Allied Health Strategic Plan

WSLHD Allied Health Strategic Plan Progress Report 2019 – 2022

As at 30 June 2021 there were 1402 allied health professionals employed in WSLHD (equalling 1176 FTE) across 23 separate professions.

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FOREWORD

I am pleased to provide you with this progress report two years into the WSLHD Allied Health Strategic Plan 2019-2022 which was developed following wide spread consultation among all staff including allied health, nursing and midwifery, medical, corporate and senior executive colleagues. Despite the many distractions of the COVID-19 pandemic, its incredible to see how much allied health has done. Its important as part of our wellbeing and satisfaction at work to celebrate and reflect on our achievements. While there is still another 12 months to go, we are on track to achieving the goals we have set for ourselves. While we will continue to build on these achievements, there are still some key areas we need to focus on such as Aboriginal health, disability workforce participation, clinical supervision and education governance for our staff. Take time to read this report, reflect on the achievements and gather some renewed energy for what allied health could achieve in 2021/2022. I am continually impressed by the professionalism and dedication of our 1400 strong allied health workforce in WSLHD. The agility in which our allied health teams are able to operate to meet the changing needs of our population has been demonstrated through the many achievements outlined opportunities on the horizon for allied health to make its mark on the way health care of the future will be delivered in WSLHD and I look forward to seeing this unfold. in this report. Well done to everyone. There are many

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Keeping People Healthy

Patient Experience Matters

Int Ed Cl

OBJECTIVES PROPOSED ACTION AREAS / DELIVERABLES 1.1 Population Health Drive, develop and engage health programs/services that are responsive to incidence, prevalence and demand data to increase the health and well-being of the people in Western Sydney 1.2 Aboriginal Health Embed improving Aboriginal health as a core focus of all allied health services in WSLHD 1.3 Mental Health Ensuring people living with mental illness are provided with holistic care with a focus on physical health needs to improve the health, wellbeing and life expectancy of people with mental illness Wellbeing Improve the health and

3.1 Ou Buildi cultur learni 3.2 O Buildi resea 3.3 O Buildi under learni 3.4 E Comm devel of ou workf excel pract scope

2.1 Partner with our patients and consumers to develop a patient-centred service that delivers excellence in allied health treatment across the continuum of care 2.2 Partner with Aboriginal stakeholders and the Aboriginal community to ensure patient experience and care needs are identified and allied health services are culturally responsive to these needs 2.3 Support patients with disability to access the National Disability Insurance Scheme (NDIS) or other relevant services and provide necessary care and support across the continuum of care

Jacqueline Dominish District Director Allied Health WSLHD

3.5 C Strate

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Graeme Loy Chief Executive WSLHD

VISION To be recognised leaders in delivering e‹ective value based models of care through innovation in research, education and clinical practice

MIS Deliv the h Sydn

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Western Sydney Local Health District ALLIED HEALTH STRATEGIC PLAN 2019-2022

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Exceptional People

Information underpins everything we do

Spending Wisely

Integrated Research, Education and Clinical Practice

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4.6 Ensuring that recruitment processes and notification of employment and secondment opportunities are transparent and fair 4.7 and sustainable performance development model 4.8 To foster a culture where accountability, professionalism and open communication is expected from ALL 4.9 Invest in the quality of Western Sydney’s current and future health by facilitating lifelong inter- professional learning 4.11 Enhance the teaching skills of discipline educators 4.12 education through enhanced partnerships with education providers and industry 4.10 Strengthen education governance

3.1 Our Culture Building a sustainable culture of research and learning 3.2 Our Capability Building our capability in research and learning 3.3 Our Capacity Building our capacity to undertake research and learning 3.4 Education Strategy Commitment to the development and training of our allied health workforce to ensure excellence and clinical practice at the top of scope.

5.1 Develop a clear and consistent communication strategy to ensure timely and accurate dissemination of information to allied

6.1 Improve the management of our financial resources 6.2 Increase the value of the services we deliver

4.1 Ensuring strong professional and operational governance of all allied

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wellbeing, clinical

6.3 Improve utilisation of our workforce

and adherence to professional practice standards 4.2 Developing the capability and skills of allied health leaders and managers to produce dynamic change

5.2 Develop a “data driven performance culture” within allied health 5.3 Determine appropriate IT requirements for allied health 5.4 relationships and governance processes with Digital Health Solutions (DHS) to ensure the information requirements of allied health professionals are addressed in a timely and appropriate manner governance processes with Business Analytics Support to ensure access to and utilisation of data is fit for purpose and meets business needs 5.5 relationships and

holders nal nsure ce are lied are nsive ients o access ability me s and ry care oss the re

agents able to lead from all areas of the

organisation and deliver transformational change

4.3 Embedding processes that support and nurture the growth

3.5 Clinical Practice Strategy

and development of the allied health workforce

research into clinical practice

4.4 Grow the Aboriginal allied health professional and allied health assistant workforce 4.5 Enhancing the participation of people with disability in the allied health workforce

4.13 Ensure allied health education

priorities are linked to Western Sydney LHD Strategic plan

MISSION Deliver high quality, patient-centred care that improves the health and well-being of the people of Western Sydney and beyond

VALUES Committed to delivering a world class allied health service which us underpinned by the NSW CORE Health Values and our service values of patient-centred care, professionalism and curiosity/innovation

value earch,

Western Sydney Local Health District ALLIED HEALTH STRATEGIC PLAN 2019-2022

33 strategic objectives, 123 individual KPIs 1402 Allied Health Staff are employed in WSLHD

We are on track but still more work to do

KPIs Achieved 2019-2021

55%

Achieved

25%

In progress/on track

20%

Not commenced

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10 20 30 40 50 60

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Progress towards achievement of Key Performance Indicators Allied health staff across WSLHD have worked extremely hard over the past 2 years to improve care for patients through delivery of evidence and value based care services, focusing on data driven performance and being responsive to the needs of our community in WSLHD. Widespread consultation occurred across WSLHD which informed development of 33 strategic objectives contained within the Plan. The WSLHD Allied Health Strategic Executive Committee subsequently developed 123 individual key performance indicators (KPIs) to enable achievement of key initiatives.

A culture of driving performance has been enabled over the past two years for allied health across the LHD using this Plan to focus on key priorities. This has been supported through ongoing performance monitoring and quarterly reporting to the District Director Allied Health with outcomes reviewed by the WSLHD Allied Health Strategic Executive Committee to refine ongoing work priorities. It is pleasing to see, despite the challenges experienced due to the COVID-19 pandemic how much has been achieved with 80% of KPIs either already achieved or on track. Specific highlights are outlined in this report against each of the key Better West Strategic Priorities. There is still more work to do and in the next 12 months the focus will be on further sustaining and embedding improvements in addition to the following areas: ■ Further progress in the area of improving Aboriginal

health within allied health services ■ Disability workforce participation ■ Further integration of physical and mental health services ■ Education governance across the LHD ■ Clinical education ■ Clinical supervision of allied health staff ■ Developing capability of clinical supervisors

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88 % of allied health staff at Westmead have completed online “Aboriginal Culture – Respecting the Difference” training

Case conferences occurring between Mental Health, Drug Health, and disability support services for complex consumers

Partnerships with Get Healthy Coaching Service established with dietetics at Blacktown Hospital metabolic clinic

Dietetics and exercise physiology servicing Rapid

Access Cardiology Heart Failure Clinics

Video calls made between inpatients and families during peak of COVID-19 2nd wave at BMDH and WMH 765

Strategic Priority 1 KEEPING PEOPLE HEALTHY

■ Substance use in pregnancy service established including psychology and social work. ■ Drug Health home and community based

■ Aboriginal Liaison Officer focus groups at Westmead occurring with Aboriginal elders. ■ Admin staff have completed asking the question training “are you Aboriginal or Torres Strait Islander?” ■ 22 allied health staff trained and deployed as COVID Vaccinators including 1 Aboriginal physiotherapist who worked in multiple outreach clinics to the Aboriginal community. ■ 3.6FTE of allied health staff recruited to support acute mental health units during COVID to increase therapeutic activity and physical health awareness. ■ Allied health services are integrating and working closely with their mental health colleagues across child, adolescent and adult services across the LHD. ■ Case conferences occurring between Mental Health, Drug Health, and disability support services for complex consumers. ■ COVID-19 In Touch Wellbeing team was stood up with psychology and social work staff to support mental health and social care needs of COVID-19 positive patients in the community.

Assertive Case Management Program established for high risk drug and alcohol patients including occupational therapy, psychology and social work to prevent frequent hospital admissions.

■ Dietetics and exercise physiology servicing Rapid Access Cardiology Heart Failure Clinics. ■ Partnerships with Get Healthy Coaching service established with dietetics at Blacktown Hospital metabolic clinic and physiotherapy at Westmead through the Get Back to Healthy Trial for low back pain. ■ Allied health staff participated in co-design of towards zero suicides workshops. ■ 270 video calls made between inpatients and families during peak of COVID-19 at ■ 495 video calls facilitated between inpatients and families by social work staff at Westmead Hospital (WMH) during COVID-19 second wave. ■ Social work students at Blacktown increased service capacity by providing early intervention antenatal case management to lower risk pregnant women. ■ 88% of allied health Staff at Westmead have completed online “Aboriginal Culture – Blacktown/Mt Druitt Hospitals (BMDH) enabled by redeployment of Aged Day Services staff (diversional therapists and allied health assistant’s).

Respecting the Difference” training and 100% of Chronic and Complex and Child and Family Allied Health Staff.

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Podiatry staff at Blacktown/ Mt Druitt attended Culturally Responsive Practice Training with

ComPacks on demand escalations saved 572 bed days and $334,320 in 2020/2021

Indigenous Allied Health Australia

Patient Experience Matters launched in November 2020 in Drug Health with the allied health service

scoring 100% in Trust & Respect

staff deployed to residential aged care facility and disability group home COVID-19 outbreaks 41

Strategic Priority 2 PATIENT EXPERIENCE MATTERS

■ The WSLHD Disability Inclusion Action Plan 2021-2024 was developed. ■ Allied health staff supported the statewide roll out of Patient Related Experience Measures (PREM) and Patient Related Outcomes Measures (PROM)s in Leading Better Value Care programs. ■ Podiatry staff at Blacktown/Mt Druitt attended Culturally Responsive Practice Training with Indigenous Allied Health Australia to support delivery of culturally responsive high risk foot services to the Aboriginal community. ■ Patient Experience Matters launched in November 2020 in Drug Health with the allied health service scoring 100% in Trust & Respect, involvement in treatment & recommending service to others. ■ Executive oversight of NDIS built in at each facility with regular reviews of NDIS inpatients in collaboration with NDIS Coordinator to ensure high quality care and prompt discharge of patients to community.

■ ComPacks on Demand escalations saved 572 bed days and $334,320 in 2020/2021. ■ 41 allied health staff were deployed to residential aged care facility and disability group home COVID-19 outbreaks with providing over 650 hours of clinical care across physiotherapy, social work, occupational therapy, diversional therapy and allied health assistant’s to keep people safe, mobile and mentally well. ■ 578 age appropriate activity packs were designed by diversional therapy staff, aged day services staff and allied health assistants from Blacktown Hospital. These were packed and delivered to two large residential aged care facility COVID-19 outbreaks to provide residents with cognitive stimulation.

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5 staff undertaking PhDs have received career development scholarships valued at $300,000

National Allied Health Conference, August 2021 saw 10 presentations delivered from WSLHD allied health

16 allied health professionals are enrolled

in higher degree of research

WSLHD allied health staff achieved

130 publications in peer reviewed journals across 2020/2021

Strategic Priority 3 INTEGRATED RESEARCH, EDUCATION AND CLINICAL PRACTICE

■ 16 allied health professionals are enrolled in higher degree research. ■ 5 people undertaking PhDs have received career development scholarships, from Westmead Charitable Trust, valued at a total of $300,000. ■ WSLHD allied health staff achieved 130 publications in peer reviewed journals across 2020/2021. ■ Allied health received over $3 million in new participating in a $2 million NHMRC Grant Funded Research Project The Get Healthy Coaching Service to reduce the burden of low back pain: effectiveness, cost effectiveness, and implementation. ■ National Allied Health Conference, August 2021 saw 10 presentations delivered from WSLHD allied health. Topics included: health literacy, clinical education, COVID19 response, telehealth. ■ Allied health research newsletter being published on a quarterly basis to showcase excellence in research practice across the LHD. research grants between 2019-2021. ■ Westmead Hospital physiotherapy is

■ Allied health research biennial report 2020 was published and disseminated across WSLHD and partners. With a focus on providing information about translation of research into practice which was well received. ■ The Professor of Allied Health ran a six part series online research methods course in March – April 2021 with over 50 allied health and nursing staff attending. ■ A position statement for value of allied health research in Australia, embedded in health services was launched at a pre-conference workshop to the National Allied Health Conference, led by Professors of Allied Health from around Australia including the WSLHD Professor of Allied Health: https:// australianalliedhealthprofessors.wordpress.com/

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40 Allied health

managers had enrolled in the Managers Capability Program

5 Aboriginal cadets were recruited in 2020 from Physiotherapy, Speech Pathology,

Allied Health COVID-19

Casual Pool was established with 63 casual allied health staff

Occupational Therapy and Radiography

43 physiotherapists were trained in critical care to support COVID-19 workforce surge into ICU

Strategic Priority 4 EXCEPTIONAL PEOPLE

■ Allied health professional and operational governance is strong with Facility Directors of Allied Health appointed at Westmead, Blacktown/Mt Druitt, Auburn and Drug Health. ■ Allied Health Workforce Manager has been established to support evidence based workforce planning across the LHD. ■ Allied Health COVID-19 Casual Pool was established with 63 casual allied health staff employed during 2020/2021 to support the LHD COVID response. ■ 43 physiotherapists were trained in critical care to support COVID workforce surge into ICU. ■ 56 allied health staff including physiotherapists, social workers, dietitians, speech pathologists and occupational therapists were identified as skilled to work in ICU. ■ WSLHD allied health clinical supervision policy reviewed and updated.

■ 40 allied health managers enrolled in the Managers Capability Program targeting core skills in managing people, processes and performance. ■ Aboriginal podiatry role created and in process of recruitment. ■ Five Aboriginal cadets were recruited in 2020 from Physiotherapy, Speech Pathology, Occupational Therapy and Radiography. Three cadets have graduated from the program and been offered permanent employment in the district. ■ As at October 2021, 1.2% (17 staff) of the district’s allied health workforce identify as Aboriginal or Torres Strait Islander. This is a 34% (6 staff) increase since February 2021.

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8.1% increase in non admitted patient activity

100% of Child and Family and Chronic and

Allied health mental health inpatient teams first in state to adopt activity data entry into v3 forms

Complex allied health staff have completed online “Aboriginal Culture - Respecting the Difference” training

28 day readmission rates have decreased across all LBVC programs

Strategic Priority 5 INFORMATION UNDERPINS EVERYTHING WE DO

■ Digital Health Solutions and the Allied Health Portfolio continue to have a strong partnership and have supported clinical teams with transition to TeleHealth/Virtual Care throughout 2020/2021. ■ Allied Health supported the initial roll out of Office 365 to inform broader roll out across WSLHD with all departments now using the platform. ■ The WSLHD Allied Health Data Governance and Digital Health Committee continues to lead improvements in information management and digital health initiatives. ■ WSLHD Data Definitions for Allied Health Policy Finalised. ■ The Allied Health Activity Dashboard was updated to enable higher functionality and reporting of activity down to the level of individual clinicians. This will help services monitor and report on activity to inform service planning and performance. ■ The Allied Health Mental Health inpatient teams have been one of the first teams in the state to be trained in capturing individual patient activity into the state based v3 form. ■ Implementation of the clinician lead WSLHD LBVC Dashboard has developed clinical data analytics capability at the clinician level and is driving real time improvement in clinical indicators and service outcome metrics across value based health care clinical programs.

■ Leading Better Value Care (LBVC) has decreased admissions, preventable ED visits and avoided unnecessary surgery. FY 2020/21 data indicates ongoing improvement despite the pressures of the COVID-19 pandemic: – Non admitted patient activity increased by 8.1% (19% 2019/2020). – Reduction in inpatient admissions by 2.5% across LBVC programs (5% in 2019/2020) with the exception of diabetes and COPD. – 14.9% of LBVC outpatient services were delivered virtually through 4723 occasions of service (OOS) in 2020/2021 (15% via 4068 OOS in 2019/2020). – 28 day readmission rates, average length of stay and emergency department visits exhibited a downwards trend across all LBVC programs. – Osteoporosis re-fracture rate over 4 years of patients attending the clinics in WSLHD is now 0.97%. – 29% of patients who complete 6 months in the osteoarthritis chronic care program remove themselves from joint replacement surgery lists (Deloitte forecast was 5-15%) with improved mobility and body mass index scorings. Each Joint replacement costs $35,000-$40,000. – High Risk Foot Service amputation rate shows an overall downward trend in 2020/2021 – 3.2% vs 2019/2020 - 3.8%.

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60% of patients seen by RAID-ED directly discharged from ED

RAID-ED improved patient reported experiences measures in ED with Westmead scoring 100%

$3.1 million in research funding obtained by allied health over past 2 years

and Blacktown 90%

Strategic Priority 6 SPENDING WISELY

Rapid Assessment Intervention and Discharge Emergency Department Project

Evidence based workforce planning has been a focus throughout 2020- 2021 including consistent allied health workforce planning to ensure allied health is operating to the top of their scope of practice and the right skills are being deployed at the right time to the right place. Two unique multidisciplinary allied health workforce models of care were implemented to improve efficiency, patient outcomes and experience.

The Allied Health Rapid Assessment Intervention and Discharge – Emergency Department (RAID-ED) Model of Care (MoC) was implemented to lower the demand on inpatient hospital beds preventing hospital admissions to Westmead and Blacktown Emergency Department’s (ED). It also measured patient experiences from the treatment received. This MoC prioritises patients’ needs by supporting medical and nursing staff and assessing patients immediately after triage in the ED. RAID- ED is a rapid response seven-day, extended hour’s service that includes physiotherapists, social workers, and occupational therapists. The RAID-ED team have seen over 5,800 patients since October 2020 and have: ■ Discharged 60% of patients they saw directly from ED. ■ Provided follow-up care for 30% of patients discharged. ■ Reduced the overall average length of stay for triage categories 2 to 5 by 34 minutes and 70 minutes at Westmead and Blacktown ED respectively. ■ Reduced the number of patients waiting greater than 24 hours at Westmead and Blacktown ED. ■ Improved overall patient reported experience (PREMS) measures in the ED with Westmead scoring 92% (previously 58%) and Blacktown 79% (previously 53%). ■ Achieved high PREMS scores specific to the RAID-ED Team performance with 100% at Westmead and 90% at Blacktown. The RAID – ED Team has been permanently funded from 1 July 2021.

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A decrease in code blacks, no

complaints for BUMP patients and positive family and staff feedback showed a successful model

Strategic Priority 6 SPENDING WISELY

Behaviour Management Plan (BUMP) Project

A decrease in code blacks, no complaints for BUMP patients and positive family and staff feedback showed a successful model. Some examples of feedback provided are:

BUMP piloted in early 2021 aiming to enhance safety and reduce the incidents of aggression in Aged Care wards at Blacktown Hospital while reducing costs related to behaviour management strategies. The team made up of occupational therapists, diversional therapists and allied health assistants worked across seven days to see all patients requiring increased supervision and all patients who had a code black called. Informed by the patient and families, personal profiles were completed, and specific activities and daily living programs created. Working closely with medical, nursing, and corporate services the team adapted hospital routines (including observations, personal care etc), provided carer education and support and worked to safely discharge patients.

“Set up dinner for my father that personalised to my mum and dad. Behaviour had changed for the better after BUMP interaction. I cannot fault this program as it made a huge change to my dad’s stay in hospital. Please provide this service to other hospitals as well”

“Time given back to nursing staff”

“BUMP team are able to de-escalate patients and identify patient triggers earlier”

Equity funding has allowed for an enhanced BUMP team to continue that incorporates a designated nurse, psychologist, and social worker. Recruitment to these positions is underway.

WHAT’S NEXT As we move into 2022, allied health will continue to focus on building on our achievements from 2019-2021 and align plans for future work with the new overarching WSLHD strategy which will be developed by the WSLHD Executive in 2022.

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WSLHD Allied Health Strategic Plan Progress Report 2019 – 2022

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