Monash Health leads the way

in appropriate imaging

A new app, free from the iTunes

store, has been developed to

provide doctors, nurses and

allied health practitioners with fast, accessible and evidence-

based decision support at the

bedside when they are

considering a referral for

imaging.

The "RANZCR Clinical Decision

Rules" app also can be used to

facilitate shared decision making

with patients, parents, and

carers about why imaging may

or may not be needed for their

particular situation.

Stacy Goergen, Director of

Research, Monash Imaging, and

Adjunct Clinical Professor,

Departments of Medical

Imaging and Surgery, led the

Royal Australian and New

Zealand

College of Radiologists' project to

develop the app as part of a

larger project to create

interactive, web-based

educational modules for

appropriate imaging.

Monash Health in Victoria, is the

only health service in Australia to

integrate the RANZCR web-based

educational modules for

appropriate imaging on its

learning management system with

policy documents on the Monash

Health intranet and now bedside point of care electronic decision

support. The web–based educa-

tional modules are available from

the RANZCR for implementation on

hospital, health service, university,

and professional college learning

management systems.

Documentation of the use of a

validated clinical decision rule

(CDR), when applicable, in the

medical record is good practice

from both the perspectives of

patient safety and organisational

risk management.

Get the App - Bedside Clinical Decision Support

for Appropriate Imaging

AMBUS - A South Australian First

In an Australian first, an

ambulance bus able to carry

and treat 12 patients at a

time will join South Australia’s

ambulance fleet.

The 12m bus can carry six patients on stretchers and

another six sitting. There is

also room for two

clinicians treating patients

and a paramedic drive.

It’ll give paramedics a criti-

cal advantage when

attending major

incidents resulting in

multiple casualties, like

bushfires and car crashes.

Photo: SAAS

http://www.adelaidenow.com.au/

news/south-australia/new-

ambulance-bus-can-carry-up-to-12-

patients/news-story/

aeeaaa2e7658292ed-

c0103f965d1ce6c

February 2016

Change Champions & Associates

Innovation Round Up

Summaries and links to

some of the interesting

innovations project we

have gathered from

Australia and overseas in

2016.

Inside this issue:

Beside CDS for 1

AMBUS 1

Australian Atlas of

Health Care Variation 2

Medicines Clinic 4

U Book 4

Physios in pain

Management in RACF 6

ICE Training Package 8

eCALD Resource 8

Culture Change Insights 9

Dogs4Dementia 9

EI 10

Dr Stacy Goergen,

Director of Research,

Monash Imaging, VIC

http://

www.linkedin.com/

pulse/get-app-bedside

-clinical-decision-

support-imaging-stacy-

goergen?trk=prof-post

Cont on page 2….

The RANZCR CDRs

app will be particularly

valuable in rural and

remote emergency set-

tings where there may be

limited multidisciplinary

support for frontline clini-

cal staff.

It will help to improve the

safety, appropriateness

and efficiency of patient

care across Monash

Health by standardising

pre - test risk assessment

prior to referral for imag-ing. The team plans to

research the

effect of this approach to

appropriate imaging

education on imaging

utilisation and test

positivity rates in 2016.

Completion of the web

based education

modules will be a

prerequisite for Monash

Health interns and ad-

vanced trainees from

2016, to ensure they have

the knowledge base to

enable them to make

wise decisions about

imaging referrals. The

app will reinforce this

training at the bedside.

The app has the joint en-

dorsement of the Austra-

lian College of Emer-

gency Medicine and the

Royal Australian and New

Zealand College of

Radiologists.

The Choosing Wisely Aus-

tralia campaign (http://

www.nps.org.au/media-

centre/media-releases/repository/choosing-

wisely-australia-launching

-in-2015)

initiated by NPS

MedicineWise has also

endorsed the app to

support the Royal

Australian and New

Zealand College of

Radiologists' Choosing

Wisely recommendations.

The CDRs featured in the

app are extensively

validated and,

importantly, each CDR

provides inclusion and

exclusion criteria for the

rule, so clinicians will

know if it applies to their

particular patient.

The conditions covered

are common in the ED

and inpatient settings

and include:

1. Blunt head trauma -

adult and paediatric

2. Cervical spine trauma -

adult and paediatric

3. Suspected pulmonary

embolism - pregnancy

and post-partum

4. Suspected pulmonary embolism - non pregnant

adults

5. Suspected DVT

6. Blunt ankle trauma -

adults and children.

The app is available now

for Apple devices - free

to download from the

iTunes App Store and will

soon be available from

Google Play for android

devices.

To download the app to

your iPhone or iPad, type

"ranzcr" into the search

box on the iTunes Store.

Get the App - Bedside Clinical Decision Support for Appropriate Imaging

(continued from page 1)

Australian Atlas of Healthcare Variation

across Australia, across

areas such as antibiotic

prescribing, surgical,

mental health and

diagnostic services.

It is the first time that data

from the Medicare Benefits

Schedule (MBS),

Pharmaceutical Benefits

Scheme (PBS) and

Admitted Patient Care

National Minimum Data Set

(APC NMDS) have all been

used to explore variation

across different healthcare

settings. The atlas is

presented alongside the first

national

recommendations for

action.

Access the data items within

each chapter or to

download the full version of

the Australian Atlas of

Healthcare Variation

http://

www.safetyandquality.gov.au/

atlas/

In collaboration with

Australian, state and

territory governments,

specialist medical

colleges, clinicians and

consumer representatives,

The Australian Commission

on Safety and Quality in

Health Care has

developed the

first Australian Atlas of

Healthcare Variation.

The atlas presents a clear

picture of substantial

variation in healthcare use

Page 2

Change Champions & Associates

Caption describing pic-

ture or graphic.

Page 3

February 2016

Improving

Consumer and Carer

Engagement in Health Care

29 February, 2016

Pavilion Room, The Arts Centre

100 St Kilda Rd, Melbourne Victoria

Register now for early bird at

http://www.changechampions.com.au

This project presents the

results from a pilot of

community-

based Medicines and

Health Literacy Clinics with

final-year pharmacy

students at the University

of Otago. The clinics are

intended to not only

provide an authentic

learning experience for

the students themselves,

but also to create an

opportunity for improving

health literacy amongst

the Otago population.

The clinics offer a patient-

centred health informa-

tion opportunity to

improve health literacy in

the community. The

HLMC (also known as a

‘Brown Bag Medication

Review’) encourages

patients to bring all of their

medicines and

supplements to a

community setting without

appointment or cost.

Typical discussions centre

around answering patient

concerns, verifying what is

being taken, identifying

medication interactions or

errors and improving

aspects of adherence.

Download the full report

as a PDF from

https://

akoaotearoa.ac.nz/

download/ng/file/group-

7/medicines-clinic-a-novel

-learning-opportunity-for-

understanding-health-

literacy.pdf

Medicines Clinic – A novel opportunity for

understanding health literacy

U Book- Patient Focused Bookings

no administration input

Allows administration

staff to book patients in or-

der of priority and time

waiting

Reduces the amount of

administration time required

to book an outpatient ap-

pointment

Uses a colour coded

system so that staff can

visually track where patients

are in the system

View real time demand

and capacity at the click of

a button down to service

level

Bulk printing of patients

letters

2013/14 there where

16486 referrals

DNA rate sustained @

1.4%

7% reschedule rate by

patient on line saving ad-

ministration time

Year on year increase

in on line bookings

Phase 2 – pilot phase

They identified early on that

the main gains with the U-

book system would be in

the area of follow up

appointments. This is now

being piloted in gynaecol-

ogy service. These

include:

Allows patients to pa-

tients to either phone and

make a mutually agreed

appointment with clerical

staff or directly book on

line via the internet, requir-

ing no administration input

Reduces the amount

of administration time re-

quired to book an outpa-

tient appointment

Uses a colour coded

system so that staff can

visually track where pa-

tients are in the system

View real time de-

mand and capacity at

the click of a button down

to service level

Bulk printing of pa-

tients letters

2013/14 there where

47295 follow up appoint-

ments referrals

Clinical management

of patients who do not

contact us within the

agreed time frames.

These are the patients

that would usually DNA.

Dawn Livesey and the

team at Hutt Valley District

Health Board, NZ are

implementing the U book

system. U Book has been

developed for patients to

be able to make their own

outpatient appointments.

Patients receive a referral

letter inviting them to make

their appointment using

Ubook, or via the usual

method of phoning the

booking office

Patient empowerment is at

the core of the Ubook

concept, but the system

also has the benefit of

streamlining the booking

administration process.

Phase 1- in place

U-book was implemented

in a service by service

phased approach First Spe-

cialist Appointments only.

There are several

components to U-book,

including:

Allows patients to pa-

tients to either phone and

make a mutually agreed

appointment with clerical

staff or directly book on line

via the internet, requiring Page 4

Change Champions & Associates

Page 5

February 2016

www.changechampions.com.au

Health Literacy

Registrations Now Open at http://www.changechampions.com.au

Friday 11 March 2016

Bourke Room, The Hotel Windsor

111 Spring St, Melbourne

VIC, AUSTRALIA

The Physiotherapy Pain Man-

agement Program is an ini-

tiative within UnitingCare

NSW/ACT Arrunga aged

care home. It involves an

innovative non-

pharmacological treatment

approach to care.

The program, which has

been underway for over 4

years looks at the overall

effects of the various pain

interventions used in

managing chronic pain in

the elderly with the view to demonstrate a benefit for

residents in reduced and

better managed pain and

thus improved quality of life.

Physiotherapists attend the

home and carry out the

pain management clinic

four days a week, treating

painful areas with therapy

modalities and interventions

such as hydrocollator heat

packs, massage, joint

mobilisation and TENS

(transcutaneous electrical

nerve stimulation).

Physiotherapist assistants

help by assisting residents to

get to the pain clinic,

assisting with resident

positioning, and preparation

and application of heat

packs.

Some residents who are

unable to visit the pain clinic

are attended to in their

rooms. Every month, the

facility management and

the physiotherapist meet to

review the pain program in

detail. During this time, the

residents’ pain is discussed

and the program is

re-evaluated.

The residents attending the

pain clinic are treated as a

group receiving heat packs

while the physiotherapist

attends to the residents

with interventions, ensuring

privacy and dignity. This

social approach provides

an additional positive

effect, allowing for interaction with other

residents and opens up

discussions for various ways

of dealing with pain.

Data was collected over

eight areas including

analgesia usage, reported

pain levels and activities of

daily living such as activity,

sleep and mobility.

1. Change in dosage/

frequency of medication

2. Change in type of

medication according to

WHO analgesic ladder

3. Change in pain

score/level

4. How pain affects

sleep

5. How pain affects

general activity level

6. How pain affects mo-

bility

7. How long pain returns

after taking medication

8. How has medication

or interventions relieved

pain in the past week

This data has been

collected from residents’

assessments and charts

and are then re-evaluated

using their most recent

documentation (six to nine

months later). The use of

analgesia was then

analysed against the WHO

(World Health Organiza-

tion) analgesic ladder to

reflect the movements of a

treatment plan over six to

nine months for controlling

pain.

The results indicate that most (85%) of the residents

on the program have

improved or maintained

their pain status over time.

With both the sensation

(through medication) and

the source of the pain

(through physiotherapy

interventions) being

addressed, the residents

reported positive

outcomes and improved

quality of life.

Across all eight areas, 11%

of residents improved, 74%

maintained and 15%

regressed. All 40 residents

on the program reported

subjective improvements,

in particular coping better

with their day and enjoying

the therapy interventions.

More information

Celedonia

Laverty, claverty@unitingcarenswact.org.

au or (02) 8878 6481, or Sri Mat-

tapalli, smattapalli@unitingcarenswact.o

rg.au on (02) 8878 6492.

Physiotherapy Pain Management Program

Inviting Stories for our May 2016 Edition

Our readers are interested in

Quality and safety

Patient flow and re-

design

Productivity improve-

ment

Care of older people

Leadership

Integrated care

Green hospitals

Patient experience

Health literacy

Mobile technologies

Submit your story and

pictures to

info@changechampions.com.au

Are you excited about the

achievements of your

innovation project?

We are now inviting

submissions of stories of

around 150-300 words for our

May 2016 newsletter.

Picture, links to other websites

etc are welcomed. Page 6

Change Champions & Associates

The focus of this event is on how the sustainability of implemented initiatives to improve

patient flow has been demonstrated.

Call for abstracts open until 20 March 2016.

Details about the range of topics likely to be covered at http://

www.changechampions.com.au

Calls for Abstracts Currently Open

Sustaining Improvements in Patient Flows 20-21 June 2016, Gold Coast, QLD

Preventing Unnecessary Emergency Department Transfers for Older People 5-6 May 2016, Melbourne, VIC

Share lessons learnt from innovations designed to improve patient safety, quality and

efficiency in hospitals after hours.

Call for abstracts open until 21 February 2016.

More information about the range of topics likely to be covered at http://

www.changechampions.com.au

Page 7

February 2016

Caption describing picture

or graphic.

The Hospital After Hours 23-24 May 2016, Sydney, NSW

Addresses opportunities and challenges by showcasing strategic approaches and

innovations programs that assist to

alleviate demand and capacity pressures on hospital emergency departments

(ED)

enable older people living in the community/residential aged care (RACF’s) to

receive timely, appropriate urgent care

assist vulnerable older people to avoid potentially unnecessary transfers to hos-

pital emergency departments.

Call for abstracts open until 15 February 2016. More information at http://

www.changechampions.com.au

The use of Ice (crystal

methamphetamine) in Aus-

tralia has received much

attention. There is a pressing

need for support for people

who use crystal metham-

phetamine, their families,

friends, and co-workers.

Information is needed that

provides an accurate

picture of the prevalence of

crystal methamphetamine

use in Australia, which

population groups are most

at risk, details of intervention

options available, and steps

that can be taken to help

people who use crystal

methamphetamine receive

the necessary treatment.

Treatment has been found

to be effective in helping

people who use crystal

methamphetamine and

there is a strong need for the

community to work together

to achieve the best

outcomes for all involved.

The National Centre for

Education and Training on

Addiction (NCETA) at

Flinders University, SA, has

developed a Training

Package for health profes-

sionals as part of

the Victorian Government’s

Ice Action Plan.

The Training Package is

designed to meet the needs

of a wide range of frontline

workers including those

from the health and

welfare, education,

criminal justice and trans-

port sectors. It was

developed following an

extensive consultation

process to identify key

learning needs.

This package provides

information and resources

for frontline workers to en-

hance their existing skills

and knowledge. The

Training Package is very

broad and comprehensive

in its approach, but has a

specific focus on the

identification and care of

people who are

intoxicated with, and/or

withdrawing from, crystal

methamphetamine and

their families and carers.

The package provides

useful material to guide

workers’ practice when

assisting clients and their

families, and working with

their colleagues.

The package has 7 inde-

pendent but

complementary modules,

with each containing up to

8 topics. The Training

Package is designed to be

flexible with content that

suits a variety of needs.

The package covers a

broad range of issues

including:

-Information about crystal

methamphetamine and its

use and harms

-How crystal

methamphetamine use

affects people and

communities

-Worker safety and

preventing, managing and

recovering from crystal

methamphetamine-

related critical incidents

.Legal issues

-Using crystal

methamphetamine with

alcohol and other drugs

-Communicating with and

supporting people who

use crystal

methamphetamine

-Preventing and

intervening in crystal

methamphetamine use

-Organisational responses

to crystal methampheta-

mine.

https://

nceta.androgogic.com.au/

ICE: Training for Frontline Health Professionals

eCALDTM Resource Development

New Zealand health

workforce.

The provision of

eCALDTM courses and

resources "for working

with patients" is funded

by the Ministry of Health

as part of the Northern

Regional

Alliance’s Asian,

Migrant and Refugee

Health Action

Programme. http://www.ecald.com/

eCALDTM resources and

courses have been de-

veloped by Waitemata

DHB’s Asian Health

Support Services to

address the need for

CALD cultural

competence training

and information for the Page 8

Change Champions & Associates

Edgar Schein’s, 20 Organisational Culture Change Insights

“Preliminary results from an overseas study

show that the presence of the specially

trained dogs can help support the person with

dementia and carer, extending their capacity

to live at home,” Professor Cunningham says.

“Reduced hospitalisation and delayed

admission to residential aged care are

possible outcomes we will be evaluating as

well as the positive impact these beautiful

dogs can have on the care-giving relationship

and carer wellbeing.”

Assistance Dogs Australia’s Top Dog, Richard

Lord says, “Assistance Dogs Australia is

enjoying working closely with HammondCare

in this ground breaking project.”

“We know that our experience in providing

service dogs for people with physical

disabilities, children with autism and for those

suffering from PTSD will hold us in good stead

when working with the participants in the

project.”

http://www.dogs4dementia.com.au/

A pilot project, which will see people

diagnosed with dementia partnered up

with a specially trained assistance dog,

has been expanded from two to five

states.

HammondCare Dementia Centre’s Dogs 4

Dementia was first launched in NSW and

Victoria in April 2015. It has since been

expanded to include South Australia,

Tasmania and Queensland.

Director of the Dementia Centre, /Prof

Colm Cunningham, says the Dogs 4

Dementia project is expected to bring

significant benefits to people living with

dementia at home with a carer.

“For the first time in Australia we’ll see

expert Dementia Centre consultants

working together with Assistance Dogs

Australia instructors to place dogs with

couples, at a time when a diagnosis of

dementia may have just been received.

“Each couple and dog will be carefully

matched and will be supported by both

organisations for the duration of the pilot.

Page 9

February 2016

Dogs for Dementia Pilot Expanded

Tim Kuppler from the Culture University recently interviewed Edgar Schein, who pioneered

culture change in organisations. Follow the link below to read Dr Schein’s 20

organisational culture insights and watch the interview video excerpt which covers a

concise explanation of the following culture fundamentals:

Don’t over-simplify culture. It’s far more than “how we do things around here.”

Focus on a problem and how culture is influencing it instead of trying to change

culture directly.

Culture is always helping and hindering problem solving. It’s important to understand

both.

Be very specific about behaviour, how it’s impacting your problem and the future

state of the behavior you want to see.

http://www.cultureuniversity.com/20-organizational-culture-change-insights-from-edgar-

schein/

This story can fit 100-150 words.

The subject matter that appears in newsletters is virtually endless. You can include stories that focus on current technologies or innovations in

your field.

You may also want to note business or economic trends, or make predictions for your customers or clients.

If the newsletter is distributed internally, you might comment upon new procedures or improvements to the business. Sales figures or earnings

will show how your business is growing.

Some newsletters include a column that is updated every issue, for instance, an advice column, a book review, a letter from the president, or an

editorial. You can also profile new employees or top customers or vendors.

Page 10

Change Champions & Associates

Page 10

In this full day introductory workshop, you will:

Gain an overview of the science and value of emotional intelligence

Consider the impact on performance of positive and negative emotions in the workplace

including the impact on individuals, productivity and organizational outcomes

Understand six competencies of the Genos International model of emotional intelligence

for leaders

Participate exercises where you try working with the competencies for emotional intelligence

Discover some tips and develop an action plan for improving your own emotional intelligence

Take away your Genos International Introduction to Emotional Intelligence work book

“I’ve learned that people will forget what you said, people will forget what you did but people will never forget how they made you feel”

Melbourne, Adelaide, Canberra, Sydney, Brisbane & Your Facility 2016

REGISTER at http://www.changechampions.com.au

Emotional Intelligence for Leaders

Also available—Strictly confidential leadership self assessments, 180˚ and 360˚ with action planning and

coaching. Enquiries at info@changechampions.com.au

Page 11

February 2016

Page 11

Agile Project Management for Health Care

COURSE REGISTRATION 2016

With Accredited Trainer, Julie Faoro

Melbourne, Adelaide, Sydney and Brisbane

The course will: Explain how to lay the foundations for successful agile projects

Explain how an agile project is managed

Clarify the different management styles needed for successful agile projects (compared to "traditional" projects)

Provide integration with PRINCE2®. Improve time-to-market and project success rates while simultaneously accelerating results by encouraging stakeholder involvement, feedback and effective controls. Achieve better communication and control over projects and adapt project

plans without disrupting the project budget, timescale and scope.

Develop professionalism in employees and include agile certification in em-ployee professional development scheme

Who should attend?

Project Managers, Project Officers, Managers, and team leaders from government, health, aged care and not for profit sectors Any area of the health care system that wish to introduce change on time and on budget.

More details at http://www.changechampions.com.au

Melbourne, Adelaide, Canberra, Sydney, Brisbane & Your Facility 2016

REGISTER at http://www.changechampions.com.au

About Change Champions & Associates

Change Champions & Associates

PO Box 302

Kew VIC 3101

M: 0467635150

E: info@changechampions.com.au

W: www.changechampions.com.au

Innovate with us on our Facebook page

or on Linked In

Change Champions & Associates designs and produces

seminars for health professionals. We also showcase

leadership development, practice development, service

and quality improvement initiatives across the spectrum of

health and interrelated facilities and the across the

continuum of care.

We are a small coalition of the committed working with our

partners to deliver a great seminar experience. We work for

cost recovery, rather than for profit.

In collaboration with our consultants, we aim to provide

valuable and practical learning experiences for a broader

range of professionals from all sectors. These opportunities

will include workshops, in houses at your facility no matter

where (we are strong supporters of those in rural and remote

areas), group and individual coaching sessions delivered by

accredited professionals.

By the end of 2016, our website will be redeveloped to en-

able a more interactive relationship with our supporters,

streamline our seminar registration process and provide

better functionality to enable networking and the sharing of

innovation projects in Australia and New Zealand

and beyond.

Sustain Success Online Resilience Program

Coaching sessions are confidential,

individualized and conducted by

telephone

Put your best foot forward in 2016!

If you are under the pump and not sure that you are

managing as well as you could, this online program, Sustain

Success, will help you to build your resilience at work and

beyond.

Best of all its easy! There is no need to ask your manager for

permission for time off to attend a course. No need to feel

embarrassed about your capacity to cope. No need to

consider withdrawing or watering down decision making

because you feel that your ability and your confidence are

living on different planets.

Developed by revered, organisational psychologist, Kathryn

McEwen, here's an opportunity to reflect on the way work

pressure impacts on the way you function at work and

beyond. You can complete the program, in your own time

and at your own pace.

Better, you will be supported by a Resilience at Work

Accredited coach. This is not a one size fits all program. One

75 minute coaching session is included in the

program

Bitten off More than you can

Chew??

info@changechampions.com.au