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Public Hospitals Division – St Vincent’s Hospital Sydney

Eighteen months ago, St Vincent’s Hospital Sydney embarked on arguably its most important planning effort in 160 years when it launched its Integrated Health Care Campus Clinical Services Strategy. In 2017-18, the hospital made significant progress in the strategy’s six areas of focus: precision medicine, new ambulatory models of integrated care, telehealth and virtual care, the Heart Lung Vascular Centre of excellence, establishing cost-effective models of care, and advocating and providing health services to poor and vulnerable people.

St Vincent’s precision medicine capability continued to grow via the Kinghorn Cancer Centre-based Genomic Cancer Medicine Program which received a $50 million grant from the Commonwealth – the largest ever genomics grant in Australia – to expand nationally over the next five years.

In late 2017, St Vincent’s submitted its plan for the Cahill Cater redevelopment project to the NSW Ministry of Health. The Cahill Cater project will enable the introduction of new integrated models of ambulatory care that will reduce inpatient treatment and increase treatment capacity. It will house the new Heart Lung Vascular Institute as well as the further expansion of virtual care, providing patients in rural and regional areas greater access to leading health services.

Based on travel times alone, it’s estimated the Cahill Cater’s virtual care services will reduce productive hours lost to health provision by 674,000, equating to $29.6 million over the 10-year period and $9.8 million in associated travel costs.

During the year, St Vincent’s Sydney participated in a multi-site project aiming to increase the identification of women experiencing domestic violence by asking every woman presenting at its Emergency Department questions about domestic violence, regardless of the reason for their presentation.

Every woman who disclosed domestic violence through screening was offered social work support. The social work intervention consisted of assessment, counselling and education about their rights and referral options. Assistance was provided to meet each woman’s immediate needs such as housing, advocacy, child care, legal advice or reporting to police, as well as longer term needs such as counselling, case work and other referrals.

In total, more than 700 women were asked questions about their experiences of intimate partner violence. Of those, 106 women disclosed domestic violence from a current or former partner and received support and counselling from a social worker.

St Vincent’s Sydney has long been Australia’s leading centre for the treatment of anal cancer – a condition that is often highly stigmatised and typically presents late.

Reflecting its leadership in this area, the Dysplasia and Anal Cancer Services (DACS) team led by A/Prof Richard Hillman, is rolling out Australia’s first targeted screening for anal cancer to prevent its occurrence and improve treatment outcomes.

Although this will initially be offered only to patients attending the St Vincent’s HIV clinic, the hospital is in discussions with local GPs, in an effort to extend screening further into the local community.

In 2017, SVHNS and Justice Connect, a community legal centre, established a Health Justice Partnership (HJP) to improve St Vincent’s Sydney’s response to the issue of elder abuse. An HJP is an innovative model of legal service delivery that integrates a lawyer into a hospital or other health setting to offer free legal assistance to vulnerable people unlikely to access such help elsewhere.

Because older people experiencing abuse have a higher hospitalisation rate than their peers, hospitals offer a window of opportunity to detect and manage the problem.

Working with members of the St Vincent’s and St Joseph’s Social Work teams, an HJP lawyer plays a key role in delivering education to staff on legal issues, improving their ability to identify legal problems experienced by patients, and make appropriate referrals to her.

St Vincent’s Hospital’s new purpose-built Haematology and Bone Marrow Transplant ward comprising 20 single negative pressure rooms was opened, particularly thanks to the crucial support of the St Vincent’s Curran Foundation and their generous donors. The new Unit will enable the hospital to continue its pioneering stem cell work which goes back to 1975 when St Vincent’s performed Australia’s first bone marrow transplant.

St Vincent’s has also been working to establish a pilot 15-bed residential Managed Alcohol Program (MAP) which involves the regular dispensing of beverage alcohol alongside accommodation and other support to alcohol-dependent homeless people.

Alcohol dependence affects almost half of Sydney’s adult homeless population. About 30% of homeless people admitted to St Vincent’s Hospital have a primary diagnosis related to alcohol and/or other drugs.

Most homeless programs in Sydney – and across Australia – require abstinence before long-term support and accommodation are provided. But for many severely alcohol-dependent rough sleepers, it’s a condition they’re unable to meet and so they continue to live largely unassisted.

The provision of alcohol allows MAP participants to focus on other aspects of their life. This might include achieving stable housing, reducing their non-beverage alcohol consumption (eg: rubbing alcohol, hand sanitiser and mouthwash) and can be easily obtained at a relative low cost and in some cases, overcoming their addictions. For this reason, MAPs are often viewed as a compassionate response that improves the lives of a cohort with extremely complex needs.

A multi-tiered stakeholder engagement plan has been set up to ensure that the proposed MAP pilot has broad support, expertise and guidance from the community and government sectors. If the proposal is successful, the MAP pilot will be the first in Australia.

Overall in 2017-18, the St Vincent’s Health Network Sydney (includes St Vincent’s Hospital Sydney, St Joseph’s Hospital, and Sacred Heart Health Service) experienced approximately 44,200 patient separations. The hospital also recorded 644,201 outpatients across specialist clinics, radiology, and telephone health services, and attended to 48,671 presentations at its Emergency Department. A total of 7864 operations were carried out at St Vincent’s Hospital Sydney.

St Vincent’s Hospital Department Doctor

St Vincent’s Hospital trials virtual reality for pain management

In recent years, St Vincent’s Hospital Sydney’s Director of Rehabilitation, A/Prof Steven Faux has established an innovative partnership with UNSW Art and Design to deliver a state-of-the-art Virtual Reality (VR) experience for stroke rehabilitation patients – using the technology to enable them to see inside their own body to better understand their condition.

After seeing the benefits of the technology to patients, it was clear that the concept could be translated into other health applications, such as Pain Management.

To facilitate this, St Vincent’s began partnering with Samsung Electronics to conduct a new research project that will see patients take part in a clinical trial to investigate the use of VR for acute pain management.

The trial will use Samsung smart-phones and a mobile VR headset to evaluate their potential use as a treatment for acute pain. The study will also investigate potential side effects, cost-efficiency, toxicity, and ability to reduce risk of opioid dependency.

“We’re thrilled to partner with Samsung on this innovative study,” said A/Prof Anthony Schembri, CEO, St Vincent’s Health Network Sydney.

“By harnessing the power of Samsung’s virtual reality technology, we’re proud to possibly uncover the potential of a pain management program that looks at new ways of helping our patients in their recovery.”