that up to the Basic Daily Fee, which was introduced people who are at risk of malnutrition, or
to 50% of older Australians in July 2021, dietitians from around Australia who are malnourished.
continue to report grossly inadequate
in residential aged care are meals being served to residents in aged And, as a condition of receiving the Basic
care. Adding insult to injury, we’re deeply Daily Fee supplement, every residential
malnourished, it was hoped aged-care home should undergo an
concerned how recent pandemic-related
that subsequent action by events and inflation driving up food prices annual on-site menu and mealtime quality
the Australian Government could be worsening the quality of food assessment performed by an Accredited
being served in facilities. Practising Dietitian.
would finally arrest this silent
We firmly believe that the supplement is In our federal Budget 2022–23 submission,
killer. But it hasn’t. being used to prop up administrative costs, Dietitians Australia estimates that additional
O
and not improve the quality of meals for funds needed to implement these basic
n 2 March, the Aged Care Mandatory
people in aged care, and this needs to stop. amendments to be inconsequential to the
Quality Indicator Program reported
public purse, with immeasurable savings
12,512 people with significant unplanned The inherent issue with the Australian from reduced oral nutrition supplements,
weight loss in the quarter to September Government’s approach to their Quality wound care and hospital admissions.
2021. Unplanned weight loss is just one of Indicator program is they’re counting people
many indicators that could be attributed who are falling off the cliff, rather than Most importantly, the ultimate saving is the
to malnutrition, which is a known cause catching them before reaching the edge. quality of life for residents in aged care.

IN CONVERSATION
In Conversation
with Anne Woollett
In Conversation provides
a glimpse into the life
of an ‘outlier’ — an
exceptional person going
above and beyond to
improve outcomes in
their field. Anne Woollett
is leading an Australian-
first pilot aimed at
providing equitable
access to clinical trials for
patients in regional areas.
I t is well known that regional/remote

patients have unfair access to clinical
trial treatments compared to their metro
improve or establish their own independent
and sustainable clinical trial units.
goal is that these hospitals, one day, attract
big clinical trials and ask us to join them as a
secondary site.
counterparts. TrialHub, an initiative led Alfred Health has a 40-year history of
by Director Anne Woollett, addresses this delivering clinical trials and currently has When did the initiative start
more than 300 open clinical trials across 19
challenge — wherein a metro hospital and where are you at?
supports regional/remote hospitals to disease disciplines.
I came onboard in May 2020 as the first
establish their own clinical trial units. Every hospital we partner with is at varying recruit. Since then, I have developed a
A year into the initiative, clinical trials levels of clinical trial delivery maturity, team structure and have since employed
have opened for the first time at Latrobe so we provide support at the level they a Monitoring and Evaluation Manager,
Regional Hospital and Rosebud Hospital, require. This can include identifying gaps Communications Manager, Education
with more centres coming onboard with and opportunities, providing workforce Manager and Teletrials Coordinator.
the program. It’s hoped Mildura Base enhancement and mentoring programs
We have partnered with four Victorian
Hospital will be offering clinical trials for the for oncologists, pharmacists, coordinators,
hospitals — Latrobe Regional Hospital,
first time next year as well as Bass Coast research managers, formalising operating
Bendigo Health, Rosebud Hospital and
Hospital. If successful, the pilot will be structures and processes, support for
Northern Health — with more to come on
rolled out to other states from 2025. identifying suitable clinical trials, and the
board this year.
implementation of the teletrial model, and
Can you please tell us what grass-root promotional support to improve I’ve been incredibly proud of how far TrialHub
TrialHub is and how the the understanding of clinical trials within has come, especially in the last 12 months.
the community. Some highlights include:
model works?
TrialHub is an Australian-first pilot model TrialHub isn’t about growing Alfred Health’s Our early career fellowships programs are
where a metro hospital with a large clinical footprint in clinical trials, it’s about providing underway; we’ve funded an Australian-first
trial portfolio, Alfred Health in Melbourne, guidance and support to our partner credentialing and training program for
partners with regional/rural hospitals to hospitals and leveraging the expertise. Our hospital-based pharmacists; we’re providing

IN CONVERSATION
©stock.adobe.com/au/leelakajonkij
tailored site-specific mentoring, leveraging Long distance travel and time off work can be What are your career
existing programs, to upskill novice and a barrier for regional and remote patients who
emerging trial units; the teletrial program want to access a clinical trial. TrialHub aims
highlights?
to make more clinical trials available closer to A definite highlight was being the first
has been developed and seven trials
people’s homes in regional and remote areas. oncology clinical trial unit manager at Peter
accepted for activation with three teletrials
By taking part in a clinical trial, a patient can MacCallum Cancer Centre in Melbourne
open and actively recruiting. We have also
contribute to the advancement of scientific when it opened in 1992. The first drug
supported the opening of a melanoma
knowledge, access new treatment and, in clinical trial I worked on for ovarian cancer
imaging clinical trial.
some cases, it can save their life. become registered and used in clinical
We continue to identify potential trials to be practice, and still is today. This showed me
delivered either by teletrial or onsite, and A big focus of the initiative is on workforce that the outcome of what we do informs
these are all focused on cancer — prostate, development, and training and mentoring evidence-based clinical care.
rare cancer and melanoma, but we will be for regional staff interested in building
and formalising their expertise in clinical Being appointed to the role of Director
expanding outside of cancer very soon.
trials without relocating to a city hospital. of TrialHub is also a highlight because
A teletrial is where clinicians at the metro
Leveraging Alfred Health’s clinical trials it’s been a cumulation of all my previous
hospital enrol, consent and treat patients
experience, TrialHub is providing a range experience and is a unique opportunity to
on clinical trials in partnership with smaller
of education and training opportunities for really embed equitable access to clinical
regional and rural centres (satellite sites).
staff to upskill in a range of areas. By offering trials and improve outcomes for all patients,
What were some of the key clinical trials as a career pathway, staff are no matter where they live.
able to stay regional and hospitals can retain
learnings from your initial How would you describe
their staff.
days at the Hub? your leadership style? And
To embed clinical trials into any hospital, it’s On a different note, what did you face challenges as a
vital you have the buy-in and endorsement inspired to get into health woman leader?
of the CEO and Executive team. The key
care? Could you tell us a bit For me, collaboration and engagement are
to TrialHub’s success has been working
closely with them as partners, recognising about your first role in the vital. It’s important that I seek input and
their local needs, and having a good industry? consensus and communicate the value of
understanding of their resources and I grew up in a regional town and I could see my colleagues’ contribution. I always aim
the disparity in access between regional and to lead by example, and I genuinely want to
capabilities. From there, we have been able
metropolitan health care. I was inspired to see those around me do well and succeed.
to build on their foundations and tailored
our support accordingly. be part of providing the best health care in I’ve seen a lot of progression in not only
regional settings, and I knew nursing would women in research but in leadership and
How does the initiative benefit set me on the right path to do so. operational roles, and women are being
patients, staff and community My first role as a 22-year-old graduate recognised a lot more. But I still think there
operating in regional/ remote nurse was to look after a cancer patient needs to be clearer career pathways for
areas? who had just been diagnosed and required women in clinical trials.
The incidence of cancer in regional areas of chemotherapy. I had no idea how to support
this patient, what to say or what information
Lastly, what are you like
Australia is higher than that of major cities
and those in rural and remote areas are more to give them. That’s when I decided to do a outside of work?
likely diagnosed with low survival cancers. stint in oncology to learn everything I could; it I enjoy spending time with my family and
was here I started to learn about clinical trials friends and being actively involved in their
Patients who are on clinical trials may have a and their benefits, so my drive to increase lives. I invest a lot of time and effort in them,
better outcome so we want all Australians to access to clinical trials was instilled right at and they make me laugh a lot and show me
have better access, closer to home. the start of my career. how to enjoy all the good things in life.

Out &
About
Above and
beyond
T he HESTA Impact Awards recognise health
and community services professionals going
above and beyond to have a positive impact on
society, the economy and the planet. Below are
the 2022 award winners:
Team Innovation
The Haymarket Foundation Medical Practice team, Chippendale NSW
Areas of impact: Gender equality, Diversity and inclusion, Improved health outcomes/
improved patient wellbeing, Sector-wide partnerships
The Haymarket Foundation Medical Practice team, established in July 2021, is recognised
for their dedication to providing accessible, specialist healthcare and housing support
services for people experiencing, or who are at risk of, homelessness.
CEO Peter Valpiani said, “It’s been a leap of faith to self-fund and launch a service that we can see
filling a gap in care.”
The prize money will go towards the purchase of specialist medical equipment for the Foundation’s
larger homelessness medical practice, which is scheduled to open later in 2022, as well as establishing
a fund to help pay out-of-pocket medical costs. The fund would help people experiencing
homelessness who do not have access to Medicare, such as refugees on temporary visas.
Outstanding Organisation
Zoe Support Australia, Mildura VIC
Area of impact: Diversity and inclusion
CEO Merinda Robertson said she couldn’t
thank her “amazing team” of staff and
volunteers enough.
Zoe Support relies on philanthropic funding
and will use the prize money to continue its
wraparound service for young mothers as
well as practical assistance.
Individual Distinction
Melissa McConaghy — PD Warrior, Artarmon NSW
Area of impact: Improved health outcomes/improved patient wellbeing
Melissa McConaghy is recognised for creating and developing PD Warrior, an exercise-based approach
to help people with Parkinson’s disease move, think and feel better.
PD Warrior delivers online and face-to-face training sessions directly
to people living with Parkinson’s. The program also works to upskill
physiotherapists and exercise physiologists to improve therapy
outcomes.
As the founder and driving force behind the program, McConaghy
has grown PD Warrior’s following to more than 30,000 people
worldwide. The program has also been taught to nearly 5000
health professionals across 22 countries in four different languages.

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AUTUMN 2022

AGED CARE AND THE SILENT KILLER

PATHWAY OUT OF THE PANDEMIC

INFECTION CONTROL TECHNOLOGY

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