A message from Group CEO, Toby Hall
Every Day Dying
The Victorian Parliament has just approved legislation to allow for assisted suicide. This is a significant change to our health system and to the relationship between health providers and their patients. Similar legislation in New South Wales did not pass when put to the Parliament last month.
As you may know, St Vincent’s has decided to take a lead and public role in contributing to the ongoing community conversation around end-of-life issues – including assisted suicide and palliative care.
Our decision to raise our voice reflects both our Catholic heritage plus our role as one of Australia’s longest and leading providers of palliative care. We established Australia’s first dedicated service for the terminally ill at St Vincent’s Sydney almost 130 years ago; the palliative care facilities at our Sydney, Melbourne and Brisbane hospitals are the largest in their respective states.
The foundation of our advocacy is that we believe death needs to be discussed more openly in our society. We want to inspire a broad dialogue about dying and the goals of health care when cure is no longer a possibility. We also want to encourage Australians to be clear about the type of care they would like at the end of their life and, importantly, what they don’t want.
We also believe access to palliative care – which remains patchy across Australia and is largely dependent on a person’s postcode, diagnosis and doctor – must be improved.
With many of Australia’s hospital and community health services without the infrastructure or training to support people to die in peace, we need to ensure that all health professionals are comfortable and resourced to provide palliative care for people at the end of life.
We’ve also made public our views on assisted suicide. While I recognise and respect that our staff will hold a range of personal views on this issue, St Vincent’s Health Australia does not support assisted suicide and euthanasia. We don’t believe assisting someone to suicide, or ending their life directly or intentionally, can ever be an expression of care for someone who is valuable. We will continue striving for something greater in our efforts to help people have the best possible, most dignified end of life.
St Vincent’s position also reflects the concerns of many of our clinicians, particularly our palliative care clinicians, who believe assisted suicide will impact poorly on the care of the most vulnerable, undermine the doctor-patient relationship, and further isolate palliative care and its benefits from the people who need it.
As part of our advocacy, St Vincent’s has developed a series of short videos entitled Every Day Dying with the aim of straightening out some of the misconceptions around end of life.
We talked to patients with terminal illnesses, family members and our staff about their experiences with death and dying.
Some of the videos relate to our concerns around the assisted dying legislation recently approved in Victoria, while others take a broader look at end of life or are simply patient stories, showing how palliative care can help a person achieve a 'good death'.
For those working in our facilities in Victoria, SVHA facilities will not provide assisted suicide but we will never turn people away and we will always respect patients’ choices if they wish to have their care transferred to another provider.
Local facilities will be supported to develop appropriate care pathways prior to mid-2019 when the scheme starts.
In the meantime, I continue to be inspired by the work of our palliative care services which is beautifully reflected in the Every Day Dying videos. You can view the videos here.
by Carmel Shaw - Director of Mission, Private Hospitals Division
We live in busy times, rushing from one thing to the next, attending to a long list of things to do. How often, when someone is asked, ‘How are you?’ do we hear the response, ‘busy!’
This time of year seems especially busy as we try to fit in as much as possible before the holidays. The season leading up to Christmas, Advent, is a time of waiting.
In the Christian tradition we wait for the birth of the Christ-child and all of the hope that He promises. In amongst the busyness of our hospitals and aged care facilities there are spaces where waiting is the only option. Waiting for surgery, waiting for a diagnosis, waiting for the birth of a child, waiting for the end of life. Often our staff enter into these ‘liminal’ spaces, the ‘in-between’ times, and join in the waiting. They listen, console, empathise, affirm. Sometimes they are simply present in the waiting time, offering nothing more than the reassurance that one does not have to wait alone.
In a time where instant gratification is in demand, we are not always so good at waiting, at being present to this moment where there is nothing to be done and no solution to apply. When we enter into the waiting time, we discover an opportunity for compassion, gratitude and trust to flourish. We experience moments of grace and connection to the things and the people that really matter. And sometimes, even when there is pain and struggle, we also find hope.
Spotlight on St Joseph’s Hospital
Communication Assistive Technology (CAT) Clinic at St Joseph’s hospital in Auburn, New South Wales offers specialist assessment and management for people with neuro-progressive conditions, such as Motor Neuron Disease (MND). CAT Clinic assessments look at the patient’s strengths and limitations to address how they would like to interact with others when their condition no longer allows them to communicate with speech. A range of devices are trialled and tested for accuracy, endurance and efficiency, and the patient is empowered to choose which device will suit their individual needs best.
CAT Clinic patient David Jones, who has Bulbar onset MND couldn’t use his voice at all. Instead he used an iPad with a free text-to-speech app, but was no longer able to communicate with his Vietnamese partner who couldn’t read English nor understand the voice accent of the app. David’s arms and hands were also growing weaker and it was clear that using the iPad by touch was going to become increasingly difficult as his MND progressed.
Wanting to be able to communicate with a voice in Vietnamese and having access to a device that would serve him in the long term was imperative to his quality of life. To that end, CAT Clinic trialled a number of communication devices, but after exhausting all options available at the Clinic, the team looked further and found a device known as the NeuroNode.
The NeuroNode is a small round device a little larger in size than a hearing aid. Fitted to David’s shirt, tiny electrodes were positioned as such that with small movements of his forehead, David could control functions on his iPad without physically touching it. By raising his eyebrows, he was able to select and open icons with ease and access his text-to-speech app interchangeably. It was simple to use, and featured a new text-to-speech app that translated English to Vietnamese, almost as fast as normal speech itself.
It was clear this device would make a huge difference to David’s life, and after receiving funding from the Department of Veterans Affairs, David became one of the first people Australia to be fitted with the device. He can now converse with his partner and know that he will always be able to, even as his MND progresses.
The CAT Clinic ensures that people with neuro-progressive disease are set-up early with a communication system, so that there’s plenty of time to learn how to use it before a crisis occurs. As in David’s case, not only is he able to participate in conversation with his partner again, it allows him to contribute to symptom management with his multidisciplinary medical and allied health team.
Perhaps, more importantly, the CAT Clinic has enabled him the opportunity to develop his memoirs, document his stories and prepare his legacy for his family and friends.
How are you inspired?
John Geoghegan is Director of Nursing & Operations at St Joseph's Hospital Auburn and Adjunct Professor of Australian Catholic University. John had previously worked in health organisations owned by religious communities, which is what led him to St Joseph’s. Let’s get to know John ...
1. What inspires you most about your work?
St Joseph’s Hospital cares for the most poor and vulnerable; the older person who has no one close to them made more complex with a psychiatric illness or disability; the people with a neurological disease that devastates their life and that of their families including the people who require our palliative care services.
I’m inspired by the people who I work with who keep me going on a daily basis. I trained as a nurse and see the many comforting interactions all our staff from the many departments provide. Over the years many people from other health services have visited and I have been so proud when they said to me, ‘You know John, there’s something about coming to SJH that’s different’. I agree with them wholeheartedly.
2. What might someone be surprised to know about you?
I chuckle to myself about this. I have always loved being in a garden. Fortunately, we have staff who are passionate about our gardens which keeps me on notice about ensuring the place is managed well. I do enjoy getting ‘dirty’; digging, cutting, pruning and then sitting back and admiring with little a refreshment.
Also, I love spending time in the kitchen - I’m the weekend cook in our house.
3. What do you do when you aren’t working?
I’m currently enrolled in a Doctor of Health program through University of Tasmania that takes a lot of my spare time. Being in the kitchen with the radio playing is really relaxing, even when I have several dishes on the boil. A great battery charger for me is a walk on the beach, anytime of the year.
4. If you could invite any 5 people in the world to dinner (living or not), who would they be and what would you cook?
Lady Diana (formerly Princess of Wales); Cat Stevens (singer, musician); Sandra Bullock (actress); Sir David Attenborough (broadcaster, naturalist); Carole King (singer, song writer)
I’d cook a combination of Bruschetta, Pizza Giovanni, Juanito’s Paella and Rhubarb and Pear Tartlets.
5. What super power do you wish you had and how would you use it?
I wish I could go back in time. So many practices and ways of doing things have changed making our lifestyle more convenient and better. However, I’d like to experience some of the former practices which may help me, and others appreciate and improve how we practice and operate today.
Results of 2017 employee engagement survey
Thanks to everyone who took part in our 2017 SVHA Employee Engagement Survey.
It is really important as we strive for something greater that we know what is going well in the organisation and what is not.
Overall we scored 3.77 out of 5 and sit at the 48% percentile in Australia. This compares to 3.69 (25 – 50 percentile) last year which is a great improvement across almost every part of the organisation.
The positive feedback highlighted in the survey was that most people are very clear on what they are here to do and that they love the organisation’s Mission and their team.
The areas to improve highlighted that people too often don’t have the basic materials to do their job; that we often don’t recognise staff contributions as well as we could and we need to strengthen the capability of our managers.
SVHA Group CEO, Toby Hall said: “It is great to see that our staff engagement is improving however one of the key learnings from this year’s survey is that some staff did not receive feedback about the results of the 2016 engagement survey.
“If we ask staff to give feedback it’s our responsibility to provide the results and take action on the issues they’ve raised. This will be a priority in every area of the organisation and your managers will be sharing the 2017 survey results with you.”
Child safety …our responsibilities
The SVHA Board has approved an important addition to the SVHA Code of Conduct focused on the protection of children. The addition is based on the Framework for improving care for vulnerable children in Victorian health services and applies to all SVHA staff and volunteers at all our facilities and sites in Victoria, New South Wales and Queensland.
In line with our Mission to preferentially serve the needs of vulnerable populations, this addition to our Code of Conduct provides guidance to enable SVHA not only to meet our legal obligations but more importantly to protect and serve vulnerable children who we may come into contact with either as patients or as visitors in our aged care and health services.
Under the new child safety guidelines, all SVHA staff are required to observe child safe principles and expectations for appropriate behaviour towards and in the company of children. We are all responsible for supporting the safety, participation, wellbeing and empowerment of children.
Click here to view SVHA Code of Conduct with Attachment ‘A’ Our responsibilities – child safety.
Changes at the top
CEO of St Vincent’s Private Hospital Sydney, Robert Cusack has taken on the role of Group Manager, Business Development to lead a significant opportunity to enable SVHA to deliver on the enVision2025 strategy.
Robert has led our private hospital in Darlinghurst for almost 10 years and overseen significant development during this time, in particular the new private hospital development at Darlinghurst over the past 2-3 years. Robert’s leadership, together with his skills and knowledge spanning a long career in private health will be invaluable to SVHA’s success in this very important future opportunity.
Tim Daniel has taken over the leadership of St Vincent’s Private Hospital Sydney. Tim has been the CEO of Greenslopes Private Hospital, Brisbane and brings with him a solid foundation in private health care to the role.
Ken Gallacher has joined SVHA as Group Chief Information Officer based in Sydney. Ken has a wealth of experience, both in corporate and government and in a range of industries. He also served on the board of Cure Brain Cancer Foundation.
Ken was most recently the Director of Technology for the ABC, a role he held for the past 7 years where he revitalised the technology area including establishing an ABC-wide IT strategy and supported the transformation of audience engagement and business operating using new technologies.
Prior to this, Ken was a partner at PWC where he helped rebuild its advisory practice locally and globally focusing on IT effectiveness with numerous clients in the ASX top 100. Other roles have included CIO with Westfield and AMP.
Due to personal circumstances, CEO St Vincent’s Hospital Melbourne, Susan O’Neill, recently resigned as CEO. Angela Nolan has taken on the interim CEO role.
In announcing her resignation, Susan said ‘St Vincent’s is a very special place and it has been a privilege to lead such a wonderful team of people. I have enjoyed unwavering support in my quest to change the way we think about our work, and have observed with great satisfaction the enthusiastic support of colleagues striving to continuously improve our processes, and deliver ever better care.
‘I am very proud of the great teamwork that is evident in these change projects, and I regret that I won’t be able to be part of St Vincent’s future success, however I am confident that St V’s is on a pathway to a great future.’
St Vincent's takes a stand against bad behaviour
SVHA is partnering with the Australian Institute of Health Innovation at Macquarie University to assess its innovative approach to addressing entrenched cultural problems in the health sector.
The SVHA Ethos program has been developed over the past 12 months. It was first introduced at St Vincent’s Hospital Melbourne in July 2017 and is being rolled out nationally across all our hospitals. The program aims to embed safe, respectful and professional behaviour and provide a consistent, transparent and equitable way to address staff conduct that undermines patient or staff well-being.
The partnership has successfully secured a National Health and Medical Research Council partnership grant of $1.2M to evaluate the program nationally over four years.
SVHA’s Chief Medical Officer and Group General Manager of Clinical Governance, Dr Victoria Atkinson, said the partnership grant would facilitate world-first research looking at the impact of the Ethos program on staff behaviour and patient experience.
“It’s well known that bullying, discrimination and harassment are significant problems in Australia’s health care sector and St Vincent’s is not immune,” said Dr Atkinson.
“The Royal Australasian College of Surgeons found that around half of the College’s fellows and trainees had experienced bullying, discrimination or sexual harassment. Other professional colleges have found similar disturbing rates of unacceptable behaviour.
“These cultural issues impact negatively on the well-being of doctors and other health professionals. It’s part of the reason why risk of suicide in doctors is substantially higher the general Australian population.
“But while the sector is struggling to respond effectively to entrenched bad behaviour what St Vincent’s has done is take a very public stand against it, and we want to bring all of our staff with us: in health care, administration and support services; everyone in every role, across the entire organisation.
“Sometimes staff may feel ill-equipped or unable to speak up when they witness or experience disrespectful behaviour. They might feel that if they report the problem, it won’t be addressed; or perhaps they’re afraid of repercussions? Or maybe it’s just because – in the unit or department they work – there’s an acceptance that inappropriate behaviour is somehow ‘normal’?
“Ethos is designed to overcome these barriers and contribute to making staff and patients feel welcome, valued and safe.”
“It needs to be said that in most health care organisations, serious bad behaviour is perpetrated by only 2-3% of people. We acknowledge that the majority of staff model behaviours that are focussed on patient well-being and founded in integrity.
“There’s also been no lack of desire among health care providers to address the entrenched cultures within health care that allow disrespectful behaviour to be tolerated. Safety efforts such as clinical care bundles, checklists, root-cause analyses, procedures, protocols and guidelines and staff programs that promote well-being have achieved a measure of success but not the degree anticipated.
“This is because without addressing behaviour, improved systems alone aren’t enough. Achieving safe, reliable, high quality care requires well-designed systems and well-functioning teams.
“SVHA recognises that culture change of this magnitude can’t be undertaken in isolation so in addition to introducing Ethos, we are building partnerships across the sector to create a coalition to improving the culture in health care.
“We have begun this process with a Memorandum of Understanding (MOU) with the Royal Australasian College of Surgeons and we aim to establish MOUs with professional and regulatory bodies and partnerships with health services across the nation,” said Dr Atkinson.
Forum reflects on reconciliation
SVHA held its second Aboriginal and Torres Strait Islander Forum recently in Sydney. Entitled our Building our Culture, Building our People, the Forum brought together Aboriginal and Torres Strait Islander staff and senior leaders from across SVHA and two New South Wales community elders.
The forum provided participants the opportunity to connect and reflect on our journey of engagement and employment of Aboriginal and Torres Strait Islander people over the past 12 months, the provision of health care to the local Aboriginal communities that our hospitals serve and the importance of reviewing and improving our reconciliation vision for the future.
The opening key note was given by Dr Mark Wenitong, senior medical advisor of Apunipima Cape York Health Council. Dr Wenitong provided insights into the delivery of high quality, culturally appropriate and comprehensive primary health services to 11 communities in the Cape. He spoke about the ‘high’s and lows’ of service delivery and the important and valuable role of Aboriginal and Torres Strait Islander employees in the provision of primary health services.
SVHA Group CEO, Toby Hall joined Chair Redfern Aboriginal Medical Service, Sol Bellear and General Manager National Partnerships HESTA, Bart Moye in a lively and interesting ‘on the couch’ session highlighting the differences and similarities in each organisation’s approach to reconciliation.
CEO St Vincent's Health Network Sydney, A/Prof Anthony Schembri, spoke passionately about the work of our Aboriginal Health Unit while CEO Reconciliation Australia, Karen Mundine, spoke highly of SVHA’s achievements against the targets in our Reconciliation Action Plan. Many outcomes from the forum will be implemented to ensure SVHA continues to grow on our reconciliation journey and participants look forward to gathering again next year in Melbourne.
Take care on the stairs
Did you know a recurring safety issue across SVHA sites and facilities is staff falling down stairs – at least one person a month. This is not acceptable in an organisation which takes the safety of its staff seriously. In response, our Work Health & Safety Managers are developing a national approach to this issue starting with an awareness campaign called ‘Take care on the stairs’.
Simple stair safety tips:
1. hold the handrail
2. don’t rush
3. don’t use your phone
Our first online annual report …it’s all about you
We are pleased to launch SVHA’s first online Annual Report. Our digital annual report features video content and infographics to help tell the stories of our advocacy for justice in health care, our healing Mission and the many ways St Vincent’s staff are inspired to deliver health care with compassion for all and a deep desire to serve the poor and vulnerable.
SVHA’s enVision2025 strategy of ‘serving, seeing and striving for something greater’ is the roadmap for how we deliver on our Mission. This report captures our progress against the goals and priorities of the strategy in the four key areas of our Public Hospitals Division, Private Hospitals Division, Aged Care and Research.
The SVHA online Annual Report is available at: St Vincent’s Health Australia 2016-17 Annual Report.
Resident artists spread Christmas joy
This year, St Vincent’s Care Services chose 3 very gifted artists to create their annual Christmas card. Nina Brown, Maria Raffa and Eunice Taylor are residents of St Vincent’s Care Services Mitchelton in Brisbane, and are all active members of the facility’s art classes. Each resident was asked to create a Christmas themed painting, and their artwork was transformed into cards accompanied by their explanation of what this time of year means to them. The approach is a wonderful way to celebrate our residents and recognise the many talented individuals we have living in our facilities.