Strategy and Corporate overview
The Strategy and Corporate division supports national health reforms and National Partnership Agreements, develops strategies for attraction and retention of the health workforce, and maintains critical physical and technological infrastructure for the ACT's hospitals and health services.
The Strategy and Corporate division consists of eight branches: Policy and Government Relations; Business and Infrastructure; People, Strategy and Services; Performance Information; eHealth and Clinical Records; Quality and Safety; Academic Unit of General Practice; and Canberra Region Prevocational Management Committee.
Strategy and Corporate administers ACT Health's contract for the provision of public hospital services by Calvary Health Care ACT at Bruce and at Clare Holland House, and supports these close working relationships. Calvary Health Care ACT's report on its achievements in 2013-14 is provided in an annexed report.
Senior appointments during the reporting period included Professor Kirsty Douglas as Director of the Academic Unit of General Practice (AUGP), Dr Marianne Bookallil as GP Advisor and Dr Andrew Mitchell as the Director of Territory Wide Surgical Services.
Much of the work supported by Strategy and Corporate appears elsewhere in this report. Other highlights for the division during this reporting period are set out below.
National Disability Insurance Scheme
The National Disability Insurance Scheme (NDIS) was launched on 1 July 2014 and its implementation continues across ACT Health. Strategy and Corporate's work in this area includes financial planning, service configuration, community sector contracting, phasing in for clients of ACT Health services, and workforce issues.
In September 2013, ACT Health became the first jurisdiction with the capability to access and view national eHealth records within the existing clinical portal. This functionality builds on the work that had already been done to enable ACT Health to submit its clinical documents to the national Personally Controlled Electronic Health Record, and assists ACT Health in its commitment as an effective and efficient service provider.
For the first time, ACT Health is using real-time reporting to help clients make decisions about the best treatment options available to them. These initiatives improve the patient journey and contribute to the sustainability of the health service.
A web-based report called ED Live was developed during the reporting period and released to the public in July 2014. The website, the first of its kind for the Territory, reports on the current status of the two public hospital emergency departments. Clients can use this information to decide which service to access, and consider alternative services for less urgent medical needs. ED Live links to the Digital Canberra and dataACT Government strategies.
The Performance Information Portal now allows ACT Health users to view real-time activity in many areas of the organisation, as well as access historical trends and activities in particular areas of its operations. Further developments will be rolled out during 2014-15, including a theatre utilisation module and a bed management tool.
The ACT Health Surgeon Waiting Times web page has a new and improved format, containing different information on waiting times. The new format was developed with key stakeholders and shows the current number of people on each surgeon's waiting list and the median time waited. The web page also shows the number of theatre sessions allocated to each surgeon each four-week cycle. The web page will be updated monthly.
To improve users' experience of ACT Health facilities, free wireless internet access for healthcare consumers is now available within the Canberra Hospital and community health centres at Belconnen, Tuggeranong and Gungahlin.
ACT Health is now recognised by the National E-Health Transition Authority as a leading jurisdiction in supply chains, after ACT Health's reforms in this area. In late 2013, Supply Services, with the assistance of Health ICT and SSICT, initiated a project to use wi-fi to replenish ward stock at Canberra Hospital. The wi-fi pilot program was completed in May 2014. Supply Services staff are now able to scan a ward imprest room and upload the replenishment order instantly, without disruption to service or time wastage. Warehouse staff are able to process orders, prioritise workflow and deliver supplies. This is a huge benefit for the warehouse and supply chain scheduling. With wi-fi, Supply Services is better equipped to handle the continued growth of the Canberra Hospital.
Systems and technology
ACT Health now trades electronically with 22 of its major suppliers, which represents about half of spending on medical and related consumables. Electronic catalogue synchronisation has reduced the number of price and payment variations for the trading suppliers, by more than 60 per cent. Electronic trading provides early shipping status from suppliers, and Supply Services (in the Business and Infrastructure Branch) uses this information to advise its internal customers of when goods can be expected to be delivered, enhancing the customer service experience.
In 2013-14, the Canberra Hospital Business Intelligence Unit was established as part of the Performance Information Branch. Information management staff were realigned to ensure a more consolidated approach to information provision across the organisation.
The eHealth and Clinical Records branch oversaw the upgrade of the clinical portal, including software and underlying ICT infrastructure.
The Data Warehouse core framework implemented in 2013-14 uses widely available technology to integrate, manage and share information via a web portal.
The division continued to use e-learning to strengthen staff skills and professionalism, including for the workplace induction pathway and training on writing, aseptic techniques and neonatal care. New e-learning programs were rolled out across the directorate, and others were updated. Further initiatives are addressed in E.2 Learning and development.
Reviews and planning
A significant review of the Mental Health (Treatment and Care) Act 1994 was completed during the year, and an extensive amendment bill was tabled in the ACT Legislative Assembly on 15 May 2014.
Policy and Government Relations Branch has identified 20 strategic priorities for the ACT Alcohol, Tobacco and Other Drug Strategy for 2015-19. A draft for consultation is expected to be ready by late 2014.
In 2014-15, ACT Health will chair an inter-directorate committee to lead the development of a 10-year whole-of-government mental health and wellbeing (MH&W) framework. This framework will work towards the directorate's strategic priorities of continuing to meet the growth in demand for mental health services, and protecting vulnerable groups.
It will explicitly address self-harm and suicide prevention. The government acknowledges that many of the social determinants affecting mental health, wellbeing and suicide prevention lie outside the health domain and therefore require a whole-of-government, whole-of-community approach. The framework will be ready by July 2015.
A replacement for the ACT Mental Health Services Plan 2009 - 2014 will be developed in parallel to the whole-of-government MH&W framework. The replacement will be specific to ACT Health and will sit within the Health Directorate Corporate Plan 2012-2017. It is also expected to be ready by July 2015.
A new reconciliation action plan is planned for release in July 2015.
Workforce planning will be one of the key pillars required to support major projects and reviews across ACT Health, including the establishment of the University of Canberra Public Hospital. The abolition of Health Workforce Australia as part of the 2014-15 Federal Budget presents challenges and opportunities in this area, including the redesign of workforces to support the requirements of national registration and the Australian Health Practitioner Regulation Agency.
People Strategy and Services is also investigating strategies to support the retention of the mature workforce (those aged 45 and over).
Further information about People Strategy Services activities can be found in E.1 Human resources management reporting and E.4 Workplace relations.
Performance Information Branch
The review and redesign of the Performance Information Branch has progressed during the reporting period. The new structure is establishing a more streamlined governance and reporting arrangement; enhanced workflows and communication between business units; a strategic information management governance approach; a renewed data quality assurance framework; and a timely, efficient and responsive service for our clients' needs.
In addition to routine scanning of clinical records, the Clinical Record Service undertook a significant back-scanning project to digitise a range of paper records, including 'baby cards', and physiotherapy and medical oncology records. In total, 86,031 records were scanned by the Back-scanning Project Team, in addition to the usual scanning workload. A team of 26 temporary staff members was employed to carry out this work. During the first six months of 2014, the Clinical Coding Team achieved a 46 per cent reduction in the number of records waiting to be coded.
The Academic Unit of General Practice (AUGP) has developed research activities that encompass child health, integrated service development, clinical research, individual routes to health and healing, social determinants of medical care, and scholarship in teaching and learning.
The AUGP has led the research stemming from the ACT Health Kindergarten Health Check, which it has been conducting with the school health nurses of the directorate's Women Youth and Children since 1998. During 2013-14, a new Kindergarten Health Check parent questionnaire was developed using validated survey tools. Research is currently being conducted on the most appropriate manner in which to give parents data on their child's body mass index. Work in 2015 will include a broad evaluation of the program.
Despite the rising rates of obesity, almost no research has been done regarding the management of obesity by general practitioners. The AUGP is reviewing the literature and synthesising the many clinical guidelines on obesity into a single document for use in general practice.
Future work will focus on developing more systematic and reliable ways to articulate, measure and value the complex nature of primary care consultation.
Canberra Region Prevocational Management Committee
The Canberra Region Prevocational Management Committee (CRPMC) was established in October 2013 to provide local contextual input to the junior medical officer accreditation process and to improve the overall junior doctor education and training program.
The program had previously been assessed by the Health Education and Training Institute of NSW. CRPMC, a body with direct and comprehensive knowledge of the ACT context, will now oversee and improve the program, and will work to establish a clearer and more effective governance structure in this area. It expects to apply to the Australian Medical Council to become an accrediting body.
In early 2014, two Nissan LEAF electric vehicles became part of ACT Health's motor vehicle fleet, as part of an ACT Government initiative. Staff were trained in the use of the electric vehicles, which proved very popular.
In 2014-15, Strategy and Corporate will explore opportunities to include additional electric vehicles in the fleet. Charge stations have been included as part of the major upgrade to the Tuggeranong Community Health Centre.