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Where will Research Week take you?

Taryn Wills

Taryn Wills has won $4000 in fellowships at Research Week over the last two years, taking her to conferences in Edinburgh and USA to meet leading neuroscience researchers.

A PhD student at the Melbourne Brain Centre at Austin Hospital, Ms Wills last year won the $1000 Austin LifeSciences Prize for Basic Scientific Research for research looking at the potential for nerve cell regeneration after spinal cord injury.

"You speak to your collaborators on Skype, but when you have the chance to meet in person you can discuss further, it makes your ties stronger and you meet additional people - everything kind of snowballs," she says.

"The year before I won the $3000 GlaxoSmithKline Prize, and that completely paid for all my costs to go to a very big conference in America. It opened a lot of doors and opportunities to speak to people regarding future work - for me, postdoctoral work - so it presented a lot of collaborative opportunities for the future. You also get a lot of really good feedback, and exposed to ideas and views you haven't thought of."

She has submitted an abstract for Research Week again this year, "but it's not just for the prizes. It's great to find out what other researchers are doing within the Austin itself. Because there are so many research groups here, you might have something really similar going on in the building next door, and find that you can collaborate, or even just share equipment. It also creates a good interface between the basic science and the clinical researchers," she says.

More than $21,000 in scholarships are offered at Research Week this year again. Abstract submission closes next Saturday 17 August. Abstracts can be submitted at http://www.austin.org.au/research/research-week/ 

Transit Lounge triple patients

Louise and Jo, transit lounge nurses

Meet Louise and Jo: two of the gun team from the Austin's Transit Lounge, who have tripled patient admissions over the last 3 months! Jumping from less than 30 to around 90 patients a week has kept nurses on their feet, and helps significantly to make beds available on the wards for patients needing admission from the Emergency Department.

Never before has increased use of the Transit Lounge been sustained for so long. So how have they done it? "The staff here are so dedicated and hardworking and will do whatever I throw at them, because they want to assist to get patients through the hospital," Louise says of her Transit Lounge nursing team. "And the ward clerks are a wonder, taking on all the extra paperwork that has to be completed early in the morning to come down with the patients."

For those unfamiliar with it, the Transit Lounge is a section within the Ambulatory Care Centre where patients head when they are ready for discharge, but need to wait for a family member to pick them up or a final prescription to be ready.

There has been no single ‘magic bullet' that has helped the team achieve this result, but rather a series of incremental improvements to tackle the obstacles to discharging patients to the Lounge. These included everything from a forum for ward clerks, to changing to chairs that are more appropriate for patients with mobility issues, to making a map of Transit Lounge available to nurses and ward clerks via the computer system so that they can see when to allocate patients.

"Eventually the Transit Lounge will be known as where you come to pick up your family from hospital," Louise says.

 

New project cuts IV line infections to almost zero

IV line insertion

"I woke up in the night and I was sweating and had uncontrollable shaking. I thought I was going to die," Jim said.

Jim - who agreed to tell his story to prevent the same thing from happening to others - had developed a Staphylococcus aureus bacteraemia (SAB) infection from an intravenous (IV) line in his arm.

More commonly known as ‘Golden staph', Staph. aureus is one of the superbugs challenging modern hospitals. Often resistant to most common antibiotics, superbugs are a major cause of suffering.

Admitted to the Austin Hospital after having a ‘mini-stroke' or transient ischaemic attack, Jim's infected IV line caused him to develop septicaemia, an infection of the blood. He needed IV antibiotics, which led to kidney failure and antibiotic-related hepatitis.

"They said it had infected my kidneys and my liver. I was in the hospital for two or three weeks and then I had Hospital in the Home. They came to my house every day for a month," Jim said.

Fortunately for patients at Austin Health, the chances of developing an IV line infection in one of its hospitals are now almost zero, thanks to the rollout of new IV insertion packs.

Manager of Infection Control, Donna Cameron, said that when her team reviewed hospital practices to see if anything could be done to prevent IV-related infections, they found a number of inconsistencies in hospital practices.

"Different wards were using different antiseptics and equipment and IVs weren't being dated, so it was difficult for staff to know how long they'd been in. If you leave them in for more than 72 hours, they become an infection risk," she said.

"We developed our own IV insertion pack. It includes a bright green sticker to go on the IV with the date on it and bigger larger green sticker to go into the patient notes. It comes with a stick of skin antiseptic and the new protocol says that you need to wait for at least 30 seconds for the antiseptic to dry before you put the needle in."

"We also now use sterile gloves, because even though IV insertion was supposed to be a touch-free procedure, we found that most people need to re-feel the patient's vein just before they insert the needle or anchor the vein close to where they insert the needle," she said.

"In the year before we rolled out the project we had 13 IV-related SAB infections. In the year since we've had only one, in November last year," she said.

The success of the program relied on a collaborative effort from the Infectious Diseases, Microbiology, Quality Safety and Risk and Clinical Education departments, who together devised a new IV insertion standard.

Central to this was a staff training program that ensures all staff be credentialed in Austin Health's procedure before they can insert IVs.

The impact of the new procedure on patient lives is clear. The financial savings are also impressive. It's estimated that the reduction of SABs will save the hospital between $300,000 to $500,000 per year.

The procedure is now being considered for rollout in other hospitals across Australia. In this regard, it follows in the footsteps of Austin Health's hand hygiene program, which was rolled out as a national standard after it cut the rate of overall SAB infections at Austin Health by 50 per cent.

 

Liver Transplant Unit celebrates 25 years

Dylan and Professor Bob Jones

By slicing off a portion of Jennifer's liver and transplanting into her one year-old son Dylan, Austin Hospital liver transplant surgeons not only saved tiny Dylan's life, they made history, performing Victoria's first live liver transplant.

The Victorian Liver Transplant Unit (LTU) celebrates its 25th birthday this month, and has many such history-making moments to remember.

Since Victoria's first liver transplant procedure on June 20, 1988, the team have gone on to save 848 lives, and perform Victoria's first paediatric liver transplant later that year, the first split-liver transplant in 2007, and Australia's first intestinal transplant in both an adult and a child, in 2010 and 2011, respectively.

Today, Dylan Nish is nearly seven, and in the words of mum Jennifer "full of energy 24/7, and just as tall as his eight year-old brother. If he didn't have to sleep, he wouldn't!"

"He's just a normal little boy, and it's only due to the liver transplant unit. Words just can't describe what they've achieved for us, and it's not just what they achieve; it's how caring they are too," she said.

Not content to rest on their achievements, the unit's surgeons are continuing to attempt new procedures that will save more lives, including more complex, multi-organ transplants.

All milestone birthdays should be celebrated in style, and the LTU are celebrating their 25th with a ball at the Grand Hyatt on September 6. Tickets are $125, with profits going to the Liver Transplant Unit.

Download the booking form to purchase a ticket.

Nerve surgery gives people with quadriplegia use of their hands

Jim Anderson

Article by Rosie Nunn

After a spinal cord injury left him with quadriplegia, 23 year old Jim Anderson had no hand function at all, and limited movement in his elbows.

When he was offered the opportunity to be the first person in Australia to undergo a triple nerve transfer to restore some of his hand and arm function, he was unwavering in his decision to take the risk.

"I said yes before they even explained it," Mr Anderson said. "Nothing was going to get worse. It has definitely made life easier."

After five months of intense rehabilitation, he is able to extend his fingers and demonstrate the use of his triceps.

Mr Anderson is now one of ten patients with C5 and C6-level quadriplegia to have regained some use of their arms and hands after nerve transfer surgery at Austin Health.

In nerve transfer surgery, nerves that no longer function due to spinal cord injury (in this case, nerves that control the arm and hands) are rerouted to working nerves, restoring lost function.

Surgeons at Austin Health's Victorian Spinal Cord Service have brought together a number of these procedures together for the first time, with very promising early results.

Plastic surgeon Natasha van Zyl described the project as a "labour of love" that will change lives.

"What we are doing is changing a person who is quadriplegic into someone who is paraplegic. And that of course has massive implications for their function. They can now pretty much run a normal life from a wheelchair," Ms van Zyl said.

 

New treatment for melanoma to be trialled in the Cancer & Wellness Centre

Professor Jonathan Cebon
Professor Jonathan Cebon

Melanoma patients at the Olivia Newton-John Cancer & Wellness Centre will have the opportunity to be part of a major international trial of a melanoma treatment that could extend their life for years.

The new trial, which aims to enrol 915 people and will include a number of Australian hospitals, will look at giving patients with advanced melanoma a combination of two drugs, ipilimumab (Yervoy) and nivolumab.

It builds upon a much smaller study of 52 people run by the Ludwig Institute for Cancer Research (LICR) in the United States, which found that the treatment shrank 90 per cent of participants' tumours - and for a third of them, shrank their tumours by more than 80 per cent.

Professor Jonathan Cebon, who is director of both the Ludwig Institute for Cancer Research and Cancer Services at Austin Health, said that the average survival rate for advanced melanoma was six to seven months, but that 80 per cent of the patients in this trial were alive after one year of treatment, and that some had lived for more than two years.

In an interview in this morning's Age, he said he was excited about the upcoming trial because treatments for advanced melanoma were limited and the only drug that had controlled advanced melanoma for more than two years was Yervoy, which had limited effectiveness when used alone and cost patients approximately $120,000.

"With this clinical trial, the majority of patients responded and many of them appear to be alive and well many months later without evidence of relapsing, so it's a real game changer,'' he told the Age.

Trip of a lifetime in a van with a difference

Ros and Charlie Ball with Austin Health's Tony Skipper
Ready to roll - Ros and Charlie Ball with Austin's renal technical services manager, Tony Skipper

Roslyn Ball and her husband Charlie say they are not 'grey nomads', they're 'silver travellers'. Either way, like many before them, they will soon set off on a trip of a lifetime to the Kimberleys, stopping in Mildura, Port Augusta, Alice Springs, Katherine and Broome on the way.

Along the way they will stay primarily in caravan parks, so that Ms Ball can use the kidney dialysis machine that's been built into their caravan. She has been on dialysis for more than ten years and is thrilled at the prospect of being away in the bush. "Charlie and I met 23 years ago, when we were members of a Hawthorn bushwalking club," she said. "We met on the track in Matlock, in the high country and we both love getting out and about".

But being on dialysis requires five-hour sessions three times per week, and the vast majority of patients dialyse in hospital satellite dialysis centres. And that makes going on holiday tricky. "We always try to accommodate visitors at our satellites when they visit Melbourne," said Allyson Manley, Manager of Renal Medicine. "But it's not always possible to fit people in and we often have to say 'no'." she said.

Enter Tony Skipper and his renal technical services team. They manage the Austin's fleet of home dialysis machines; supply consumables; conduct regular maintenance; and trouble-shoot. Mr Skipper worked with Mr Ball to build the dialysis machine into the caravan and set up the water and electricity supply. "Charlie was an engineer, so we worked on the caravan together" he said. It was really Charlie's work, but we helped." Mr Skipper's team have worked with the Balls to plan where to stay and ensure the appropriate facilities are available.

Skipper's brief was to enable Ms Ball to dialyse when she is in the bush, so water tanks and an electricity supply were installed in the van to enable her to complete a short dialysis session away from mains power and water. "This will provide me with enough to hold me over until I get to the next town." said Ms Ball. "We couldn't be happier with Tony's team," she said. "They're always happy to help us and that includes when we're away, on the road".

Austin Health is embarking on a promotion of home dialysis and will be encouraging existing patients to take up the opportunities associated with it. "Patients who dialyse at home generally have better physical health and mental health outcomes, and Ros is modelling the benefits." Ms Manley said.

 

Professor recognised for a lifetime of osteoporosis discoveries

Professor Ego Seeman
Professor Ego Seeman with some of his students

On two occasions now, Professor Ego Seeman has shifted the direction of thinking in osteoporosis research worldwide.

The first was in 1989, when he was the first to demonstrate a childhood origin to osteoporosis, by showing that the daughters of women with osteoporosis also have reduced bone mass.

This turned the attention of the world's osteoporosis researchers, who for some 50 years had been examining the bones of the elderly - to instead look at bone growth and development during the first 20 years of life.

His work next led to a change in thinking when a student, Roger Zebaze, observed that most bone loss appeared to be in cortical rather than trabecular bone.

This flipped the scientific paradigm yet again: while 80 per cent of researchers were looking in what seemed the most logical place - the spongier and more naturally porous trabecular bone - Seeman and Zebaze had discovered that it was actually the compact, outer shell known as cortical bone where most bone mass loss was taking place.

It is for these achievements that Professor Ego Seeman will fly to Japan later this month to accept the John G Haddad Award from the International Bone and Mineral Society at their international meeting.

It's the latest award of many that have dotted a research career spanning over 30 years and featuring more than 300 publications. Highlights include being one of only seven investigators from outside the USA ever awarded the American Society of Bone Mineral Research's Fred C. Bartter Award in 2002, and the International Osteoporosis Foundation Medal of Achievement for Outstanding Investigation in Osteoporosis Research in 2009.

However, it's the discoveries and innovative thinking from his students and research team that really seems to make Professor Seeman tick.

"The training I give to students is the most important thing I've done, because to develop some else's career is to do some good. If you look at your own teachers, the ones who inspired you didn't do so because of what they said, but because of the way that they taught you how to think, and how to ask critical questions," he said.

Certainly, the professor seems to have a knack for finding and fostering some of the brightest, enquiring minds in endocrinology, from all over the world. And it's drawing out that talent that he sees as his greatest achievement and lasting legacy.

He encouraged Dr Zebaze to come from Cameroon work with him at the Heidelberg Repatriation Hospital. Dr Xiao-Fang Wang came from China to study racial differences in bone structure with him, Dr Yohann Bala from France to examine why the microstructure of bone becomes fragile and medical physicist Dr Ali Ghazem Zadeh from Iran to use computed tomography to study bone structure.

Another student, Dr Sandra Iuliano, has just received a major grant to study the affect of calcium supplementation in residents in 300 nursing homes.

"You don't want your students to be like you; you want to encourage them to find their own talent," he said. "The role of a mentor is to bring out the talent that's within a student."

Despite considerable investment in his students and other young researchers, Professor Seeman continues to contribute game-changing research discoveries, and is currently leading research into how bone structure is the cause of its own decay.

"The cell machinery that builds bone is the very thing that destroys it. Gradually, the mechanism that replaces old bone with new bone puts less back than it removed, and the structure decays a bit. When that happens over 80 years, you end up having to get around with half a skeleton," he explains.

"But when it comes to your own research, you can't really know what you've contributed for another hundred years, because you can never really know if you're right," he says.

The Wellness Centre: A place where I am understood

Lierre Bayley

At age 27 the last thing you expect to hear are these three words, "You've got cancer."

But that's exactly what happened to Lierre.

"I had pain under my arm and I thought it was my glands swelling. I was getting viruses and was really sick," she tells us.

"When I found a lump and was sent to get a mammogram I was crying. This was not normal, I knew something was wrong."

Lierre went to see a breast surgeon and had a biopsy.

"I went and got the results on my own because I knew I could deal with it but I couldn't deal with my family's reactions, I was more worried about others' feelings. For my parents it was devastating."

"Waiting for treatment, you feel nervous. It's traumatic just sitting there waiting. Before the Wellness Centre opened, sometimes I'd be sitting in the hospital for over an hour with nowhere to go and nothing to do; I was literally staring at the wall."

"Here in the new Centre you have the pager which alerts you when the doctors are ready to see you, you're able to move around. Once here I'd have a cup of tea, it relieves all that anxiety and for a split second you forget where you are and what you're doing here."

"The staff and volunteers are welcoming and friendly; it's more like a home than a hospital. I felt like I could come here and be understood; I didn't need to explain myself. "It's nice to come to the Wellness Centre after an appointment and before I go home - just to relax and be supported by people who know me."

"I knew that physically and medically I was doing everything I could. There was nothing else I could do, I'd ticked all the boxes, but it wasn't enough to actually make me feel better as a person. I needed to find something that was going to give me some relief."

"I was getting swelling in my arm and it hurt. Laser Acupuncture was suggested, I was sceptical - but it was incredible, the relief was immediate. I could feel the tension releasing up my neck. My arm had no pain afterwards, I found something that actually worked."

"I would never ever have considered art therapy before. I went more out of curiosity, the next time the sense of release that unfolded was extraordinary. I was able to physically express what I was feeling without words. Having breast cancer at age 27 I couldn't relate to anyone else with breast cancer as I was so much younger than most of the other patients. I felt like I didn't fit in, that the circumstance I was going through didn't relate. I just wanted to talk to someone my own age."

"So we got together a group of us who were all young and on the same page. It was such a relief to know that there were other people out there like me. It was a light bulb moment when I met Kate in the group and we realised we had so much in common. We now catch up and have lunch. We're friends. Our cancer has bonded us. The wellness centre is a place where I feel like I am totally understood without having to explain myself."

"The Wellness Centre hasn't cured my cancer or medically made me better, but emotionally I am able to cope and deal with things. I attribute coming out the other side to the support of the Wellness Centre, and the opportunities that were offered to me in there."

Read this story and more in the latest copy of The Well Wisher

Renal Unit plans to triple access to home dialysis

Katherine Cherry

If you had to have dialysis, would you prefer to do it in hospital or at home?

Despite the benefits, only 16 per cent of Austin Health's chronic kidney disease (CKD) patients receive dialysis at home - a figure that the Renal Unit are planning to more than triple to 50 per cent, through two new projects recently funded by the Department of Health.

The first involves training 36 Royal District Nursing Service (RDNS) nurses, to support people to receive automated peritoneal dialysis (APD) at home.

APD is the easiest form of dialysis to learn. It gives people the option of dialysing overnight and minimising disruption to their work and lifestyle.

However, CKD patient pathway coordinator Katherine Cherry says that many patients don't take it up, whether because they don't feel confident using the dialysis machine by themselves, or lack the manual dexterity or eyesight to do so.

"Hopefully, having support from the RDNS nurses means that more people will choose to do APD at home, and will be able to stay at home longer," Ms Cherry said.

The second is a more involved piece of work that will use principles taught by Austin by Design to find where barriers to all types of home dialysis exist and overcome them.

Home dialysis gives patients the added benefit of dialysing every day, rather than travelling to hospital or a dialysis centre to receive three intensive bursts of dialysis each week.

"It's gentler on the body doing dialysis every day because it more closely mimics your natural kidney, and you don't have that build-up of waste between sessions," Ms Manley said.

"It's like the difference between only changing your socks three times a week, or having a fresh pair to put on every day," she said.

And of course there are the lifestyle benefits too.

"If people are doing their own dialysis it means they can be more flexible about it, instead of working to our schedule," she said.

 

Scientific proof of Alzheimer’s disease 20 years before it hits

Chris Rowe

A major Australian study proves for the first time a person is going to suffer Alzheimer's disease - up to 20 years before symptoms appear.

The research, published in The Lancet Neurology, details the way the brain has been measured to change in three distinct stages. Twenty years before symptoms appear, there is a build-up in the brain of insoluble, fibrous proteins called amyloids. These are visible using PET scanning.

The second, pre-clinical stage involves the gradual atrophying (dying) of the hippocampus and the third measurable change involves distinct levels of memory loss at 17 years, four years and three years out from the clinical onset of dementia.

"This is the first time we have actually been able to establish the time it takes to get Alzheimer's disease," says Professor Chris Rowe, Austin Health's Director of Nuclear Medicine.

Sadly, at this stage there is no cure for this crippling form of dementia which worsens as it progresses and eventually leads to death. It is usually diagnosed in people over 65 with the average age of diagnosis at 80 years.

"Predicting the rate of preclinical changes and the onset of the clinical phase of Alzheimer's disease are essential to help medical researchers design and time therapeutic interventions aimed at modifying the course of the illness.

The study was a project led by Austin Health, with The Florey Institute of Neuroscience & Mental Health, CSIRO, Edith Cowan University.

 

The champions of redesign: Vesna Kostovski

Vesna and team

The usually behind-the-scenes work of the Austin Hospital kitchen is due to take centre stage next week at a statewide conference.

Food Services Operational, Compliance and Contract Coordinator Vesna Kostovski last year led four redesign projects that saved the department over $50,000, and dramatically increased the freshness of patient meals. The team's achievements have attracted the attention of the Department of Health, which has invited Vesna to present at its Commission for Hospital Improvement Seminar on March 21.

The projects presented include one that improved the department's processes for bread ordering and use that cut the maximum age of the bread used in patient meals by 75 per cent, and in sandwiches by 30 per cent. The project has already won accolades for the Food Services Department, which came runner-up at the Austin by Design showcase awards last October.

Vesna says that the department's secret is humanising every problem.

"We always put a patient face to the problem," she said. "We asked ourselves: if it were our grandmother on the ward, what would we want her to be given?"

"It's all about how we can give better service to our patients by using fresher products or trying new things. Redesign gave us a tool for doing it without threatening our staff, because we were analysing the operational processes," she said.

"Now, our staff own the problems and they tell us: this is not the right way of doing it, or this is how we could save money here."

Vesna's enthusiasm for redesign was first sparked when Food and Retail Services manager Colin Smith encouraged her to represent Food Services as part of a multidisciplinary team that was taking part in Austin by Design training. That support from management - going right up to executive director level - has played an important role in the team's success, and the number of projects they have been able to undertake.

One project on show improved the quality, shelf life and variety of flavours of the texture-modified fluids provided to patients in Darley House. Another reorganised the delivery of spare sandwiches to the wards - saving an anticipated 16, 425 sandwiches from being binned every year - while another increased staff productivity by standardiseing the amount of cutlery bagged for patient meal trays.

And the work continues: Food Services already have another redesign project on the go, and another two in the pipeline.

"For me, lean methodology is not a way of doing but a way of thinking. We constantly reassess how we're doing and consider how we're getting it right, and in what ways we can improve the quality of what we deliver for our patients," Vesna said.

Lean methodology is taught by Austin by Design as a way to help teams to assess and improve the efficiency of their current systems and processes, so that they can improve the service that they offer to patients without requiring additional resources.

This is the first of a series running in WAG and on the Hub throughout 2013 focussing on the champions of redesign.

 

Wally Lewis celebrates six years seizure-free at Austin Hospital

Wally Lewis cuts the cake

Former Rugby League superstar Wally Lewis celebrated six years living seizure-free by delivering a $75,000 donation to the Austin Hospital's Epilepsy Program - and sharing this impressive cake with the patients and staff on the epilepsy monitoring ward.

In 2007, Austin Hospital neurosurgeons removed a piece of Lewis's brain 5.5 cm long and 3 cm wide that was responsible for causing his seizures, in a procedure known as a temporal lobectomy.

"I used to hide behind my epilepsy. And every time I did a radio or TV interview, I was absolutely petrified I'd have a seizure. Then of course, I announced it to the world in the worst possible way, by having a couple of seizures reading the sport on live TV," Wally said yesterday.

"But once I made a decision to do something about it, the rest was easy."

"Now thanks to the Austin Hospital, I've had a restart to life. I've been able to go back to a very normal life reading the sport."

Comprehensive Epilepsy Program Director Professor Sam Berkovic said that there are few people who have done as much for the public understanding of epilepsy as Wally Lewis.

"I have had a number of patients who have come to have their epilepsy properly investigated and treated, because they've either read Wally's book or they've had the opportunity to meet him in person," Professor Berkovic said.

"They think: If Wally Lewis can do it, then I can do it."

Austin Health's Comprehensive Epilepsy Program is the leading epilepsy centre in Australia, treating patients from all around the country, New Zealand and South East Asia. The donation will go toward upgrading the high-tech epilepsy monitoring chairs and EEG equipment on 6 East.

Wally Lewis donated a cheque to the Austin's Comprehensive Epilepsy Program on behalf of the Former Origin Greats (FOGs), a Queensland organisation made up of the 174 players who have represented Queensland at State of Origin level. FOGs has donated over $1 million to charity since 1997, from funds raised at their annual State of Origin Luncheon at Suncorp Stadium.

Wally Lewis's book,
Out of the Shadows, is published by HarperCollins.

 

Austin Health Victoria’s top metro health service in 2012

Minister Davis presents the Austin Health team with the Metropolitan Health Service of the Year award

Austin Health has been presented with the award for Metropolitan Health Service of the year at the 2012 Victorian Public Healthcare Awards.

This is the second time that Austin Health has won the award, which is now in its eighth year.

Minister for Health David Davis said that the Premier's Award for Metropolitan Health Service of the Year is the highest honour to which a Victorian metropolitan public health service can aspire.

"Austin Health is an internationally recognised leader in clinical teaching and training, affiliated with eight universities. It is the largest Victorian provider of training for specialist physicians and surgeons," Minister Davis said.

"The innovative work and commitment of staff and volunteers have all contributed to make Austin Health an outstanding metropolitan health service," he said.

Austin Health CEO Dr Brendan Murphy said the award is recognition of the extraordinary work put in by staff.

"It is the effort and commitment of our staff that has resulted in the impressive list of achievements that gave us the award. We are a truly fantastic team who deliver the highest quality healthcare," Dr Murphy said.

Runner up for the award was The Royal Women's Hospital, which received a Highly Commended Award.

Austin Health is one of Victoria's largest healthcare providers, employing more than 8,000 people across the Austin Hospital, Heidelberg Repatriation Hospital and the Royal Talbot Rehabilitation Centre.

In 2011-12, 100,765 inpatients and 185,526 outpatients were treated at Austin Health. Its emergency department was the busiest in Victoria in 2011-12, with 70,325 people presenting.

 

Testing times for mentally ill patients

Elizabeth Cornish

Did you know that people with a mental illness are five times more likely to have diabetes as the rest of the community?

At Austin Health, clinical nurse consultant Elizabeth Cornish acts as a bridge between the mental health and diabetes services for clients that she says "can easily fall through the gaps."

"In addition to the symptoms of mental illness, the medications often cause significant weight gain, tiredness and reduce motivation, which make it difficult for people to exercise and eat well. These things all contribute to insulin resistance and rising blood sugar levels," Ms Cornish says.

People with a serious mental illness are often too unwell to make managing diabetes a priority, and some do not have a GP.

Working out of the North East Area Mental Health Service (NEAMHS) clinic, Ms Cornish screens clients for diabetes, and offers them education and support, often liaising directly with their psychiatrist and case worker.

All 267 NEAMHS Continuing Care Service clients in 2011-12 were referred for metabolic screening. While diabetes prevalence in Australia is less than five per cent, eight per cent of the clients had type 2 diabetes and 16 per cent pre-diabetes or required further blood testing to confirm diabetes.

"Diabetes is considered to be a progressive disease because blood sugar levels will gradually rise but we aim to keep it well controlled by implementing lifestyle changes such as exercise, better diet and weight loss," Ms Cornish says. "If that's not enough, we can use medication."

Part of Ms Cornish's role is also to increase awareness of the issue of diabetes amongst mental health staff, so they put focus on assisting clients to reach and maintain their optimum physical, as well as mental, health.

Reducing your risk

Diabetes can lead to serious complications including heart disease, blindness, erectile dysfunction, kidney disease and amputation. Maintaining a healthy lifestyle is vital for people with diabetes, or at risk of developing it.

To reduce your risk of developing diabetes or complications:

  • maintain a healthy weight
  • exercise regularly
  • eat a healthy diet
  • manage your blood pressure
  • manage your cholesterol levels
  • do not smoke

Want to read more about recent quality improvements at Austin Health? Read the full story - and more - in our 2012 Quality of Care Report.

Exploring death and grief through art an award-winning combination

Molly Carlile accepts her award from Mr Michael Dwyer (left), CEO, First State Super and Professor John Catford (right), Vice-Chancellor (Academic) and Vice-President of Deakin University.

Supporting people to discuss and accept death - including through the arts - has won Molly Carlile the prestigious 2012 Deakin and Health Super Leadership in Nursing and Midwifery Award.

When she first started speaking in the community about palliative care, Ms Carlile said she found it difficult get people discussing death and grief.

"Then I found the arts", she said. "The arts have so much to offer us in terms of engaging with people, informing them and supporting them."

Now manager of Palliative Care Services at Austin Health, Ms Carlile is also an acclaimed author and playwright, and has taken on the additional role of building the Arts in Healthcare Program for the Olivia Newton-John Cancer and Wellness Centre.

She says that nurses are in a unique position to inform, empower and support communities to face the reality of death, have conversations with family and friends (particularly children) and care for those around them.

She plans to use the prize money to travel to the Culture Health & Wellbeing conference in the UK next year to initiate some research initiatives with Manchester Metropolitan University and Durham University.

"We have so much to learn from them and we also have so much to offer. Aussies are creative people and Aussie nurses are great innovators, I'm proud to be one!"

Ms Carlile thanked Professors Margaret O'Connor and Jonathan Cebon for nominating her and Austin Health for allowing her the flexible working arrangements that enabled her to continue to tour with the plays, speak at conferences and work on ‘unusual' partnerships outside of the traditional health environment.

"I've had so much support from senior staff at the Austin, without that I would not be able to do what I do", she said.

Ms Carlile is also giving two presentations at the Art of Good Health and Wellbeing conference later this month, ‘Finding a place for the arts in an acute facility' and ‘The art of dying well'.


Molly Carlile's latest play, The Empty Chair, a comedy about dementia, is being performed at the Ivanhoe Girls Grammar Performing Arts Centre at 7:30pm on Tuesday 20 November. Find out more or buy tickets from http://www.northwestpalliative.com.au/home.php

 

Record number of kidney transplants

Kidney transplant team

Austin Health performed a record number of kidney transplants last financial year, giving 47 people a better quality of life.

For many years the Austin averaged 20 to 25 kidney transplants annually, but that number has been rising, partly due to successful national campaigns around organ donation, and partly due to Austin Health's role within the Victorian Kidney Transplant Collaborative.

As part of the collaborative, Austin Health performs living-donor kidney transplants, as well as all deceased donor transplants, except for those from St Vincent's and Geelong Hospitals.

In addition, Austin Hospital now undertakes transplants from live donors who are blood group incompatible, and is involved in the National Paired Kidney exchange program.

Most patients who need a renal transplant have had their kidneys irreparably damaged as a complication of diabetes.

Patients who receive a transplant from a deceased donor will have needed dialysis at least three times a week prior to receiving their new kidney. However, where a live donor is available, the hospital tries to perform the transplant before the patient needs dialysis.

Renal and islet cell recipient transplant coordinator Debbie Gregory says not every patient can be transplanted and it is not the ‘magic fix' some people think.

"You do have to take tablets all the time, make sure you maintain your general health, and whilst patients are educated that there are significant benefits to transplantation, there are also unavoidable risks."

However, the improvement in a patient's quality of life is usually great, she says.

"One patient... said he didn't know how sick he was until after his kidney transplant, he realised that he no longer needed an afternoon nap and his work decisions were more clear and concise," Ms Gregory says.

"There are people who have never travelled overseas before who have been able to travel, others that have gone back into working full time or gone to uni; one mum was able to be there for her daughter when she was starting school."

Ms Gregory urges people to discuss their organ donation wishes with their family and to register with DonateLife.

Want to read more about recent quality improvements at Austin Health? Read the full story - and more - in our 2012 Quality of Care Report.

 

Changing the paradigm of responding to deteriorating patients

Daryl Jones

An Austin Health ICU specialist is changing the paradigm of how hospitals respond to deteriorating patients - in a move he believes could save more patient lives.

Associate Professor Daryl Jones believes that a preemptive strike is the best approach to reducing the risk of cardiac arrest in hospital patients.

He says that the Austin Hospital first introduced Medical Emergency Teams (MET) over 10 years ago. The teams responded to patients who were deteriorating but not yet in cardiac arrest, decreasing the number of cardiac arrests by 66 per cent.

Now Jones is advocating moving away from a reactionary response entirely. Instead, he is encouraging hospital staff to monitor the early signs that a patient is likely to deteriorate, so that they can escalate their patients' care to medical emergency teams even sooner.

He has co-authored an article on the issue in the Medical Journal of Australia - and was featured in the May edition of Hospital & AgedCare.

Creating the right environment for brain recovery after stroke

A/Prof Julie Bernhardt

Animals placed in environments that are enriched socially, cognitively and physically make much greater functional improvements after brain injury than those who are not. So how could this help people to recover after a stroke?

This is what Associate Professor Julie Bernhardt - director of the world's largest stroke rehabilitation trial, AVERT - hopes a $20,000 Churchill Fellowship will help her to discover. She will travel to Sweden, the United States and Spain, to look at programs there and investigate whether we can and should change the model for how we approach brain recovery.
"We've tested increasing physical activity in the AVERT trial, and know it can help to improve outcomes. Some people have tested the importance of listening to music to stimulate brain recovery, but we haven't brought it all together in an environment where patients are stimulated to talk, think, listen to music, move around, direct their own activity and socialise," she says.

"I want to explore the full package and see if it produces added benefit. I'd like to know if we can and should change the model for brain recovery."

She is particularly excited about visiting Texas, where a group of architects have started to work on the concept of patient-empowered hospitals. "People are specialising in cutting-edge architectural design that tries to stimulate patients and encourage them to move more freely around the hospital. Having some way to engage patients and having variations in their environment is important," she says.
A/Prof Bernhardt says the Olivia Newton-John Cancer & Wellness Centre aims to create an enriched environment for cancer patients. The new Mellor Ward at the Royal Talbot Rehabilitation Centre will also incorporate these ideas.

"We've got lots of examples of bits of the puzzle. I just want to bring the whole puzzle together," she said.

Demystifying anaesthesia

Professor David Story
Professor David Story

Medical television shows are populated by surgeons, doctors and nurses - but rarely anaesthetists.

Austin's Professor David Story believes this is why the anaesthetist is generally not well understood.

As the first Chair of Anaesthesia at The University of Melbourne - and one of only a handful in Australia, one of Prof Story's first priorities is to engage government, the public and other medical professionals about anaesthesia.

"As patients have become older and sicker, the risks to patients are increasingly dealt with by the anaesthetist rather than the surgeon. Our role is to manage people's complex medical conditions," he said.

Prof Story will have an ambitious research agenda before him. He is also heading The University's new Centre for Anaesthesia, Peri-operative and Pain Medicine, which will research an array of topics such as difficult airway management, smoking cessation and ways to decrease pain and complications after surgery.

"Austin Hospital is probably the leading anaesthesia research group in the country. We have multiple studies particularly in patient outcome and patient safety. We're interested in complications and patient welfare after surgery. We also have particular expertise in the areas of fluid management," he said.

 

Prof Story will also be looking to enhance medical education with anaesthesia expertise.

"Anaesthesia has a long-standing relationship with the airline industry because there are a lot of similarities between us. Like airline pilots, we use simulation more than any other specialty. In fact, simulation was developed by anaesthetists to create life-like medical situations that require good team management. We are very keen to impart some of that knowledge to the broader medical community," he said.

Men's health boost for Austin Health

Prostate cancer nurse David Gray
Prostate cancer specialist nurse, David Gray

David Gray knows the challenges prostate cancer patients face. Having worked as urology surgical liaison nurse for 18 months at Austin Hospital, he booked hundreds of patients in for surgery and talked to many of them about their treatment.

"Prostate cancer can be mentally tough but the more patients knows of their procedures, the more education they have, the easier it is for them to deal with it. I figured if I could help these patients learn more about their treatment, then hopefully their quality of life after treatment would improve," he said.

Mr Gray is now building a program at Austin Hospital to do just that. As one of Victoria's first prostate cancer specialist nurses, his role will be to help support men through their prostate cancer treatment including providing patients with vital information about their diagnosis, their treatments and their potential side effects.

Prostate cancer patients will be encouraged to make contact with Mr Gray, as the prostate cancer specialist nurse, when they receive their diagnosis.

Mr Gray admits some men are not always open to talking about medical issues but he is hopeful that a high number of men will utilise the soon-to-be available support. "The fact there is more public interest in men's health makes it easier. With people like David Parkin and Sam Newman willing to be open about their surgery, more men are taking interest in their health and having medical check-ups than they might have done a decade ago." he said.

Mr Gray, who is due to complete a Masters in Urology and Continence at Latrobe University at the end of the year, says the side effects of prostate cancer treatment vary from person to person. "It's highly individualised. Some people don't have any side effects and they're very lucky. Side effects for other guys will be very severe. My job is to give the patients a guide on the risks which they may or may not develop so they are prepared," he said.

The pilot position is one of 13 roles across Australia, funded for three years by the Prostate Cancer Foundation of Australia.

Jasmine's story: "Thank-you for helping to save my life"

Jasmine

Looking at Jasmine, you couldn't know what she has been through.

At age three Jasmine was diagnosed with ulcerative colitis, an auto immune disease.

"Over the years my liver got worse. I was so badly jaundiced I was green," she says.

"My body was shutting down. The doctors told us that I'd need a new liver. When I was 16 we were introduced to the doctors at Austin Hospital," Jasmine says.

"Eventually I got sicker; I didn't think I was going to get through," she said.

Just as time was running out, Jasmine got the new liver that saved her life, in an eight-hour liver transplant.

"Recovery for the first two weeks was hard, it was very painful and it hurt so much," she said.

"I didn't understand the concept of being well, because I'd been sick my whole life."

"It was a really big change I had to accept, but a wonderful one, waking up from the surgery feeling like a whole new person."

Make a contribution toward equipment for the Liver Transplant Unit, to help Austin Health continue to offer the best medical treatment available.

Jasmine's message to people who donate to Austin Health?

"Thank you for helping to save my life. I wouldn't be here if people didn't care. One action you take can change so many people's lives."
Donate online now

 

Self-check-in a first for a Victorian public hospital

Anna Vandenberg with Specialist Clinics manager, melinda Cosgriff

Austin Health's ‘self-check-in and electronic calling system' is set to be a Victorian public health first when it is implemented in Specialist Clinics in September.

Gone will be the need for patients to register their arrival at reception. Instead, patients will experience a self-check-in system that is both empowering and efficient.

Melinda Cosgriff, manager of Specialist Clinics, says the new system will revolutionise the scheduling process by improving patient privacy, reducing waiting times and reducing the risks associated with delays in treatment. "On arrival at the clinic, patients will swipe their Medicare or DVA cards or scan their appointment letters at the self-managed kiosk. The kiosk will produce a numbered ticket for the patient. The clinic staff will see on their computer that a patient has arrived and start to prepare paperwork and review test results required for the appointment. When the clinician is ready, the Electronic Calling System, will display the ticket number and room number on the screen in the waiting room for a short time," she said.

The time-stamps of patients' arrivals, the calling to the clinic room and length of time with the doctor will provide statistics to support changes for scheduling of appointments to match demand with supply.

In the Olivia Newton-John Cancer & Wellness Centre, the same process will be integrated. However, instead of a ticket, patients will be given a pager and encouraged to make use of the Centre's facilities instead of sitting in a waiting room. They will be able to get themselves a coffee, visit the Wellness Centre or make use of the Information and Resource Centre.

The project has been co-funded by Victorian Managed Insurance Authority (VMIA).