5 Dr Elsie Chan Ophthalmologist Specialising in the treatment of conditions affecting the cornea, Elsie Chan works at the Eye and Ear as a consultant ophthalmologist in the Cornea Unit, Emergency Department and General Eye Clinic. “I chose the specialty because I love the variety and challenges of managing corneal disorders.” Regularly on call to consult in the Emergency Department where she treated Dean’s eye injury, Elsie has seen the improvements in the care of emergency patients. When Elsie was on call for the General Eye Clinic in February she was called to the Emergency Department to see Dean, and with her registrar, operated on his injured eye. “Dean’s quick thinking helped to save his sight because he got to the Eye and Ear so fast. I’m delighted he had such a good outcome following surgery.” Biwen Zhang Associate nurse unit manager Ward 8 Biwen Zhang is an associate nurse unit manager who treated Dean during his recovery at the Eye and Ear. Nurses care for the needs of the patient from the time they enter the hospital to when they leave, as well as supporting the surgeon and anaesthetist during surgery. Biwen says patients who have suffered metal fragment injuries require extra reassurance following surgery due to the sudden nature of their injuries. “We have to give the patient education about how to care for their eye following surgery, but we also need to give them lots of reassurance. For patients like Dean, the accidents happen suddenly and they may not be able to go to work. It’s important that we talk to the patients and give them access to resources such as social workers.” Richard Smallwood Medical photographer Richard is a medical photographer who captured images of Dean’s injury and scarring during his recovery. Medical photographers use specialised equipment to produce detailed images that assist in diagnosis and monitoring of eye disease and injuries. For patients like Dean, images can be captured before and after surgery, as well as during recovery to ensure the injury is healing correctly. Richard says when he photographs a metal fragment injury before a patient goes into theatre, he must act quickly to reduce the patient’s discomfort. “Patients like Dean experience a lot of pain and discomfort so it’s important that we capture a useful image as quickly as possible, rather than trying to get the perfect shot that may be more useful in a different situation.” hand
10 Some of the work being undertaken to improve the quality and safety at the Eye and Ear is described below. Clinical governance Partnering with Consumers Clinical governance is the system in which the Board, managers and staff are all responsible for the quality of care provided and for working to continuously improve this care. Victoria has a clinical governance framework, which includes the areas of consumer participation, clinical effectiveness, an effective workforce including professional scope of practice and performance management and risk management. The Eye and Ear regularly reviews its clinical governance policy to ensure these areas are addressed. A committee and reporting structure defines who is responsible for monitoring, reviewing and implementing change where required. The introduction of the National Safety and Quality Health Service Standards provided the impetus to review the clinical governance framework and make changes to encompass the work being undertaken across the organisation. Some of the initiatives in place to assist the Eye and Ear meet its clinical governance responsibilities include: − an annual Quality Plan with progress updates provided to the Board Quality Committee quarterly − a risk register which is used to track existing risks and management strategies − a consumer register and associated procedures to promote consumer involvement in a range of activities across the organisation − MyLearning, an online learning tool which allows Eye and Ear staff to complete, track, and monitor training courses required for their roles. The tool also provides the hospital with greater transparency on how we are meeting our training obligations. Partnering with Consumers aims to ‘create a health service that is responsive to patient, carer and consumer input and needs’. This report highlights examples of how the Eye and Ear is working with consumers and involving consumers in decision- making within the organisation. The Eye and Ear is working with consumers to increase participation in a range of activities.
13 Accreditation Preventing and Managing Pressure Injuries For the period July 2012 to June 2013 there was one pressure injury reported at the Eye and Ear. A focus of the working group has been to look at the processes in place in theatre to identify at-risk patients and to put strategies in place to minimise the chance of pressure injuries occurring. Preventing Falls and Harm from Falls Falls prevention processes have been reviewed, resulting in an updated procedure, education package, assessment and management tools for the organisation. All clinical areas were involved in this review. A focus of the falls working group has been to look at ways to assist Emergency Department staff to identify patients who are at risk of falling and to have a range of strategies which can be put in place quickly and simply in this busy environment. Accreditation is a process whereby an organisation is assessed by external surveyors against a set of criteria. It is one method to ensure that appropriate standards of care are provided by health services. The Australian Council on Healthcare Standards’ periodic review (an onsite survey which takes place midway through the accreditation cycle) took place at the Eye and Ear in December 2012. The surveyors reviewed all mandatory clinical, support and corporate criteria, as well as the recommendations made following an organisation- wide survey conducted in 2010. The Eye and Ear received an ‘outstanding achievement’ 4% 4% 4% 7% 48% systems, seven ‘extensive achievements’ and seven ‘marked achievements’. All recommendations from the previous organisation- wide review, which occurred in 2010, were actioned and closed. There were further 33% Patient falls by location July 2012–June 2013 Ward 8 Emergency Department n=27 made during periodic review and these are currently being addressed. Over the last 12 months we have introduced adult deterioration detection charts, a program to control the use of antibiotics and Special Eye Clinic OPD Level 4 Emergency Department OPD AOS Clinic Medihotel Ambulance Bay prevent bacterial resistance, and further education on aseptic technique and an auditing program to ensure adherence to the program for optimal patient outcomes in infection prevention.
28 We care about your thoughts and appreciate your feedback The 2011–12 Quality of Care Report was distributed to the community via our website, at various distribution points in the hospital and was sent out to community group leaders and GPs. We asked readers for their feedback through a feedback form attached to the report. Our Community Advisory Committee also provided feedback on the report through their meetings. Based on feedback, this year we have included more patient and staff profiles, focussed on the readability of the report and have increased the font size and improved the contrast. We have also printed on environmentally friendly paper. Distribution of this report The 2012–13 Quality of Care Report will be distributed to health care partners, GP clinics and community leaders. Copies will be available in Eye and Ear foyers and on the website: We welcome your feedback about all aspects of our services and this report. Please keep us informed by: Telephone (03) 9929 8666 Email Mail Consumer Liaison Officer The Royal Victorian Eye and Ear Hospital Locked Bag 8 East Melbourne VIC 8002 In Person You can speak to our Consumer Liaison Officer. © 2013 The Royal Victorian Eye and Ear Hospital This work is copyright. Apart from any use permitted under the Copyright Act 1968, no part may be reproduced without prior permission from The Royal Victorian Eye and Ear Hospital. Requests and enquiries concerning reproduction and rights should be directed to Marketing and Communications, The Royal Victorian Eye and Ear Hospital, Locked Bag 8, East Melbourne, Victoria, 8002, Australia. While every effort has been made to ensure the accuracy of this document, The Royal Victorian Eye and Ear Hospital makes no warranties in relation to the information contained herein. The Royal Victorian Eye and Ear Hospital, its employees and agents disclaim liability for any loss or damage which may arise as a consequence of any person inappropriately relying on the information contained in this document. The Royal Victorian Eye and Ear Hospital Quality of Care Report 2012–13 Production: Marketing and Communications, The Royal Victorian Eye and Ear Hospital Design: Viola Design Photography: Leo Farrell Medical Photographic Imaging Centre, The Royal Victorian Eye and Ear Hospital Printed on ecostar, an environmentally responsible 100% recycled paper made from 100% post-consumer waste that is FSC© CoC certified and bleached chlorine free (PCF). Printed throughout using vegetable based inks.