2005-06 Year in Review - Sydney Local Health District - NSW ...

0506Year in Review

ContentsChief Executive’s Message.................................................................................................................................... 02Locations.................................................................................................................................................................................. 04Purpose and Goals......................................................................................................................................................... 05Health Service Profile ................................................................................................................................................. 06Highlights ............................................................................................................................................................................... 08Facilities .................................................................................................................................................................................... 10Clinical Groups .................................................................................................................................................................. 20Nursing and Midwifery Services .................................................................................................................... 32Clinical Governance Unit........................................................................................................................................ 33Quality Clinical Indicators ..................................................................................................................................... 34Asset Management...................................................................................................................................................... 38Corporate Services......................................................................................................................................................... 39Financial Services............................................................................................................................................................ 40Information Management and Technology Division ............................................................... 40Internal Audit Department.................................................................................................................................. 41Public Affairs and Marketing.............................................................................................................................. 41Organisational Chart.................................................................................................................................................. 42Workforce Profile............................................................................................................................................................. 43Teaching and Training Initiatives ................................................................................................................... 44Research ................................................................................................................................................................................... 45Area Health Advisory Council............................................................................................................................ 47Community Participation ...................................................................................................................................... 47Volunteers .............................................................................................................................................................................. 48Donations and Bequests ........................................................................................................................................ 48Financial Summary....................................................................................................................................................... 49Health Service Locations......................................................................................................................................... 5001

WelcomeMike WallaceChief ExecutiveSydney South WestArea Health Service02 Year in ReviewOn 10 March 2006, I was appointed Chief Executive of Sydney South WestArea Health Service (SSWAHS). My appointment followed the inspiringtenure of Professor Diana Horvath AO, who served as Chief Executive ofthe Central Sydney Area Health Service, and later SSWAHS, for 13 years.Professor Horvath’s achievements were numerous. They includeddevelopment of the internationally recognised clinical stream system;the successful amalgamation of the South Western Sydney and CentralSydney Area Health Services; and the implementation of rigorousbusiness practices where financial management was simplified,administration streamlined and IT modernised, allowing healthcareproviders to use the latest technology to make their work more efficientand more accurate.Professor Horvath, who always placed safe and effective patient careat the core of our objectives, has since taken up the position of ChiefExecutive of the Australian Commission on Safety and Quality in HealthCare. We all wish her well in her new endeavour.It has now been two years since the former NSW Minister for Health, theHon Morris Iemma, announced the reforms to the NSW Health systemwhich resulted in the amalgamation of the South Western Sydney andCentral Sydney Area Health Services. SSWAHS continues to work to effectall of the required organisational changes associated with theamalgamation.Staff have worked diligently throughout the year to establish singleArea-wide clinical stream structures, determined in line with theamalgamation plan, in order to deliver the best patient care.SSWAHS has significantly benefited from the merger of these streams,which allows sharing of knowledge and a common approach to thedelivery of patient care. Other flow-on benefits have included thecentralisation of administrative functions, resulting in financial savingsof $4.8 million. These savings have been redirected to frontlineclinical services.All staff can be extremely proud of reducing to zero the list for long-waitpatients, i.e. those patients waiting for elective surgery for more than12 months.At the end of June 2005, there were 1,384 long-wait patients on thewaiting list. As part of the NSW Government’s Predictable SurgeryProgram, the list was reduced to zero by 30 June 2006, and this can bedirectly attributed to the commitment of our doctors and nurses andthe professionalism and dedication of all our staff.

LocationsFairfieldLiverpoolCanada BayAshfieldStrathfieldLeichhardt3210 5 9Burwood21420 162423 13 2115City of Sydney29 1 272518 11 1730 3 22 28 33MarrickvilleCanterburyWollondillyCamden318 673426CampbelltownBankstown1235NORTHWingecarribee19 4SSWAHS Hospitals and other Facilities123456789Area Administration and Liverpool HospitalBalmain HospitalBankstown-Lidcombe HospitalBowral and District HospitalBraeside HospitalCamden HospitalCampbelltown HospitalCarrington Centennial HospitalConcord Repatriation General Hospital/Thomas Walker (Rivendell)/Dame Eadith Walker10 Fairfield Hospital11 The Canterbury Hospital12 Queen Victoria Memorial Home13 Royal Prince Alfred Hospital14 Rozelle Hospital15 Sydney Dental Hospital16 Karitane Family Care Centre17 Tresillian Family Care CentreMajor CommunityHealth Centres181920212223242526272829303132333435BankstownBowralCabramattaCamperdownCanterburyCroydonFairfieldHoxton ParkIngleburnLiverpoolMarrickvilleMillerMoorebankNarellanPrairiewoodRedfernRosemeadowTahmoor04 Year in Review

Health Service ProfileOn 27 July 2004, the Hon Morris Iemma,Minister for Health, announced therestructure of area health services acrossNSW, including the formation of the newSydney South West Area Health Service(SSWAHS), amalgamating the previousCentral Sydney and South Western Sydneyarea health services. The amalgamatedSSWAHS came into being as a legal entityfrom 1 January 2005.SSWAHS is comprised of the followinglocal government areas (LGAs):Above: Nurse Cassandra Curran tends toShazlia Saleh at Canterbury Hospital onInternational Nurses Day.Right: Kaarina Paasila, the first person tograduate under the NSW Public SectorAboriginal and Torres Strait Islander NursingCadetship program, which is designed toencourage Aboriginal and Torres Strait Islanderpeople to train and work as registered nurses,with patient Roger Hunter at Liverpool Hospital.■ City of Sydney (part)■ Leichhardt■ Marrickville■ Ashfield■ Burwood■ Strathfield■ Canada Bay■ Canterbury■ Bankstown■ Fairfield■ Liverpool■ Campbelltown■ Camden■ Wollondilly■ Wingecarribee.SSWAHS covers a land area of 6,380square kilometres and has a currentpopulation of approximately 1.33 million,representing 20 per cent of the NSWpopulation.With areas projected for bothsubstantial new land release forresidential development and mediumdensityurban infill, SSWAHS will continueto be one of the fastest-growing parts ofthe state. Its population is projected toincrease by up to 300,000 people by 2030,a 22 per cent increase.06 Year in Review

Participants in an Aboriginal asthma awarenessday held at Tharawal Aboriginal Corporation atAirds with (l) Tharawal worker Mark Trewhellaand Joanne Perry from the Macarthur child andfamily nursing team and (r) Tharawal nurseApaula Placcid and Colleen Foy, Area NetworkPaediatric Clinical Nurse Consultant.SSWAHS population growth to 20262m1.5m1m0.5m02001* 2006 2011 2016 2021 2026* 2001 eastern zone population – 486,1822001 western zone population – 796,950Population characteristicsSSWAHS is the most ethnically diversehealth area in Australia, with 39 per centof the population speaking a languageother than English at home. This is mostnotable in Fairfield and Canterbury, whereover 60 per cent of the population do notspeak English at home. A high proportionof new migrants to Australia, includingrefugees, choose to settle in south westSydney. There are also considerablevariations between local governmentareas (LGAs) in the proportion of thepopulation identifying as Aboriginal(highest in South Sydney andCampbelltown).In addition to the influx of new migrants,the Area’s population is growing byaround 19,000 new births per annum. Insome places, notably Canterbury, Liverpooland Bankstown, birth rates are betweenPopulation projections by age group500,000400,000300,000200,000100,000Associate Professor Guy Marks, Area Directorof Respiratory Medicine (Western Zone) basedat Liverpool Hospital with a young participant ina study on factors causing the onset of asthma.2.09 and 2.16, considerably above thestate average of 1.79, and this trend isprojected to continue, with young familiesexpected to comprise a large proportion ofresidents in new residential developments.LGAs with the highest proportion ofyounger people (0-14 years) areCampbelltown, Camden and Liverpool.Across the Area there are 266,000 childrenunder the age of 15, representing 20 percent of the population.LGAs with the highest proportion of olderpeople (85 years and over) are Ashfield,Burwood and Strathfield. Across the Areathere are 180,000 people over the age of65, representing 17 per cent of thepopulation. There are large numbers ofelderly people in some LGAs, with morethan 24,000 people over the age of 65 inBankstown and around 18,000 in both0-14 years15-44 years45-64 years65-74 years75+ yearsFairfield and Canterbury. Hospital dataindicates that people over the age of 65utilise 45 per cent of all acute hospital beddays. The number of people aged over65 is projected to increase by 45 per centby 2016, when they will represent 13 percent of the population.South west Sydney has some of thepoorest communities in the state,characterised by a large number of recentmigrants, significantly higher levels ofunemployment and a high proportion offamilies dependent on welfare. The Areahas nine of the ten most disadvantagedmetropolitan Sydney postcodes.The age-standardised death rates forSSWAHS residents are higher than thestate average for both males (721.8 per100,000 vs 709) and females (457 per100,000 vs 443).The four major causes of deathare circulatory diseases, cancers,injury/poisoning and respiratorydiseases. These comprise about 80 percent of all deaths in both SSWAHS andNSW. These four causes of death are allapplicable to both males and females, butdeaths due to cancer, injury/poisoning andrespiratory diseases were higher amongmales. The proportion of female deathsdue to injury/poisoning is about half thatfor males (4 per cent vs 8.5 per cent).02001* 2006 2011 2016Sydney South West Area Health ServiceYear in Review 05>06 07

facilitiesSelected activity chart by facilityHospital name Separations % of Total bed Average Daily Occupancy Acute Non- EDsame day days length of average of rate bed days admitted attendancesseparation stay inpatients patient(acute)servicesBalmain Hospital 2,093 18.82% 24,624 8.6 67.5 12,087 135,989 17,016Bankstown Hospital 29,018 36.01% 138,672 4.5 379.9 100% 127,403 394,147 33,823Bowral Hospital 8,629 45.36% 23,127 2.6 63.4 76% 21,854 102,248 16,390Braeside Hospital 2,875 65.74% 23,392 1.0 64.1 2 20,953Camden Hospital 6,751 82.46% 25,315 2.1 69.4 89% 13,021 102,995 10,833Campbelltown Hospital 23,898 14.32% 99,490 4.2 272.6 96% 98,726 298,420 39,490Canterbury Hospital 16,577 27.19% 60,604 3.3 166.0 91% 53,470 190,981 27,027Concord Hospital 41,233 60.83% 149,109 3.3 408.5 107% 135,060 301,490 25,525Department of Forensic Medicine 44,423Fairfield Hospital 16,664 26.14% 61,633 3.7 168.9 82% 61,562 274,242 26,345Karitane Mothercraft Society 578 4.15% 2,009 3.5 5.5 2,009 31,756Liverpool Hospital 65,038 55.65% 240,357 3.6 658.5 100% 231,434 628,397 51,794Queen Victoria (Thirlmere) 9,839Royal Prince Alfred Hospital 59,753 42.81% 251,978 4.2 690.4 98% 251,626 663,911 49,960Royal Prince Alfred Institute ofRheumatology & Orthopaedics 2,195 22.32% 10,012 4.6 27.4 57% 10,012 18,672Rozelle Hospital 3,085 2.82% 60,391 13.2 165.5 35,534 11,953Scarba House – Central Sydney Unit 3,073Scarba House – South West Sydney AHS 4,617Sydney Dental Hospital 188,657Thomas Walker 271 0.37% 2,562 7.5 7.0 1,371 7,800Tresillian Care Centre 2,407 1.41% 11,180 4.6 30.6 11,180 58,362SSWAHS expenditure 310,783SSWAHS total 281,065 43.40% 1,184,455 3.9 3,245.1 96% 1,066,351 4,142,227 298,203Data provided by NSW Health10 Year in Review

BalmainHospitalA/General ManagerAnn KellyBalmain Hospital and its communitybasedservices continued to provide animportant aged care and rehabilitationrole in SSWAHS eastern zone.Balmain Hospital has a total of 78 beds,with an 88 per cent occupancy rate. Totalbed days numbered 24,624 and therewere 1,774 admissions.The General Practice Casualty providestreatment for residents in the local area.The Strength Training RehabilitationOutreach Needs in General Medicine(STRONG) Clinic has treated over 2,000patients between the ages of 30 and 100.Over 500 general practitioners referpatients to the Clinic. Clients attendingthe Clinic have experienced improvementsin strength, balance and endurance.The hospital also provides clinics indiabetes, continence, homoeopathy andacupuncture. These services continue tocater for patients and clients fromculturally and linguistically diversebackgrounds.During October, the Australian Councilon Healthcare Standards (ACHS)conducted an organisation-wide EQUIPaccreditation survey at Balmain Hospitaland Camperdown General Geriatric andRehab Medicine Community, and awardedfull accreditation of four years to bothservices.An Acupuncture Clinic in conjunction withthe Masters of Medical Acupuncturecommenced in June and has been verysuccessful in the first month of operation.Attendances and outcomes for this clinicwill continue to be monitored.Refurbishment is taking place in MortsDock Ward. The STRONG Clinic willrelocate to this area and a 14-bedTransition Care Unit will open inAugust 2006.BankstownHospitalGeneral ManagerGlenda CleaverBankstown Hospital is a principal referralhospital providing acute services thatinclude emergency medicine, maternity,general and specialist surgery, generaland specialist medicine, day surgery,outpatients and neonatology, as well as arange of specialist outpatient services.The hospital treated over 28,000 patientsand provided over 390,000 non-admittedpatient occasions of service during theyear. There were almost 34,000attendances at the emergencydepartment and 1,893 births.The hospital achieved a four-yearaccreditation in the Australian Council onHealthcare Standards organisation-widesurvey in March 2006.The emergency department introducedthe Fast Track initiative, which reducedwaiting times for ED patients. The numberof patients waiting more than 12 monthsfor surgery was reduced to zero inJune 2006.An additional 12 beds were openedacross the hospital, renal dialysisrelocations created two additional chairs,and The Way Forward funding allowedan additional ICU bed and staffingenhancements in the unit.An existing building is being refurbishedto accommodate the newly appointedProfessor of Medicine and his researchteam in a new Research Centre.The Arts for Health Program participatedin the Dads 4 Dads project, establishing adedicated exhibition space to display artcelebrating the role of fathers. The Art ofAgeing, another Arts for Health Programinvolving 150 older people, led to thecreation of writings, drawings andphotographs, which were shown in thehospital’s Arts for Health galleries.Bankstown Hospital also won theopportunity to host the 2006 Inter-Hospital Mini-Olympic Games.Minister for Health John Hatzistergos andSydney City Councillor Verity Firth outsideBalmain Hospital.Sydney South West Area Health ServiceYear in Review 05>06 11

FacilitiesBowral and DistrictHospitalGeneral Manager Denis ThomasBowral and District Hospital provides awide range of services, including generalmedicine, obstetrics and gynaecology,paediatric, surgical, orthopaedics,ophthalmology and emergency services.New pre-admission clinic facilities havebeen established, and the removal ofasbestos across the site has beencompleted.Following the appointment of a full-timestaff specialist in obstetrics andgynaecology, antenatal (including midwifeonly) and gynaecology clinics have beenestablished in Bowral and Tahmoor.Paediatricians increased their hours andmoved into new consulting rooms on site.The position of VMO Geriatrics was createdand Dr Peter Noonan was appointed asMedical Director of the EmergencyDepartment.Nursing services recruited seven overseasnurses and established two clinical nurseeducator positions. Admissions and GPLiaison Nurses have been established onthe general medical-surgical ward.Plans have been developed for therefurbishment of the Children’s Ward andrelocation of the Short Stay Unit.The Captain Starlight twins visit a young patientat Bowral Hospital.Photo courtesy of the Southern Highlands NewsCamden andCampbelltownHospitals andQueen VictoriaMemorial HomeGeneral Manager Amanda LarkinCampbelltown Hospital, a majormetropolitan hospital with 306 beds, andCamden Hospital, a district hospital with83 beds, provide intensive care, cardiology,maternity, gynaecology, paediatrics,palliative care, respiratory and strokemedicine, surgery and emergencymedicine and broad aged care servicesto the Macarthur community.Camden and Campbelltown hospitals alsoadminister the 100-bed Queen VictoriaMemorial Nursing Home.Activity at Camden and Campbelltownhospitals continued to grow, with a 2.09 percent increase in admissions and a 13 percent increase in emergency presentations.Campbelltown Hospital opened 27 newbeds and completed the $133.7 millionMacarthur Strategy with the opening of anew stroke ward and new cardiology andallied health and paediatric outpatientareas. Other capital works includedredevelopment of the renal unit toaccommodate four additional chairs, arestructure of the ED reception area andcompletion of the Mental Health Sub-Acute Unit. A second linear acceleratorand planning CT were installed in theMacarthur Cancer Therapy Centre.The Camden Midwifery Group Practicecommenced in March, providing womenin the Camden area with continuity ofmidwifery care throughout their pregnancy,birth and postnatal period.Additional ED specialists started workingacross Liverpool and Campbelltownhospitals. Planning began for the Universityof Western Sydney (UWS) Medical School,with some teaching staff recruited andplans prepared for a clinical school on theCampbelltown Hospital site. Professor BradFrankum was named the inaugural ClinicalDean of the School and Professor ofClinical Education.CanterburyHospitalGeneral Manager Gary MillerCanterbury Hospital is a majormetropolitan general hospital. It serves adiverse population of more than 135,000people, with more than 57 per centborn overseas.Services provided include general surgeryand medicine, obstetrics and gynaecology,paediatrics, aged care, rehabilitation andpalliative care.The hospital continued to implementstrategies to further reduce blockages inthe patient’s journey through theemergency department and patient wardsfor those requiring admission, includingopening eight new beds in July. This has,for the second year running, resulted in a20 per cent reduction in the number ofpatients waiting more than eight hoursfor a ward bed.Services in the ED were enhanced withthe appointment of a nurse practitioner toassess and treat patients presenting withless complex problems.The hospital continued to reduce thewaiting times for elective surgery, with nopatients waiting more than 12 monthsfor their operation.Maternity Unit was filmed in the hospital’smaternity unit, in which an average of 80per cent of the mothers-to-be were bornoutside Australia. The program, whichscreened on SBS Television, shows howhospital staff cater to the cultural diversityof the community.The Annual Foundation Ball was held inOctober at the Canterbury Hurlstone ParkRSL, raising $50,000 for operating theatreequipment.12 Year in Review

makepreventioneverybody’sbusinessPhysiotherapist NatanyaGrinius helps Valerie Bishopwith cardiovascular exercisein the Institute of Rheumatologyand Orthopaedics Gym atRoyal Prince Alfred Hospital.Exercise reduces theincidence of a repeatcardiovascular event.Sydney South West Area Health ServiceYear in Review 05>0613

Richard Barca has his foot bandaged by Marrickville Health Centre community nurse Maria Jenkins.CommunityHealthGeneral ManagerAssociate ProfessorPeter SainsburyCommunity Health provides a range ofcommunity-based prevention, earlyintervention, assessment, treatment,health maintenance and continuing careservices to improve or maintain the healthand well-being of individuals andcommunities. These services are providedfrom 144 community health centresthroughout SSWAHS, and in schools,homes and workplaces.Community Health was established asan Area-wide facility in SSWAHS in March2006, and an interim organisationalstructure has been established.Formal reviews have begun the creationof Area-wide services for sexual health,sexual assault, child protection, women’shealth, multicultural health and youthhealth.Primary care and community healthnurses provide acute nursing care andchronic disease management to people inthe local community.Following the birth of a child, a home visitby a nurse who provides parenting supportand an introduction to available healthservices is offered to the family. During theyear, 19,273 families were offered thisservice and 16,886 received a home visit.New nursing clinics providing woundmanagement, continence services andpostoperative care have been establishedat Croydon and Campbelltown healthcentres. Primary care and communityhealth nurses in Macarthur areparticipating in a statewide project toachieve improved wound managementoutcomes.Community Health HIV services completeda project with older clients, identifyingtheir future health service needs and theimportance of health promotion activitiesto reduce their risk of heart disease.The construction of Marrickville HealthCentre was completed and plans forcommissioning developed. An audit of allCommunity Health owned buildings wasundertaken to assess safety, access,storage, working conditions and buildingworks required.ConcordRepatriationGeneral HospitalGeneral ManagerDanny O’ConnorConcord Repatriation General Hospital(CRGH) is a principal referral hospital anda teaching facility of the University ofSydney. It offers a comprehensive range ofspecialty and sub-specialty inpatient andoutpatient services.CRGH leads the NSW response inadult burns trauma, and the unit isacknowledged internationally.In December the burns operating theatreswere commissioned and the Aged Careand Rehabilitation Precinct opened.The Cancer Pharmacology ResearchLaboratories opened in March with afocus on developing more effectivecancer treatments while increasingquality of life for patients.High resolution melt analysis wasintroduced in the Northcott Neurosciencelab for the identification of genemutations which cause nervedegeneration. This technology is thefirst of its kind to be used in a researchlaboratory.Construction of a $6.9 million AsbestosDiseases Research Centre was announcedin March and will greatly enhance care forasbestos-related diseases and provideworld-class research facilities.The hospital is embarking on a five-yearOperating Theatres Capital Works Projectto maximise utilisation of the theatresand improve patient flow. Stage Onestarts in December 2006 with theconstruction of two digital operatingtheatres.Research at CRGH has a primary themeof ageing, with excellence in men’s health,bone disease and genetic aspects ofneurodegenerative disorders. Animportant feature is the multidisciplinarynature of many of the studies.Research activity in 2005/06 has increasedby 20 per cent over the previous year.14 Year in Review

FacilitiesDepartment ofForensic MedicineGeneral ManagerMark PattersonThe Department of Forensic Medicine(DOFM) provides forensic medicineservices to the NSW State Coroner andstatewide support for forensic medicinepractitioners in all areas of autopsy-basedand clinical forensic medicine.DOFM is the premier forensic medicineeducational body for undergraduate andpostgraduate students in NSW.Its expertise includes Disaster VictimIdentification (DVI), aviation medicine,bereavement counselling, medicalinvestigation of crime scenes, pre-trial andtrial advice, provision of second opinionsand presentation at medico-legalseminars.The NSW Bone Bank (St George Hospital)began accessing bone donations throughDOFM. Strict adherence to the provisionsof the Human Tissue Act is maintained,with next-of-kin consent essential for anyretrieval to take place.DOFM continued to provide expertassistance to outside organisations, withstaff being seconded to the AustralianFederal Police to undertake DVI proceduresin Bali, Jakarta and Irian Jaya.DOFM representatives continue to serveon the Forensic Pathology ServicesCommittee of the NSW Department ofHealth and to provide high-level advice tothe Department on optimum structuresand arrangements for forensic pathologyservices to support the NSW coronialsystem.FairfieldHospitalGeneral ManagerMark ShepherdFairfield Hospital is a 218-bed majormetropolitan acute general hospitaloffering services in medicine, surgery,obstetrics, paediatrics and emergencymedicine and a range of community-basedservices. The Whitlam Joint ReplacementCentre is located here and provides electiveorthopaedic services for the Liverpool-Fairfield and Macarthur communities.A newly acquired echocardiographymachine has led to enhanced diagnosticsand improved management for patientswith heart disease. The introduction ofmobile cardiac monitoring within themedical ward has resulted in earlierdetection and improved treatment forcardiac patients.A new ultrasound machine and increasedstaffing now allow pregnant clients to haveroutine ultrasound done at the hospital,avoiding the need for referrals.There were no patients waiting longerthan 12 months for surgery at the end ofthe last financial year.The University of New South Wales hasinvited Fairfield Hospital to become oneof its affiliated teaching hospitals inrecognition of its contribution to medicalteaching in joint replacement surgery,which increased by 27 per cent during thefinancial year.The hospital has been awarded a four-yearaccreditation by the Australian Council forHealthcare Standards (ACHS) following anorganisation-wide survey.Fairfield Hospital’s Senior OrthopaedicPhysiotherapist, Tyson Russell, supervising patientOve Lassen with water-based rehabilitationexercises after joint replacement surgery. TheWhitlam Joint Replacement Centre, located atFairfield Hospital, performs up to 400 jointreplacement procedures each year, and isa centre for research.Sydney South West Area Health ServiceYear in Review 05>06 15

FacilitiesKaritaneChairman Board of DirectorsProfessor Bryanne BarnettExecutive ManagerMr Robert MillsKaritane operates from four sites –Carramar, Fairfield Heights, Liverpool andRandwick. Its philosophy is to enhanceparenting knowledge, skills andconfidence, allowing clients to make asuccessful adjustment to parenthood.Karitane also offers a 24-hour Careline toprovide information and support toparents. There is a strong focus onresearch activities.Karitane has consulted and collaboratedon many projects during 2005/06,including the Juvenile Justice Mother andChildren’s Project. Karitane is also activelyinvolved in the development of the NSWHealth Child and Family Health NursingPractice Standards Framework and isrepresented on the NSW Health Childrenand Young People’s Health PriorityTaskforce.A number of innovative programs toprovide outreach education services wereimplemented, including the KaritaneEvening Parenting Education seminars andthe Karitane Rural Professional EducationService. Demand across NSW has beenhigh for the specialised trainingworkshops provided for professionalssupporting families with toddlers andpreschoolers with behaviour difficulties.Planning for Karitane’s $4.5 million capitalredevelopment program is complete andbuilding works will commence in October2006. The program will be funded fromKaritane’s trust funds and a NSW Healthgrant of $1 million.New capital works on the Carramar sitewill include an expanded education andresearch facility with a conference venueand an outreach service.Liverpool HospitalGeneral ManagerDr Teresa AndersonLiverpool Hospital is the tertiary referralhospital for south western Sydney, providingmedical, surgical, emergency medicine,intensive care, oncology, mental health,women’s health and newborn care services.It is a major trauma centre for NSW and hasa strong commitment to teaching andresearch across a wide range of disciplines.A $9.2 million refurbishment of the ED morethan doubled the unit’s size, and patientsmoved into the new $32.5 million MentalHealth Centre early in 2006. The hospitalalso participated in the NSW Health clinicalredesign project for emergency mentalhealth.Clinical services were enhanced by thecommissioning of a new PET-CT scanner,an additional ultrasound machine and theopening of the Respiratory FunctionLaboratory. An Extended Day Only Unit wasopened in March, designed to improvepatient flow by having elective short staysurgical patients monitored in the unit priorto discharge.The number of patients waiting morethan 12 months for surgery has beenreduced to zero, with a significant decreasein the overall number of patients on surgicalwaiting lists.The Stage 2 Redevelopment of LiverpoolHospital will be a major focus over thenext five to ten years. Development of theProject Definition Plan for submission toNSW Health commenced and it isexpected that building work will startin 2006/07.Liverpool nurses Zendy Galindo RN, MichelleFalzon Trainee EN and April Royeras UGprepare to test their skills in the InternationalNurses Day bed-making competition.16 Year in Review

Royal PrinceAlfred HospitalExecutive Director Di GillRoyal Prince Alfred Hospital (RPA) is aprinciple provider of specialist healthcareand one of the leading medical teachinghospitals in Australia. The wide range ofservices provided include the NationalLiver Transplant Unit, renal dialysis andtransplant services, emergency, traumaand intensive care services, medicalimaging, cardiology and cardiothoracicsurgery, women’s and children’s health,the Institute of Rheumatology andOrthopaedics, respiratory medicine andcancer services (including the MelanomaUnit), the Breast Cancer Institute and theSydney Cancer Centre.RPA has placed significant emphasis onprocesses and systems in order to improvepatient flow throughout the hospital.Strategies focused on eight main areasand led to significant improvementsacross the majority of key performanceindicators in a period, with an 8.6 per centincrease in the number of patientspresenting to the ED.The hospital also successfully reached theNSW Health target of zero long waitpatients by the end of June 2006.The capital works development programhas continued, with Stage 2a constructionof laboratory services and pharmacycommencing in mid-November 2005.RPA achieved its four-year accreditationstatus following an organisation-wideACHS survey conducted in October 2005.Preparations have commenced for the125-year anniversary of RPA, with anumber of exciting events planned for thecelebrations in September 2007.RozelleHospitalA/General ManagerClair EdwardsRozelle Hospital is the largest mentalhealth inpatient service in SSWAHS, witha total of 219 beds. Services include adultacute units, an intensive psychiatriccare unit, older persons’ mental health,inpatient drug health, and rehabilitationand recovery services. The siteaccommodates a number of nongovernmentorganisations, specialprojects and the mental healthadministration for the eastern zone.A 12-bed acute unit was commissioned toassist the reduction of access block inemergency departments in the westernzone of SSWAHS. The Intensive PsychiatricCare Unit increased capacity from 10 to 12beds and underwent minor renovations toimprove facilities for patients.Two $10,000 scholarships were awardedto senior clinical and research nursingstaff to improve models of care in mentalhealth service provision.Dr Greg Kesby, head of high-risk obstetrics at RPA.Completion of the 174-bed Mental HealthPrecinct at Concord Hospital is planned forMarch 2008. This will see the transfer ofinpatient services from Rozelle Hospital tothe new purpose-built facility in mid-2008, improving the environment inwhich staff provide quality mental healthcare to people within SSWAHS. The AreaMental Health Service has developed atransition management plan to assist themove to the new precinct.In recognition of the ageing infrastructureof buildings used by the inpatient services,significant work has been undertaken,prior to relocation, to complete firecompartmentation and separation inpatient areas. Work continues to maintainheritage buildings, the Chinese Gardensand fountains on the grounds withassistance from NSW Health and theDepartment of Planning.Sydney South West Area Health ServiceYear in Review 05>06 17

FacilitiesSydney DentalHospitalGeneral ManagerGraeme AngusArea Clinical Director AssociateProfessor Sameer BholeThe Sydney Dental Hospital (SDH) is oneof two dental teaching hospitals in NSW,and provides a range of specialist services,including paediatrics, orthodontics,periodontiocs, oral surgery, prosthodontics,endodontics and implantology.Through its Special Care Dental Unit, theSDH also provides services to the frailelderly, and to people with chronic mentalhealth conditions, drug dependencies andserious medical conditions. The special careunit conducts a weekly outreach service tonursing homes and holds several seminarseach year instructing carers in oral hygienemethods.An overseas recruitment campaignundertaken by the NSW Centre for OralHealth Strategy has led to overseasdentists applying for positions with theSDH and our community oral health clinics.The Department of Health provided OralHealth Services with funding of $480,000to purchase 22 digital X-ray machines forthe SDH Community Oral Health Clinicand the Oral Surgery Department. Threedental chairs were also purchased toreplace existing chairs at the Concordclinic.Head of Peridontics, Dr Barbara Taylor,published results of a study showing asignificant reduction in risk factors forcardiovascular disease after treatmentfor severe gum disease. This study, acollaboration between Dr Taylor, Dr GeoffTofler from Royal North Shore Hospitaland Norwegian researchers, has generateda high level of interest both locally andoverseas.Relationships with universities andtraining organisations currently offeringdental degrees in NSW continue to beexpanded, strengthening the hospital’sleadership role in graduate andpostgraduate training.Tresillian FamilyCare CentresGeneral ManagerDavid HannafordPresident of CouncilBob Elmsie OAMThe child and family health professionalsat Tresillian Family Care Centres offeradvice to families with a baby or child upto five years old. Tresillian also deals withmany women who have complex mentalhealth issues such as postnatal depression.The Tresillian Parents Help Line operates24 hours a day, seven days a week and isfree for rural callers.Tresillian has three residential units, atCanterbury, Willoughby and Nepean, andthree day stay units, at Wollstonecraft,Canterbury and Nepean. Outreach Teamsoperate from Wollstonecraft andCanterbury.Dr Cathrine Fowler was appointed to theposition of Tresillian Chair in Child andFamily Health at the University ofTechnology, Sydney (UTS) Centre forMidwifery and Family Health – a jointappointment between UTS and TresillianFamily Care Centres. Tresillian Council hasfunded the chair for five years.This appointment follows the launch ofthe Graduate Certificate in Child andFamily Health Nursing in partnership withUTS, which has brought the longstandingTresillian Nursing Education Program intoa university setting. The first cohort ofstudents began at UTS early inMarch 2006.In February, ninemsn funded a six-monthground-breaking pilot program providingonline advice for new mothers. Thepartnership, Messenger Mums, allows newmothers to contact a Tresillian Child andFamily Health Nurse for advice, 20 hours aweek, via ninemsn’s leading instantmessaging service, MSN Messenger.Students from Ashfield Boys and Ambarvalehigh schools visited the Sydney Dental Hospitalto be fitted with mouth guards in the colours ofthe Wests Tigers Rugby League team. They arepictured here with Dr Soni Stephen, head ofpaediatric dentistry at the SDH.18 Year in Review

Photo: Jeff de Pasquale, The Camden Advertiser.These happy new mums were some ofthe first to deliver their babies through theCamden Midwifery Group Practice, a new servicewhich offers women with low-risk pregnancies theoption of having the same midwife throughouttheir pregnancy care, birth and beyond.create betterexperiencesSydney South West Area Health ServiceYear in Review 05>06 19

clinical groupsPopulationHealthDrug HealthServicesOral HealthServicesDirector AssociateProfessor PeterSainsburyPopulation Health deliversevidence-based programsdesigned to improve the healthof the population, reducehealth inequalities and addressgaps in services. It includes theHealth Promotion Unit, thePublic Health Unit, theResearch, EvidenceManagement and SurveillanceService (REMS), the HIV/AIDSand Related ProgramsCoordination Unit and theCentre for Health EquityTraining, Research andEvaluation (CHETRE).Population Health has been anactive partner in the GreaterWestern Sydney Health ImpactAssessment Project, examiningthe health impacts of urbandevelopment proposals ingreater western Sydney.The Health Promotion Unitbegan a nurse home-visitingprogram, Healthy Beginnings,aimed at reducing childhoodobesity from birth byimproving first-time mothers’approaches to healthy feedingand active play for children.The Public Health Unitprovided 26,000 vaccinations tochildren in 168 schools and codeveloped,with a CounterDisaster Unit, the draft plan forresponding to pandemicinfluenza.Director Karen BeckerDrug Health Services (DHS)operates across 23 sites,including 9 hospitals and17 community healthfacilities. Services include theOpioid Treatment Program(methadone andbuprenorphine clinics),counselling, specialist medicalclinics, inpatient withdrawalmanagement (detoxification),inpatient rehabilitation,outpatient withdrawalmanagement, court diversionprograms, harm minimisation(including needle syringeprograms), hospitalconsultation and liaisonservices, community outreach,tobacco cessation clinics and arange of associated projectsthat address key clinical issuessuch as Aboriginal health andco-morbidity.A range of initiatives toprogress the amalgamationof DHS as an Area-wideservice resulted in increasedcoordination, resourceefficiencies and enhancementsto models of clinical care.The State Wide Advisory Teamis involving GPs andcommunity pharmacies in thetreatment of opioid-dependentpatients through a number ofconsultations and trainingprograms.An Aboriginal LiaisonOfficer, based at Fairfield,was appointed in Februaryand an Aboriginal Women’sSupport Group at RPA OpioidTreatment Clinic commencedin June.Access to and dischargefrom detoxification andrehabilitation services hasbeen improved. Solid clinicalpartnerships continue to bemaintained with the RedfernAboriginal Medical Services,and DHS is also working closelywith the Redfern WaterlooAuthority to address issues ofpublic alcohol consumption.Clinical services for the highriskpopulation of pregnantdrug-using women include twoclinical nurse consultants whocoordinate teams focusing onearly intervention.SSWAHS offers four dedicatedtobacco cessation clinics.Nicotine replacement therapyis also available to SSWAHSstaff.Area Clinical DirectorAssociate ProfessorSameer BholeGeneral ManagerMr Graeme AngusOral Health Services,incorporating the SydneyDental Hospital (SDH), providesgeneral dental services foreligible people residing inSSWAHS. The SDH is also amajor referral centre fortertiary oral healthmanagement.The community oral healthclinics provide general dentalservices to both eligible adultsand children at their clinics. TheSchool Assessment Programprovides an assessment andtreatment service to children.Integration of the InformationSystem for Oral Healthdatabase was completed in2005/06 ahead of schedule.The appointment of theassociate director clinicaloperations for the CommunityOral Health Service, along withthe three service managers forthe eastern, central and southwest clusters, has assisted theclinical and corporate functionsof the recently merged service.The acquisition of 22 digitalradiography units for theCommunity Oral Health Clinicat the SDH has seen thehospital become the biggestprovider of digital radiographyin Australia and hasdramatically improved clinicalefficiency.20 Year in Review

Mental HealthServicesClinical DirectorDr Victor StormThe Area Mental Health Serviceprovides clinical inpatient andcommunity-based services,including early intervention,acute assessment and treatment,rehabilitation, communitysupport, consultation/liaison,dietary disorders, and geriatricpsychiatry. It also conductsextensive education, trainingand research activities.The new 50-bed LiverpoolHospital Mental Health Centreopened in February, consolidatingall adult mental health inpatientand outpatient clinical servicesin one two-storey, purpose-builtbuilding. It provides a base forthe Liverpool communitymental health services andaccommodation for research,teaching and administrativeservices.A collaborative project betweenArea Mental Health and CatholicHealth Care has enabled elderlypatients with long-term needsto be cared for in purpose-builtaccommodation in CatholicHealth Care’s Holy Spirit facilityat Croydon.Construction of the new 20-bedsub-acute mental health facilityat Campbelltown has beencompleted.The Marrickville Acute CareMental Health Team wasawarded the Local AreaCommander’s Certificate ofAppreciation by CommanderVicky Arena and CommissionerKen Moroney.Planning is well advanced forthe move of clinical servicesfrom Rozelle Hospital to a newmental health campus atConcord Repatriation GeneralHospital in 2008.Above: Member for Menai AlisonMegarrity, Minister Assisting theMinister for Health (Mental Health)Cherie Burton, Premier Iemma,Minister Hatzistergos, generalmanager Liverpool Hospital TeresaAnderson and Area clinical directorMental Health Services Dr VictorStorm at the opening of the$32.5 million Mental Health Centreat Liverpool Hospital in February.Middle: Staff at the NSWService for the Treatment andRehabilitation of Torture andTrauma Survivors (STARTTS).The service, a world leader in itsfield, is located at Carramar insouth west Sydney. Left to right:Marni Issa, Lana Joseph, CarmelaMorano, Marla Camacho, ClaudiaBorquez and Alison Russell.Right: Artist Pierre Comarmondand Rotary Greenway’s RickSassin pictured in front of Nirvana,a stained glass window in thecontemplation room at LiverpoolHospital Mental Health Centrewhich was purchased with a$1,000 grant from RotaryLiverpool Greenway.Sydney South West Area Health ServiceYear in Review 05>06 21

Clinical GroupsAllied HealthServicesCancerServicesProfessor Bruce Armstrong,director of Cancer Research atthe Sydney Cancer Centre.Clinical DirectorDr Katherine MooreAllied Health includes theprofessions of physiotherapy,podiatry, psychology, speechpathology, social work,orthoptics, nutrition anddietetics, occupational therapyand orthotics, as well as libraryservices and health careinterpreter services. AlliedHealth professionals work inpartnership with clients andtheir families to optimisephysical and psychosocialfunction and develop healthylife skills.A nutrition service wasprovided to the HIV clinic atBigge Park Centre, Liverpool,and dietetics staff wereinvolved in a new educationservice for pregnant women atFairfield Hospital. Malnutritionscreening was introduced atConcord, RPA and Canterburyhospitals for earlyidentification of patients atrisk of malnutrition, and a newrenal pre-dialysis clinic was setup in conjunction with a nurseand a social worker inCampbelltown.At Bankstown Hospital, aninflammatory bowel diseaseoutpatient nutrition clinic wasset up, and a new groupprogram has been establishedfor young male haematologypatients to help themunderstand and cope withtheir cancer.The Women and Children’sHealth Social Work Team, inconjunction with newborn carestaff and the Department ofCommunity Services, ran asuccessful program for fostercarers of babies with neonatalabstinence syndrome.Director ProfessorChris O’BrienCancer Services is responsiblefor approximately 16 per centof the state’s cancer burden,with approximately 5,300 newcancers diagnosed in the Areaeach year. There are alsosignificant inflows of cancerpatients in the eastern zonefrom referrals made fromregional NSW to the SydneyCancer Centre.Services are delivered througha network of three centres –the Sydney Cancer Centre (acollaboration in cancer carebetween RPA, Concord Hospitaland the University of Sydney),the Liverpool Cancer TherapyCentre (CTC) and theMacarthur Cancer TherapyCentre. There is also a CancerUnit at Bankstown. Outreachservices are provided throughthe Sydney Cancer Centre topatients in the Greater WesternArea Health Service at Dubbo.The Area Cancer Service isclosely linked with the CancerInstitute (CI) NSW. SSWAHS isone of five areas selected bythe CI NSW for development ofthe Clinical Cancer Registry.Three new linear acceleratorshave been installed at RPA, anda new linear acceleratorinstalled at Liverpool has beencommissioned. Campbelltownhas two linear accelerators.Waiting times are now athistorical lows for patientsrequiring radiotherapy.In the western zone, ProfessorMichael Barton has beenappointed to the Chair inRadiation Oncology, jointlyfunded by CI NSW, theUniversity of New South Walesand SSWAHS. Planning isunderway for the $390 millionredevelopment of LiverpoolHospital and the Liverpool CTC.The appointments of ProfessorBruce Armstrong, director ofCancer Research, and Ms AnneLunnon as executive officer(research) will significantlyenhance researchdevelopments.The large historicaldepartmental databases of theSydney Cancer Centre are beinglinked into a common platform– SCORPIO – which in turn willbe linked to both radiationoncology at RPA and themedical oncology electronicmedical record.22 Year in Review

AboriginalHealthArea DirectorVicki WadeThe Area-wide AboriginalHealth Service providescomprehensive services to theAboriginal communities ofRedfern, Glebe, Marrickville,Bankstown, Fairfield, Liverpool,Macarthur and Wingecaribee.Service delivery is flexible, witha number of programs offeredas outreach services.Priorities in Aboriginal Healthinclude vascular health,diabetes, chronic care, mentalhealth, drug and alcohol,sexual health, healthpromotion, oral health, childand maternal health, andaged care.Aboriginal Health works inpartnership with other clinicalservices and departmentsto provide high-qualitymultidisciplinary care and hasformal partnerships with localAboriginal CommunityControlled Health Services(Redfern and Tharawal).Programs are based on localAboriginal community needs,the best evidence available, theappropriateness of proposedinterventions and the potentialfor impact on improvingAboriginal health status.The Aboriginal Health Serviceworks within the Two WaysTogether framework,advocating a whole-ofgovernmentapproach toimproving the health ofAboriginal people.Sydney South WestPathology Service (SSWPS)Co-directorsAssociate ProfessorPeter Stewart andProfessor David DaviesSSWPS began operating asan Area-wide service in 2005.In 2005/06, SSWPS respondedto 2.55 million requests andgenerated 7.5 millionindividual laboratory testsacross the full range ofanatomical pathologydisciplines, including cytology,chemical pathology,haematology and bloodbank, and areas of advancedspecialised testing such asmolecular genetics.SSWPS staff provide onsitelaboratory services at allSSWAHS hospitals. Staff arealso involved in education atSydney and New South Walesuniversities, and the service hasa significant research program.The laboratory informationsystem has been substantiallyrestructured. Results of alltests are now viewable in allSSWAHS facilities, and astructured system ofpasswords ensuresconfidentiality. Progressis also being made instandardising equipment.Redevelopment of facilities atConcord Hospital is close tocompletion, and constructionof new laboratories at RPAcommenced in December.Planning for the majorredevelopment of LiverpoolHospital and its laboratorieshas begun.Gail Smith (right), AboriginalDay-care Co-ordinator, withmembers of the Miller CommunityHealth Centre’s Aboriginalwomen’s elders group.Signing the partnership agreement at Tharawal Aboriginal Corporation(TAC) (from left): Co-ordinator Aboriginal Health (western zone) BrendonKelaher, Chairperson Tharawal Board Charlie Mundine, Health MinisterJohn Hatzistergos, Representative of Aboriginal Health and MedicalResearch Council Melinda Bell, SSWAHS Director of Population HealthPlanning and Performance Dr Greg Stewart and Chief Executive OfficerTAC Darryl Wright, with performers from Yidaki Didg and Dance Australia.Sydney South West Area Health ServiceYear in Review 05>06 23

eastern zoneBone, Joint and ConnectiveTissue ServiceClinical DirectorDr Peter HolmanThe Bone, Joint and ConnectiveTissue Service includes theclinical specialties oforthopaedics, rheumatology,immunology and allergy,plastics, reconstructive surgery,HIV, HIV dementia, sportsmedicine, infectious diseasesand trauma, and is provided atthe Institute of Rheumatology(IRO) at RPA, and orthopaedicsat Concord and CanterburyHospitals.Equipped with an operatingtheatre, bone bank, preadmissionclinic, diagnosticservices (including radiographyand bone mineraldensitometry), andtherapeutic services (includinghydrotherapy), IRO provides aone-stop service for patientswith rheumatology andelective orthopaedic needs.The OrthopaedicDepartment at Concordprovides comprehensiveinpatient, ambulatory andoutpatient services and hasclose working relationshipswith specialties includingmetabolic bone disorders,geriatrics, rheumatology,nuclear medicine andrehabilitation. Services areprovided to the generalcommunity and at tertiaryreferral level, with specialexpertise in the reconstructionand replacement of majorjoints. A range of clinicalresearch and teaching activitiesare also undertaken.CardiovascularServicesClinical DirectorProfessor Philip HarrisCardiovascular Services is amultidisciplinary serviceincorporating the clinicalspecialities of cardiology,endocrinology, nephrology,renal transplantation andcardiothoracic and vascularsurgery at RPA and Concordhospitals.Renal transplantation achievedoutstanding clinical outcomesat or above Australian and NewZealand benchmarks in 2005/06.The rural outreach program hasagreements in place to providecomprehensive professional andclinical support to NSW ruralregions.At RPA the first application of insitu Split Liver Transplantationtechniques in Australia hasresulted in more patientssurviving with excellent clinicaloutcomes.Jane Ransford of Strathfieldcelebrated her 100th birthday instyle with her many friends at theKindilan Day Centre, one ofConcord Hospital’s general geriatricand rehabilitation facilities.There has also beena significant reduction inwaiting times for paediatricliver transplants despite fallingdeceased organ donor rates.Laparoscopic techniques forliving kidney donor surgery isminimising the physical burdenof donation and is expected tolead to a 50 per cent increasein the number of living kidneytransplant procedures in2006/07.The RPA CardiothoracicDepartment was recognisedas the national benchmark forquality of training of registrarsand fellows by the RoyalAustralasian College ofSurgeons. More than 600 heartoperations were performed bythe cardiothoracic surgicalteam.The Concord CardiologyDepartment has had anoutstanding year of researchand development, with twoPhD students supervised bysenior cardiologists awardedprestigious prizes from theCardiac Society of Australia andNew Zealand. Royal AustralianCollege of Physiciansaccreditation has beenawarded in recognition of theadvanced training andeducation program developedin the Department ofEndocrinology at ConcordHospital.The RPA Diabetes Centreprovided almost 10,000services to over 3,250 patients,including referrals from outsideSSWAHS.24 Year in Review

Clinical GroupsGastroenterology andLiver ServicesClinical DirectorProfessor Les BokeyGastroenterology andLiver Services offers amultidisciplinary approach ingastroenterology, uppergastrointestinal, colorectal,hepatobiliary, liver transplantand general surgery at Concord,RPA and Canterbury hospitals.Transplantation servicescelebrated the 20thanniversary of livertransplantation at RPAand pioneered a uniquesurgical technique in a tripletransplant procedure of liver,pancreas and kidney.Additional operating time hasbeen allocated at ConcordHospital’s division of surgery,ensuring more patients haveaccess to surgery withinrecommended timeframes.RPA’s gastroenterology unit hasintroduced the technique ofdouble-balloon enteroscopy.Capsule endoscopy has beenused to investigate small bowelCrohn’s disease.The Department ofGastroenterology andHepatology at Concord is oneof the busiest endoscopydepartments in NSW and is atraining centre for advancedendoscopy techniques.The upper GI Units at RPA andConcord provide tertiaryreferralhepatobiliary andcomplex endosurgicalprocedures. Complex liverresections are offered at RPA,and complex oesophagealsurgery is offered at Concord;both are available as statewideservices.The Concord and RPAColorectal Units are bothtertiary-referral centres. TheRPA Colorectal Unit continuesits surgical outcomes andattitudinal research. TheConcord Colorectal Unitcontinues its research intocolorectal cancer outcomes,tissue banking and proteomics.Both units are involved inpostgraduate training, andConcord runs the Sydneycolorectal surgical course,which involves surgeonsfrom both units.General, Geriatric andRehabilitation MedicineClinical DirectorDr John CullenGeneral, Geriatric andRehabilitation Medicine (GGRM)provides multidisciplinaryservices for the elderly, peoplewith disabilities and those withgeneral medical problems ininpatient, ambulatory careand community settings.The Centre for Education andResearch on Ageing (CERA)at Concord Hospital is animportant component ofGGRM.The Aged Care andRehabilitation Precinct atConcord Hospital was openedin December, co-locating allGGRM inpatient andambulatory care services,community teams,administration and researchprograms.A substantial and sustainedfall in Community Aged CareAssessment Team waitingtimes has been achieved bythe Concord and Canterburyteams.GGRM continues to workwith local divisions ofGeneral Practice in theCommonwealthGovernment’s Aged CarePanels to improve the qualityof medical care in residentialaged care facilities.A carer education projectwas completed withPathways Home funding.Carer education kits havebeen distributed to over250 local carers.Clinical Associate Professor Peter Bye, winner of the RPA Medal forExcellence in Research for the development of hypertonic saline therapy,an inexpensive natural therapy for people with cystic fibrosis.Sydney South West Area Health ServiceYear in Review 05>06 25

Clinical GroupsMedicalImagingServicesClinical DirectorProfessor MichaelFulhamMedical Imaging (MI) Servicesuse highly specialisedtechnology to provide picturesof the structure and functionof the body for diagnosis andtreatment of a variety ofmedical conditions. Scansrange from simple proceduressuch as an X-ray of the chest ora limb to more complicatedstudies such as CT, MR andPET-CT and interventionalprocedures where aneurysmscan be treated. The complexityof the imaging workloadcontinues to increase.New multi-slice (64 slice)CT scanners were installed atConcord and RPA hospitals.These scanners allow fasterpatient throughput andimproved image quality, andcan be used in the assessmentof cardiac disease. A SPECT-CTdevice was also installed atConcord Hospital.MR services at Concord havecontinued to expand since theinstallation of the 3.0T scannerlast year, and a new ultrasoundand day stay unit has openedto cope with the increasingdemand for this technology.Clinical indicators developedat RPA in the Department ofPET and Nuclear Medicine havebeen adopted by the AustralianCouncil for HealthcareStandards (ACHS) for useacross the country.NeurosciencesClinical DirectorAssociate ProfessorMichael BesserNeurosciences includes thespecialties of neurosurgery,neurology, neuropathology,otolaryngology, ophthalmologyand pain management.Up-to-date modernophthalmological equipmenthas been installed across theArea in conjunction with theHearing and Balance Unit toprovide an overall first-classneuro-ophthalmological service.The cochlear implant servicecontinues to provide spectacularresults in restoration of hearing.A pain fellowship has beenestablished which willconsiderably improve bothacute and chronic pain servicesin the Area.The interventional neurovascularservice has been considerablystrengthened by theappointment of a neurosurgeonwith endovascular training,as well as the additionalappointment of aneuroradiologist.A clinical trial in haemorrhagicstroke, known as the FAST Trial,is currently in progress at theStroke Unit and shows promisefor limiting neurologicaldeterioration in brainhaemorrhage.Respiratoryand CriticalCare ServicesClinical DirectorAssociate ProfessorPaul TorzilloRespiratory and Critical CareServices incorporatesemergency medicine, intensivecare, respiratory medicine andanaesthetic services acrossSSWAHS eastern zone.Intensive care services provideboth intensive care and highdependencycare to thehospitals within this area andto the state, as required by theStatewide Medical RetrievalService.Emergency departments havebeen striving to improve theirtarget achievements in aclimate of increasedpresentations by both walk-inpatients and ambulancepresentations. Respiratorymedicine continues to see adecrease in total admissionnumbers, predominantlyinfluenced by a reduction inadmission for patients withchronic obstructive pulmonarydisease.The Chronic Care Project(Chronic ObstructivePulmonary Disease) program,which includes pulmonaryrehabilitation, has delivered theexpected support to thesepatients within the community.The tuberculosis service hasbeen consolidated acrossboth zones and delivers acomprehensive public healthservice in collaboration withthe adjoining area healthservices.Women’sand Children’sHealthClinical DirectorDr Andrew ChildWomen and Children’s Healthincludes the clinical specialitiesof obstetrics, ultrasound andfetal medicine, neonatology,paediatrics, gynaecologicaloncology, reproductiveendocrinology and infertilityand general gynaecology(which includes the sub-unitsof urogynaecology andendogynaecology).A steady increase in the birthrate across Australia has seenan increase in our maternityservices of 10 per cent.Improvements in obstetricservices have includedincreased involvement of GPsin antenatal care, purchase ofstate-of-the-art ultrasoundequipment, and improvedinpatient facilities for antenatalpatients to cope with both theincreasing medical complexityand age of our pregnantpopulation. An additional highdependencycot was opened inthe RPA neonatal intensivecare unit.In gynaecology there has beena significant increase inoutpatient attendances, andthe early pregnancyassessment service hasprovided a valuable resourcefor both local GPs and ouremergency department. Linkswith Sydney IVF have provedinvaluable, and our RPA IVF unithad very creditable successrates and was commendedduring a recent accreditationvisit.26 Year in Review

care in thecommunityCommunity nurseMarilyn Pattrickfrom the MacarthurAmbulatory CareUnit visits GeorgeSargent at home.Sydney South West Area Health ServiceYear in Review 05>06 27

western zoneCardiovascularClinical DirectorDr Bruce FrenchRenal MedicineArea Director DialysisServicesAssociate ProfessorMichael SuranyiRenal Medicine Services areprovided by seven nephrologistsand staff. Renal care ispredominantly ambulatory,and is provided at Liverpool,Bankstown, Fairfield,Campbelltown and Bowralhospitals. Inpatient care isprovided only at Liverpool andBankstown hospitals, withcomplex renal inpatientsmanaged at Liverpool. Dialysisservices have been expanded atBankstown and Campbelltownhospitals and dialysis services atFairfield and Bowral hospitalswill commence in the next year.All physicians are involved ineducation of medical students,junior medical staff and localGPs, and all consultantscontribute to projects throughthe Liverpool Renal ResearchCentre. The unit has collaboratedwith eastern zone renalphysicians in producing an Areawidemodels of care proposal inlate 2005. The unit has beeninvolved in screening forvancomycin resistantenterococcus (VRE) in dialysispatients. The unit benchmarksits dialysis outcomes dataagainst Australian and NewZealand centres. Outcomes areat least equivalent to the pooledoutcome data in the ANZ DATAregistry.Cardiac ServicesArea DirectorDr Andrew HopkinsCardiology units are based atall western zone hospitals.Liverpool Hospital providesdiagnosis and interventionalcatheter laboratory facilities,as well as electrophysiologyservices. Bankstown, Liverpool,Fairfield and Campbelltownhospitals provideechocardiography services,with all except Fairfieldcurrently providing an activetransoesophagealechocardiography service.Liverpool Hospital has an activeresearch unit, headed byProfessor John French. AnArea-wide cardiac networkcommittee has overseen theintroduction of protectednetwork beds at LiverpoolHospital and same-day transferfollowing angioplasty. Thegroup has implementeduniform chest pain protocolsin all hospitals and theintroduction of 24-hourprimary angioplasty for acuteSTEMI at Liverpool Hospital.Morbidity and mortalitymeetings are active in allcardiology units, and all unitsare involved in education.There is an increasing demandfor acute cardiology services,and the acquisition andmaintenance of clinicalinfrastructure is an importantongoing task. Research is anongoing priority.Cardiothoracic SurgeryDepartment HeadDr Bruce FrenchThe Cardiothoracic SurgeryDepartment is included underCardiac Services. Cardiothoracicsurgery is a western zoneservice based at LiverpoolHospital. The unit is staffed byfour cardiac surgeons, with oneproviding most of the thoracicsurgery care. Elective andemergency adult cardiac andthoracic surgery is provided atLiverpool Hospital, and aconsultative service is offeredto Bankstown, Fairfield,Campbelltown and Bowralhospitals. The unit has closeworking links with allcardiology departments, theLiverpool anaestheticdepartment and the Liverpoolintensive care department.The thoracic surgerycomponent has close workinglinks with respiratory medicineand oncology services in allArea hospitals. Consultants areinvolved in teaching activitiesfor medical students, juniordoctors and generalpractitioners. Cardiothoracicsurgery research activities areheaded by Dr Rebecca Dignan,and there is considerableliaison with the CardiologyResearch Unit. Dr Dignan isalso the supervisor of training(RACS). There is a cooperativeworking relationship with theelectrophysiology service fordefibrillator implantation.28 Year in Review

Clinical GroupsChild,Youthand FamilyClinical DirectorDr Andrew McDonaldChild, Youth and Familyprovides inpatient, outpatient,ambulatory (home-basedinpatient) and community carefor children in the areas servedby Bankstown, Fairfield,Liverpool, Macarthur andBowral hospitals. LiverpoolHospital also houses thewestern zone NewbornIntensive Care Unit (NICU).Dr Andrew McDonald hasbeen appointed an AssociateProfessor at the University ofWestern Sydney.There are now multidisciplinaryassessment teams acrossSSWAHS, based at Fairfield,Liverpool and Campbelltown, allof which employ registrars andhave an in-house trainingprogram for communitypaediatrics. Campbelltown andLiverpool NICUs have 24-hourregistrar cover.Fairfield has an active teachingprogram in undergraduate andpostgraduate paediatrics,including preparation for theFRACP exam.Innovations such as nitrousoxide sedation and courses inneonatal resuscitation havebeen introduced to theFairfield ED.Staff specialists (1.5 full-timeequivalent) have beenappointed to Bankstown toestablish a paediatricambulatory care service, withsignificant improvements to thelevel of on-site supervision andteaching of the residentmedical staff.Two full-time equivalentpaediatric staff specialists havebeen appointed at BowralHospital.Complex Careand GeneralPracticeClinical DirectorProfessor Brad FrankumComplex Care and GeneralPractice covers respiratorymedicine, ambulatory care,general medicine, generalpractice (including the GeneralPractice Unit at FairfieldHospital), neurology, aged care,rehabilitation, brain injuryrehabilitation, clinicalimmunology, clinical infectiousdiseases, rheumatology,diabetes and endocrinology, anddermatology. Clinical geneticshas also moved into this stream.All specialities provide inpatient,outpatient and ambulatory andcommunity services acrossthe western zone. Patientpresentations continue to rise,resulting in increasing workloadfor all of these specialities.The first fully functioning yearof Complex Care and GeneralPractice has seen greatcooperative effort among allsub-specialities, with anemphasis on service planning,service delivery, and qualityimprovement.Increases in staff numbers haveoccurred in senior medical,senior nursing and Allied Healthpositions, as well as in juniorpositions across the spectrum.A pulmonary functionlaboratory has been establishedat Liverpool Hospital andneurology services have beenexpanded at CampbelltownHospital. Diabetes services havebeen expanded across the zone.Immunology and rheumatologyservices were expanded atLiverpool Hospital, andrehabilitation services wereenhanced at Camden andCampbelltown hospitals.Critical CareClinical DirectorProfessor Ken HillmanCritical Care includes thespecialties of anaesthetics,emergency medicine, intensivecare, pain and perioperativeservices.Acute pain services wereestablished at Camden andCampbelltown hospitals and aclinical nurse consultant wasappointed in March. TheLiverpool Pain and ResearchCentre purchased a new imageintensifier to support theadditional numbers ofprocedures being performed inthe unit.Funding was provided tosupport additional nursingpositions in the EDs atLiverpool, Camden andCampbelltown.Above: Participants in the Dads4 Dads project at BankstownHospital.Left: Dr Jenny McDonald with ayoung client at the launch of theMacarthur Child Assessment Team(CATs) launch at CampbelltownHospital. CATs providesmultidisciplinary assessments,diagnosis and referrals for localpre-schoolers and infants withcomplex developmental delays anddisabilities.Intensive care services receivedfunding for additional beds atBankstown, Campbelltown andLiverpool.Various initiatives have beensuccessful in improving EDaccess block, including asuccessful Fast Track system atBankstown. The EmergencyShort Stay Unit was opened atLiverpool Hospital in April.An academic position inemergency medicine wasestablished with theappointment of AssociateProfessor Anna Holdgate inAugust 2005. A director ofemergency medicine, Dr PeterNoonan, was appointed to theBowral emergency departmentin June 2006.Sydney South West Area Health ServiceYear in Review 05>06 29

Clinical GroupsGastroenterology andLiver ServicesClinical Director Associate Professor Neil MerrettThe past year has seenGastroenterology and LiverServices progressively developin the western zone. Theconcentration of units intocentres of excellence continuesat the two principal referralhospitals, with endoscopicinterventional andgastroenterological services atLiverpool and Bankstownhospitals, upper GI andcolorectal surgery at Bankstown,and oesophagogastric and liversurgery at Liverpool. Planscontinue for the development ofCampbelltown as a majorcentre for gastroenterology andcolorectal surgery. Fairfield,Camden and Bowral continue toprovide general endoscopyservices.A clinical manager and assistantclinical manager have beenappointed across both zones,and all groups are heavilyinvolved in planning for theredevelopment of LiverpoolHospital.Bankstown and Liverpoolcontinue to be the busiestoesophagogastric centres inNSW. Capsule endoscopy hasbeen introduced at Liverpool asan Area service, and Bankstowncontinues to grow as aninternationally recognised unitin pancreatic surgery andresearch.Capital replacement of allendoscopes has occurred atLiverpool, Bankstown andFairfield. A Cancer Instituteinfrastructure grant allowednew intraoperative andendoanal ultrasound equipmentto be installed at Bankstown,and a Cancer Institute Fellow inupper GI surgical oncology hasbeen appointed to Bankstown.A close collaboration with theGarvan Institute has beendeveloped for progressiveresearch protocols in pancreaticand oesophagogastric cancerand in the creation of thepancreatic cancer network.Left to right: Obstetrician Dr Ajay Vatsayan, NSW Parliamentary Secretaryfor Health Paul McLeay, antenatal patient Amanda Thornton and midwifeSally Jordan at the opening of the Medical and Midwifery Antenatal Clinicat the Wollondilly Community Health Centre at Tahmoor. A similar clinicoperates at Bowral Hospital, providing local women with increased healthcare options and greater choice.ImagingServicesClinical DirectorDr Peter LinImaging Services provides atertiary-level service, withemphasis on equity, qualityand staff and patient safety.The service has experienced a4.3 per cent increase indemand since 2004/05.Campbelltown Hospitalinstalled a 64 slice CT scanner,with improved imaging andhigher throughput. Fairfieldand Liverpool installed new GELogiq 9 ultrasound units inFebruary, and four additionalradiology registrars wereemployed in early 2006.Liverpool installed a 64 slice CTscanner in June, which will beupgraded to a dual-sourcehigh-definition scanner nextyear, to be used particularly fornon-invasive heart scans. Theradiology service now operatesseven days a week in Liverpooland Campbelltown, improvingaccess for inpatients and theemergency department.Additional staff specialistradiologist positions havebeen created at Bankstown,Campbelltown and Fairfield.The Liverpool Statewide PETService grew by 18 per centand a new state-of-the-art PET-CT was installed in February,placing the service at theforefront of patient serviceand research. A new gammacamera with revolutionarygantry design and improvedimage resolution was installedat Liverpool Hospital in May.Computed radiography is nowavailable at all western zonesites.An Area-wide ImagingManagement Committee hasbeen developed to ensure astrong clinical and corporategovernance program, strategicplanning of infrastructure andstaffing levels, financialmanagement, and attractionand retention of the highestqualitystaff.30 Year in ReviewWomen’sServicesClinical DirectorAssociate ProfessorRaj GyaneshwarWomen’s Services hasexperienced a 10 per centincrease in activity during thelast year, although delivery rateshave remained constant atabout 10,000.Two Area appointments havebeen made at the clinical nurseconsultant level to support GPshared care and clinicalgovernance. A Day AssessmentUnit is planned for Liverpool,and a midwifery-led model ofcare is being developed in thebirthing unit. A MidwiferyGroup Practice has beenimplemented at Camden and isplanned for Campbelltown.Several of the Henderson-Smart Report (2004)recommendations have beenimplemented, including a staffspecialist appointment to theFeto Maternal Unit. A seniorlecturer has been recruitedto enhance reproductiveendocrine services and provideleadership in research. Inaddition, a director of obstetricsand gynaecology has beenappointed at Fairfield andrecruitment is underway for astaff specialist vacancy atCampbelltown. It is alsopleasing to report that therehas been a 100 per cent successrate at the MRANZCOGexamination.Obstetric services arenetworked so that low-tomoderate-riskwomen are caredfor locally and high-risk womenare managed at Liverpool.Gynaecological services arebeing developed at each facility.Gynaeoncology is now sharedbetween Women’s Services andCancer Services.

uildingpartnershipsAboriginal HealthWorker ClydeSampson checksyoung client MiahWright for otitismedia at theTharawal AboriginalCorporation at Airds. SSWAHSand Tharawal have an activepartnership agreement designedto ensure the optimum provisionof health care services toAboriginal people.The partnershipaims to bring theexpertise ofAboriginalcommunities tohealth careprocesses.Sydney South West Area Health ServiceYear in Review 05>06 31

Nursing andMidwifery ServicesDirector Kerry RussellNursing and Midwifery Services isresponsible for the standard of nursingcare across SSWAHS including recruitmentand retention of staff, education, clinicalpractice and research for a workforce ofsome 10,800 nurses.Recruitment of overseas nurses throughNSW Health campaigns has resulted in153 registered nurses starting at SSWAHSfacilities since 2005, with an additional 88overseas nurses independently recruitedthrough the Sydney Nurses internet site.To date, we have 14 nurse practitionerswho are authorised by the NSW Nursesand Midwives Board and ten nursepractitioners in transitional appointmentsacross a range of specialties. A mentoringprogram has been established for nursingunit managers and nurse managers.SSWAHS is also providing clinicalplacements for final-year Danish nursingstudents through a partnership withSchools of Nursing in Denmark and theUniversity of Tasmania.A competency-based assessment manual,The Nurses and Midwives Record ofAchievement, has been developed andwill be marketed widely across thehealth system.Above: Fijian midwives Aliote Biu Galuvakaduaand Aradhna Prasad, who visited a numberof SSWAHS hospitals as part of a six-weekfellowship awarded by the Brian SpurrettFoundation, pictured with Mrs Kerry Spurrettat Liverpool Hospital.Left: SSWAHS nurses Vicki Keenan andDoris Slabb, recipients of the Puggy Hunterscholarship, a Commonwealth Governmentgrant named after Dr Arnold “Puggy” Hunter inrecognition of his commitment to improvingthe health of Aboriginal and Torres StraitIslander people.Far left: SSWAHS partnered with the Universityof Notre Dame to provide clinical placements forthe inaugural year of nursing students.Left: Bankstown midwives Joanne Prior (left)and Jane Powell with new mother MurielGeagea and baby Anthony Yaghy promoting theunit’s cookbook Not Just a Bun in the Oven. Thecookbook contains over 100 recipes from themidwives’ own kitchens, and is being sold toraise funds for the hospital’s Maternity Unit.32 Year in Review

Clinical Governance UnitThe Clinical Governance Unit (CGU) plays a pivotalrole in the implementation of the Patient Safety andClinical Quality Program by providing support,education and direction for improving safety andquality of care.Incident Information ManagementThe Incident Information Management System (IIMS) wasimplemented in SSWAHS in early 2005 as an initiative under theNSW Patient Safety and Clinical Quality Program.The aim of the system is to support health care professionals inidentifying, tracking and managing clinical, workforce andcorporate incident information.More than 1,500 managers are official users of IIMS and nearly1,500 incidents are reported each month. During this first year ofimplementation, the focus of IIMS was to encourage notificationwithin the system.While the analysis of serious incidents remains a priority, theseaccount for less than 1 per cent of all incidents reported.A half-day education program (Clinical Incident ManagementSkills) was introduced in late 2005 to assist in management ofless serious incidents. Eight workshops have been run by CGUstaff (assisted by other clinical staff), with 334 participants.The workshops have been well received and will be a continuingpart of the CGU education program.Professional Practice Unit andpatient complaintsThe Professional Practice Unit (PPU) is responsible for overseeingthe management of serious complaints within SSWAHS. The PPUmanager is the designated senior complaints officer and isavailable to members of the public and staff as required anddirectly responsible for ensuring that appropriate action is takento resolve serious patient complaints.The PPU currently consists of a manager and an Area patientcomplaints officer, both of whom have a combination of clinical,legal and mediation skills. The PPU meets monthly with patientliaison officers from across the Area to develop a standard bestpractice approach to complaint handling. The PPU also worksclosely with the Human Resource and Development unit tofacilitate education around professional practice, codes ofconduct and complaint handling.A Patient Rights and Responsibilities pamphlet and Patient RightsCharter have been developed for the Area; they are available inthe major language categories and are readilyvisible to patients in each facility.An education program designed for the frontline handling ofcomplaints has been developed as a two-hour workshop and isbeing progressed across SSWAHS.Root cause analysis –patient safety programRoot Cause Analysis (RCA) is used toreview and analyse an incident toidentify the factors that contributed toit, and to recommend actions toprevent a similar occurrence. SSWAHSundertook 86 RCAs into serious clinicalincidents, and many improvements topatient care have been implementedas a result.Staff must be trained in the RCAprocess before they can lead an RCAinvestigation. Four RCA trainingcourses were run during 2005/06,with 97 participants. This trainingcontinues.Professor David Davies, Headof the Area Infection ControlAdvisory Committee andProfessor of Pathology atLiverpool Hospital, with EminaRyan, Infection Control ClinicalNurse Consultant for theClean Hands Campaign.Sydney South West Area Health ServiceYear in Review 05>06 33

Quality Clinical IndicatorsClinical indicators (CIs) are rate-based figures which can show where we are performing particularly well andcan serve as a model for others. When we are performing at a suboptimal rate, compared to national or pastdata, a CI can act as an alert for further investigation or review of clinical practice to improve the quality of careprovided to our patients. The former Central Sydney Area Health Service (eastern zone SSWAHS) has publishedin its annual report since 2002/03 a selection of CIs with either a state or national comparison. We havecontinued the reporting this year and have included some western zone indicators where relevant to thesame indicator.Adult renal transplantationNumerator: Number of patients/grafts surviving at one year.Denominator: Number of renal transplant patients/grafts.Over the past eight years the Statewide Renal Services (SWRS) transplant unit, based at Royal Prince Alfred Hospital, has had excellentoutcomes compared to data for Australia and New Zealand (derived from the ANZ DATA Registry). The SWRS results are considered abenchmark at one year follow-up. This is particularly pleasing considering the high proportion of patients who are high risk eitherimmunologically for rejection or medically because of co-morbidities.Year – % survival at one year SWRS (CSAHS) Australian/NZ SWRS (CSAHS) Australian/NZpatients patients grafts grafts1998 98% (n=59) 95% 96% (n=59) 91%1999 100% (n=51) 95% 98% (n=51) 90%2000 92% (n=52) 97% 91% (n=52) 94%2001 97% (n=62) 96% 96% (n=62) 93%2002 98% (n=61) 98% 95% (n=61) 95%2003 100% (n=66) 98% 98% (n=66) 92%2004 97% (n=70) 96% 96% (n=70) 90%2005 98% (n=64) Not available 98% (n=64) Not availableAdult liver transplantation survival ratesBoth patient survival and graft survival are measured, as a patient can have more than one liver graft.Numerator: Number of patients/grafts surviving at one year.Denominator: Number of liver transplant patients/grafts.Year – % survival at one year RPAH patients ANZLTR* patients RPAH grafts ANZLTR* grafts1999 89% (n=28) 93% (n=117) 87% (n=31) 90% (n=124)2000 90% (n=39) 92% (n=151) 83% (n=42) 90% (n=157)2001 82% (n=27) 86% (n=125) 79% (n=28) 80% (n=135)2002 100% (n=43) 96% (n=151) 96% (n=47) 94% (n=157)2003 97% (n=38) 94% (n=143) 93% (n=41) 92% (n=150)2004/05 88% (n=50) Not available 87% (n=52) Not available2005/06 97% (n=33) Not available 89% (n=36) Not available* ANZLTR: Australian and New Zealand Liver Transplant Registry34 Year in Review

ObstetricsNumerator: Number of deliveries/interventions for year.Denominator: Number of babies delivered for year.2004*Hospitals Normal Forceps Vacuum Vaginal Elective Emergencydelivery vaginal extraction breech caesarean caesareanCanterbury 59.9 0.9 8.1 0.2 10.4 10.4Royal Prince Alfred 62.3 2.7 8.2 0.6 14.4 11.8Camden 89.5 2.8 1.5 0.2 1.3 4.6Fairfield 78.7 0.4 6.4 0.2 9.3 4.9Liverpool 69.2 1.1 6.1 0.8 11.9 10.9Campbelltown 68.7 0.3 5.7 0.5 13.5 11.3Bankstown 70.7 1.8 7.6 0.3 11.6 8.0Bowral 64.3 4.1 14.5 0.3 9.3 7.5SSWAHS rate 68.1 1.7 7.7 0.5 12.4 9.7NSW statewide rate** 62.1 3.3 7.0 0.4 15.3 11.8* 2005 data not available at publication** Published in the NSW Public Health BulletinNeonatal Intensive Care UnitIn the RPA Neonatal Intensive Care Unit (NICU), the survival rate of babies is monitored and compared to the rates for other NICUs fromthe New South Wales Health Neonatal Intensive Care Unit Study (NICUS). In the more recent of the two time periods reported, we hadmore premature babies surviving.Numerator: Number of babies born at a particular gestational age, surviving to hospital discharge.Denominator: Number of babies born at a particular gestational age.2002–2004:* Percentage survival of premature babies born at different gestational ages24/25 weeks 26/27 weeks 28/29 weeks 30/31 weeksRPA 43.4 83.8 96.3 99.4NICUS 57.5 84.3 92.3 97.12005/06 data not available at publicationDay of surgery admission ratesDay of surgery admission (DOSA) rates measure how many patients are admitted on the day of their surgery compared to all patientsadmitted to surgery. A high DOSA rate has the following advantages for patients:■ it avoids unnecessary accommodation at hospital before an operation;■ it means more effective bed utilisation where hospitals can treat more patients, and consequently shorter waiting times;■ the use of preadmission clinics better prepares patients for surgery;■ a decreased time in hospital means less risk of infection.Our DOSA rate has been steadily increasing over time and it is now above the state target of 80 per cent and above the state average of87.4 per cent.Year Eastern zone Western zone SSWAHS NSW Health target NSW Health statewide rate1997/98 18.1% 47.1% Not available1998/99 34.1% 77.7% Not available1999/00 50.9% 77.2% Not available2000/01 74.4% 81.0% 80% 77.7%2001/02 81.3% 85.0% 80% 83.3%2002/03 85.0% 89.7% 80% 83.9%2003/04 89.2% 90.0% 80% 87.4%2004/05 89.6% 91.1% 80%2005/06 90.0% 91.1% 90.5% 80%Sydney South West Area Health ServiceYear in Review 05>06 35

Quality Clinical IndicatorsLaboratory ServicesAvailability of urgent haemoglobin results after hoursIt is important that laboratory test results are made available to hospital staff as soon as possible so that decisions can be made aboutpatient care. After hours, we are able to supply urgent haemoglobin results to staff within 60 minutes in 95.8 per cent of cases, which ismore efficient than the national aggregate of 93.3 per cent.Numerator: Number of urgent haemoglobin validated report results with a turn-around-time of less than 60 minutes, after hours.Denominator: Number of requests for urgent haemoglobin results received by the lab after hours.Rate Jan-June July-Dec Jan-June July-Dec Jan-June July-Dec Jan-June2003 2003 2004 2004 2005 2005 2006Royal Prince Alfred Hospital 95.7% 98.3% 97.4% 96.8% 96.5%Sydney West Area Pathology Services 98.5% 98.4% 99.1% 95.7% 98.9% 98.1% 89.0%Concord Hospital 95.8%ACHS* national aggregation rate 90.8% 93.4% 96.0% 57.4% 89.9% 89.6% Not available* ACHS: Australian Council on Healthcare StandardsSpeech PathologyImprovements in voice quality following speech pathologyNumerator: Total number of voice patients who rated an actual improvement in voice quality following speech pathologyintervention.Denominator: Total number of voice patients completing treatment and voice outcome scales.n=30 (13 Royal Prince Alfred Hospital, 12 Concord Hospital, 5 Canterbury Hospital)Sydney Voice Interest Group benchmark 2001/02 2002/03 2003/04 2004/05 2005/0680% 83.3% 87.5% 88% 88% 93%36 Year in Review

uilding asustainableworkforceNursing for the futureat Concord HospitalLeft to right: Kerrie Bubb (RN,ED), Sue Taggart (CNC BurnsSupport), Greg Moore (RN,Gastro Ward), Michael Bulaong(EN, ED) and Cole Kudrna (RN,plastics, urology, breast,dermatology ward).Sydney South West Area Health ServiceYear in Review 05>06 37

Asset ManagementCapital WorksProgramMember for Drummoyne Angela D’Amore andPremier Morris Iemma turn the first sod forconstruction of the new Mental Health precinctat Concord Hospital.Royal Prince Alfred HospitalStage 2a of the RPA redevelopmentcommenced on 1 November 2005 and willcomplete the level 3 ‘hot floor’ of theclinical services building. Constructionof new perioperative, endoscopy andbronchoscopy suites will provide patientswith seamless entry into the hospital,improving both service delivery andefficiency.Completion of the Stage 2a laboratorieswill enhance the working environment,facilitating collaboration between servicesand improving work flows. Stage 2b of theprogram will commence by mid-2007.Concord RepatriationGeneral HospitalWork commenced on the new mentalhealth precinct in 2005 with thedemolition of existing infrastructure.This 174-bed project will facilitate therelocation of mental health services fromRozelle Hospital and provide inpatient aswell as extended care and rehabilitationservices within a modern, purpose-builtenvironment.Marrickville CommunityHealth CentreConstruction of the new purpose-builtcentre was completed and all servicesrelocated in June 2006. The facilityprovides a one-stop shop for communitybasedservices, including early childhood,adolescent and family, community nursingand post-acute care, migrant health,mental health and mental healthrehabilitation, podiatry and sexual health.Camden and CampbelltownhospitalsCommissioning of the newlyrefurbished Maternity Unit, IntensiveCare Unit and staff office accommodationat Campbelltown Hospital in late 2005completed the $133.7 millionMacarthur Strategy.The new $3.2 million CampbelltownMental Health Unit, with capacity tohouse 20 sub-acute patients, wascompleted in January 2006.Liverpool HospitalThe new mental health facility at LiverpoolHospital was commissioned in January2006. This $24.8 million project provides50 beds for acute, non-acute and highdependencypatients in a modern,purpose-built environment, as well asoffice accommodation for the Area MentalHealth directorate and university affiliates.Liverpool Stage 2Service and facility planning for the nextstage of redevelopment on the LiverpoolHospital campus commenced in January2006. In June the Premier and the Ministerfor Health announced the $390 millionnext phase of works to commence in early2007, featuring a new clinical servicesbuilding, integrated refurbishments andmajor site infrastructure upgrades.38 Year in Review

Corporate ServicesNon-clinical support servicesacross SSWAHS are managed byCorporate Services and includerisk management, occupationalhealth and safety (OHS) andrehabilitation, procurement andtendering, contract management,overseeing complex investigations,and administrative and legalservices.AmalgamationAmalgamations of supply services, humanresources, payroll, the informationsystems division, capital works, pathology,transport and fleet management havebeen finalised, and amalgamation plansfor finance, food services, engineeringservices and OHS services havesubstantially progressed. Savings from therestructuring of corporate services havebeen returned to fund clinical services.SSWAHS has actively participated incommittees and working partiesimplementing the NSW Health sharedcorporate services program.Financial management has beensimplified with the creation of one generalledger. Material management has beenreviewed and rationalised and the supplywarehouse at Wetherill Park relocated toConcord Hospital. A risk analysis has beencompleted and a risk register developed.With respect to workers compensation,a surplus was achieved to both premiumrenewal and hindsight results.An Area-wide approach to purchasingand tendering has resulted in morecompetitive prices being achieved for thebenefit of clinical services.Waste managementSSWAHS facilities continued to developand implement strategies in line with theNSW Government’s Waste Reduction andPurchasing Policy (WRAPP). Facilitiesmonitor performance through thecollection of indicators for clinical work,sharps waste, general waste, recycling andOHS incidents related to wastemanagement.Energy managementSSWAHS conducted an audit of waterconsumption at all major sites andjoined Sydney Water in their Every DropCounts business program. Savings inwater usage at Concord Hospital weresufficiently large for the facility toreceive a water conservation awardfrom Sydney Water.A trial modification to the electricalsupply for a main cooling tower at RPAwas completed, with results indicatinga 70 per cent reduction in electricityusage.Sydney South West Area Health ServiceYear in Review 05>06 39

Financial ServicesThe Finance Department operates toensure that the Area’s financial resourcesand assets are managed efficiently andeffectively through appropriate planning,coordination and monitoring. Thedevelopment and maintenance ofconsistent, Area-wide financial andaccounting policies and procedures isvital for ensuring and enhancing qualitycontrol in financials and operations.The implementation of the OracleFinancials Version 11i from version 10.7was successfully rolled out in September2005, immediately allowing SSWAHS tooperate on a single system with anintegrated general ledger and a singleuniform chart of accounts. The OracleFinancials system 11i has been used asthe major budgeting and financialreporting tool.Uniform financial and budgetperformance management reports areprovided for facilities, clinical groups andcost centres across the Area, ensuringconsistency and efficiency in theinterpretation of financial data. TheAccounts Payable Function wascentralised, and the V Money system(a payment system for Visiting MedicalOfficers) database was integrated inSeptember.All budget and financial performancereports are now distributed to internalstakeholders in electronic format, andmajor efficiency and effectivenessimprovements have been made in thepreparation of financial performancereports for external stakeholders.The consolidated SSWAHS AnnualFinancial Report, and the monthly reportto NSW Health, were prepared from theconsolidated Oracle financial reports, thuseliminating the previous year’s duplicatedefforts when the financials were in twoseparate databases.Information Managementand Technology DivisionExecutive producer RPAtv George Catsi withSBS television newsreader Mary Kostakidis.RPAtv, established in 2005, is a free televisionchannel that is broadcast daily to patients’bedsides and public areas of the hospital.The Information Management andTechnology Division (IM&TD) providesinformation management and technologysupport to SSWAHS clinical, corporate andsupport services.The Electronic Medical Record (EMR)system continues to be enhanced andextended across the Area, allowingdelivery of results reporting and theimplementation of electronic orderingin the western zone. Integrated EMRsolutions were also implemented atCanterbury Hospital Maternity Unit andDrug Health Services. The PathNetLaboratory Information ManagementSystem has also been implementedArea-wide.Rollout of electronic discharge referralscontinued, with implementations atCanterbury and Campbelltown hospitals.A paperless solution for Medical Oncologyand a research database replacementproject for the Sydney Cancer Centrecommenced.A major project to retire the former SouthWestern Sydney Area Health ServicePatient Administration System began,and the western zone Oracle Financialand Materials Management System wasreplaced with the Area-wide Oracle 11iSystem.IM&TD continued to work with variousfacilities and clinical departments toenhance the scope of informationavailable through the intranet.Over the next five years, SSWAHS willcontinue to establish the single integratedpatient-centred enterprise-wide EMRclinical information system.40 Year in Review

Internal AuditDepartmentInternal auditing is an independentand objective assurance and consultingactivity designed to add value andimprove the operations of SSWAHSby bringing a systematic, disciplinedapproach to risk management, controland governance processes.The Internal Audit Departmentprovides an independent review ofhospital systems, operations, activities,policies and procedures, and, wherewarranted, recommends cost-effectivecontrols and solutions.The audit units at RPA and Liverpoolhospitals have been successfullymerged, and a consolidated audit planhas been put in place for the entireArea.Development of the consolidated auditplan allowed identification of auditableareas of sufficient risk which had notpreviously been subjected to an auditreview. A number of these systems andactivities were audited in 2005/06.This process is expected to continueuntil all financial and relatedoperations of major risk withinSSWAHS have been subjected to anaudit. Thereafter, it is expected thatall major systems, as identified in theconsolidated audit plan, will bereviewed once every two years.Public Affairs and MarketingThe Public Affairs and Marketingdepartment promotes the corporateidentity of SSWAHS and its hospitals andhealthcare facilities. It is the first point ofcontact for the media. Our goal is tocommunicate, both internally andexternally, the work being carried out atour facilities for the benefit of patientsand the wider community.Our expertise includes internal andexternal communication strategies,media advocacy, specialised promotioncampaigns, corporate publications andevent management.Public Affairs and Marketing became afully amalgamated service in September2005, providing an Area-wide serviceunder the leadership of a single directorcoordinating all media, communicationsand events across the two zones ofSSWAHS.A quarterly Area-wide printed newsletterfor distribution to all staff was producedand the community was kept informed ofnew clinical initiatives and services,additional funding, and progress on thecapital works being undertaken at ourhospitals and health services.Many stories from facilities acrossSSWAHS were featured in national,metropolitan and local media, including arange of research developments whichreceived widespread coverage.In the new financial year, Public Affairsand Marketing will promote the openingof the Marrickville Community HealthCentre and the redevelopment ofLiverpool Hospital.A major focus of the department’sproactive media strategy will be healthpromotion initiatives across the Area,assisting the public to maintain optimumhealth through adoption of a healthylifestyle and awareness of contributingfactors to illnesses such as heart diseaseand diabetes.Sydney South West Area Health ServiceYear in Review 05>06 41

Organisational ChartThe organisational structure is separatedinto tiers and incorporates the clinicalgovernance model as well as legislativeand statutory responsibilities for SSWAHS.The first tier within SSWAHS is theposition of Chief Executive. The ChiefExecutive is accountable for the overallcorporate governance, performance andstrategic planning of the organisation. Theposition of Chief Executive reports directlyto the Director-General of NSW Health.The positions within the second tier ofSSWAHS report to the Chief Executive.These senior management positions areresponsible for the delivery of clinical,strategic planning, workforce planning,performance, corporate support, financeand nursing services for the organisation.MANAGER INTERNAL AUDITCHIEF EXECUTIVEDIRECTOR PUBLIC AFFAIRSAND MARKETINGDIRECTORCLINICALOPERATIONSDIRECTORFINANCEANDCORPORATESERVICESDIRECTORSTRATEGICWORKFORCEPLANNINGANDDEVELOPMENTDIRECTORPOPULATIONHEALTH,PLANNINGANDPERFORMANCEDIRECTORCLINICALGOVERNANCEDIRECTORNURSINGANDMIDWIFERYHOSPITALGENERALMANAGERSCHIEFFINANCEOFFICERDIRECTOREDUCATIONTRAININGANDDEVELOPMENTDIRECTORABORIGINALHEALTHMANAGERCLINICALQUALITY UNITMANAGERNURSINGPOLICY ANDPRACTICEGENERALMANAGERAREA CLINICALSERVICESCHIEFINFORMATIONOFFICERMANAGERHUMANRESOURCESMANAGERCOMMUNITYPARTICIPATIONMANAGERPROFESSIONALPRACTICE UNITMANAGERNURSINGEDUCATORDIRECTORCOMMUNITYHEALTHSERVICESMANAGERSHAREDSERVICESCO-ORDINATORCOUNTERDISASTERPLANNING ANDMANAGEMENTEXECUTIVEOFFICERNURSINGGENERALMANAGER ORALHEALTHSERVICESDIRECTORNSW REFUGEEHEALTHSERVICEDIRECTORDRUG HEALTHSERVICESDIRECTORHEALTHSERVICESPLANNINGMANAGERSCLINICALBUSINESS UNITSIMAGING ANDPATHOLOGYDIRECTORPERFORMANCEMONITORING,ANALYSIS ANDCLINICALREDESIGNDIRECTORMENTALHEALTHDIRECTORPOPULATIONHEALTH42 Year in Review

Workforce ProfileThe main workforce activitiesduring 2005/06 have beenworkforce management,development and planning.The key strategic activities havebeen ongoing development of theArea’s strategic workforce planand implementation of priorityworkforce initiativesCentre for Education andWorkforce DevelopmentThe Centre for Education and WorkforceDevelopment was established to providein-house workforce developmentprograms, ensuring staff at all levelscan develop and enhance their skills.The Centre is a registered trainingorganisation, and the majority of itsprograms lead to nationally recognisedqualifications. More than 1,200 SSWAHSstaff enrolled in the Centre’s programsin 2005/06.Aboriginal WorkforceDevelopment ProgramThis program is based around individualneeds analysis and the establishment ofpersonalised development plans. It isbeing progressively establishedthroughout the Area.New staff orientation programA new staff orientation programcommenced in January, providing acomprehensive range of information tonew staff over a three-day period at thebeginning of their employment.Vocational medical trainingnetworksVocational medical training in NSW ismoving towards a more networked basis.In 2005/06, networks for basic physicianand basic surgery training operatedand a psychiatry training network wasestablished. These networks provide theopportunity for a broad range of clinicaltraining experiences to be gainedthroughout our hospitals.Workforce managementWorkforce management activities havefocused on continued amalgamation andstreamlining of services and processes.Workforce profileA monthly workforce profile has beenestablished to ensure regular reporting onour workforce by key characteristics (age,sex), by health occupation and by facility.The profile provides a regular flow ofinformation to our managers. Furtherwork is being undertaken to expand theprofile. Work is also planned to developa range of workforce performanceindicators.The workforce strategic plan will befinalised next year and will outline ourpriority initiatives and workforce directionfor the next five to ten years. A draft planhas already been used in consultationthroughout the Area on contextual issues,ideas, possible strategies and priorities.Interns at Liverpool Hospital.Sydney South West Area Health ServiceYear in Review 05>06 43

Teaching and Training InitiativesLeft to right: Clinical nurse educator EmergencyDepartment Tara Boyd, clinical nurse consultantEmergency Department Brian Shimadry andNUM Level 3 Emergency Department ShonaHanson with Concord Hospital’s Laerdalmannequin, an interactive electronic teachingtool which can simulate a wide range of medicalconditions, allowing clinical staff to practise theirskills in a lifelike emergency situation.SSWAHS is one of the leadingproviders of health education andtraining in Australia. Our trainingextends across all healthoccupations. Clinical trainingcovers both university placementsand postgraduate vocationaltraining.Centre for Education andWorkforce DevelopmentThe Centre for Education and WorkforceDevelopment is a registered trainingorganisation established in 2005/06 toprovide in-house workforce developmentprograms, the majority of which lead tonationally recognised qualifications.More than 1,200 staff enrolled incourses this year.Allied HealthAllied Health students are accepted fromuniversity for fieldwork placementthroughout SSWAHS. Graduate trainingplacements are provided for severaldisciplines. Allied Health in-serviceprograms also operate, providing anopportunity for specialised clinicaleducation.Undergraduate medicaleducationOur network of undergraduate andgraduate medical education has links tothe universities of Sydney and New SouthWales and our hospitals at RPA, Concord,Bankstown and Liverpool. Planning for anew medical school at the University ofWestern Sydney has begun and will beintegrated into our network of hospitalsin Sydney’s south west.Junior medical officersThe intern year of vocational medicaltraining is focused around primaryallocation centres at RPA, Liverpool,Concord and Bankstown hospitals.In 2005/06, networks for basic physicianand surgery training commencedoperation and a psychiatry trainingnetwork was established, providing abroad range of clinical trainingexperiences throughout our hospitals.Nursing and Midwiferyeducation and professionaldevelopmentSSWAHS is a registered higher educationinstitution under the NSW HigherEducation Act 2001 and delivers theaccredited Graduate Certificate inSpecialty Nursing. In 2005, 43 nursesgraduated with the award.SSWAHS is also a recognised provider ofclinical education for trainee enrollednurses and undergraduate bachelor ofnursing and midwifery programs. In2005/06, SSWAHS accommodated 7,311undergraduate nursing students, whospent a total of 519,038 hours in theclinical areas.Over 200 Area-wide clinical enhancementand professional development programswere offered to nurses and midwives.In recognition of the importance of clinicalsupervision, SSWAHS has begun aprogram to train facilitators to providesupervision for our community nurses,new graduates and midwifes.44 Year in Review

Following is a brief list of some of the research being undertaken at SSWAHS.A more detailed listing can be found at www.sswhealth.nsw.gov.auResearchProject Facility/Researchers Funding Duration DescriptionWeight training indiabetesBalmain HospitalM SinghN SinghK WileyDiabetes Australia$50,0001 year To demonstrate the effectiveness of weighttraining alone in diabetes.A randomised,controlled clinicaltrial of theeffectiveness ofChinese herbalmedicine in thetreatment of vasculardementiaBankstown HospitalD ChangD ChanA BensoussanJ LiuUniversity of WesternSydney$25,0002 years A randomised, double blind and controlledphase IV drug clinical trial testing theefficacy of a compound of Chinese herbalmedicine in treating vascular dementia.70 subjects with a diagnosis of vasculardementia were randomised to theintervention and control groups. All subjectshave been followed up at regular intervalsfor outcomes.Randomised trial ofEarly ChildhoodSustained HomeVisiting in aDisadvantagedCommunityCommunity HealthE HarrisC McMahonS MattheyG VipaniT AndersonV SchmiedL KempTotal funding$1,085,000DOCS$330,000NSW Health$80,000SSWAHS$225,000Australian ResearchCouncil$450,0005 years This study generates Australian evidenceof effective interventions to reduce theimpact of social and environmental factorspredisposing infants and children to illhealth and reducing their life potential.It is the first Australian randomised trial todetermine the impact of a comprehensivesustained home visiting program (antenatalto two years) in a population group living inan area of known disadvantage. As such, thistrial is a best practice demonstration modelfor professional home visiting in Australia,with significant implications for thedevelopment of early childhood policy andstrategy nationally.FenofibrateIntervention andEvent Lowering inDiabetes (FIELD)studyConcord HospitalL KritharidesNational Health andMedical ResearchCouncil (NHMRC)$115,0006 years An international study to determinewhether treatment with cholesterolloweringmedication (fenofibrate) preventsdeaths from heart disease or non-fatal heartattacks in people with type 2 diabetes.Case-control studiesof completed andattempted suicide inyoung people in NSWDepartment ofForensic MedicineR TaylorM DudleyA PageJ DuflouJ MowllNHMRC$802,0004 years This project involves case-control studies ofsuicide and attempted suicide in youngpeople in urban and rural NSW, investigatingantecedents and risk factors. The project hasbeen funded by NHMRC for four years from2004.Evaluation of a youthdevelopment unitand prospectivestudy of drug andalcohol use in threeremote AboriginalcommunitiesDrug Health ServicesK ConigraveA CloughK LeeAlcohol, Educationand RehabilitationFoundation$181,0944 years These two projects examined patterns ofsubstance abuse over time and theeffectiveness of a youth development unit,as a measure to reduce drug use, and otherproblems among young people. The projectwas conducted in collaboration with thelocal community and the Menzies School ofHealth Research.Hydrotherapyversus land-basedrehabilitation in totalknee replacementsFairfield HospitalPhysiotherapyDepartmentSSWAHS$25,0002 years Comparison of outcomes between landbasedrehabilitation and water-basedrehabilitation in patients undergoing a totalknee replacement.Sydney South West Area Health ServiceYear in Review 05>06 45

ResearchProject Facility/Researchers Funding Duration DescriptionEvaluation of clientoutcomes followingadmission to theKaritane ResidentialUnitKaritaneD NemethJ PhillipsInternal funding1 yearThis study evaluated mental health andparenting outcomes associated withadmissions at the Karitane Residential Unit.Results showed that the intervention iseffective in facilitating positive change forclients.Sustainable Accessfor the Elderly (SAFE)projectLiverpool HospitalD BasicD ConfortiC MacarthurC ShanleyD ChanA LubianaJ MassoD Le CouteurJ CullenCommonwealthDepartment of Health$1,000,0002.5 years This project will evaluate and developprograms that enable safe, equitable andcost-effective transit of elderly personsthrough the health system. The projectinvolves the development and evaluation ofan electronic discharge summary and endof-lifecare plans for hospital inpatients andnursing home residents. Other programs tobe evaluated include the CommunityTransitional Care Packages program and theAged Care Services in the EmergencyDepartment program. The long-termoutcomes of patients treated by geriatriciansat Liverpool Hospital will also be studied.Patient and CarerPerceptions of Needand CaregiverBurden: Working inPartnership toFacilitateCommunity-BasedInterventionsRozelle HospitalM ClearyG HuntG Walter$20,000Nursing and MidwiferyinnovationsscholarshipMcGeorge BequestUniversity of SydneyOngoingDetermining whether carers and consumershave similar ideas on how much care isneeded/provided prior to and during anacute inpatient admission.Centre for ClinicalResearch Excellencein Respiratory andSleep MedicineRPA HospitalR GrunsteinNHMRC$800,0005 years The focus of this research is on respiratoryand sleep disorders and the application of itsfindings to clinical practice.Centre ofClinical ResearchExcellence Program:To improve outcomesin chronic liverdiseaseRPA HospitalG FarrellG McCaughanNHMRC$200,0005 years This project will investigate treatments forchronic liver diseases, such as hepatitis Band C.Prediction of OralAppliance TreatmentOutcomes inObstructive SleepApnoeaSydney DentalHospitalP CristulliA DarendelilerH GotsopoulosNHMRC Project Grant$298,8093 years The project aims to directly compare thehealth benefits achievable with the use oforal appliances.Mothering at aDistanceTresillianC FowlerK HeggieC McMahonN KowalenkoA CashinC RossiterJ CassinGreater WesternSydney: NationalCommunity CrimePrevention Program$447,4213 years The project, in partnership with the NSWDepartment of Corrective Services, willestablish a self-sustaining education andsupport program to assist with casemanagement and address the needs ofmothers who are in prison, enhance theirability to provide appropriate and sensitiveparenting, and reduce the emotional andsocial impact on their children 0-5 years ofseparation due to incarceration.46 Year in Review

Area Health Advisory Council members (left toright): Amanda Walker, Sandra Gav, MarkSheridan, Sue McClelland, Jeremy Wilson, DellCotter, Harry Collins and Roger Garsia.Members absent from photo: Alison Bush, JohnMeadth, Adriana Navarro and Daryl Wright.Area HealthAdvisory CouncilDesigned to give health consumers andlocal communities – as well as clinicians– a stronger voice in health decisionmaking,Area Health Advisory Councils(AHACs) have been established for each ofthe eight new area health services underthe Health Services Amendment Bill 2004.The SSWAHS AHAC, chaired by ProfessorJeremy Wilson, commenced meeting inDecember 2005 with members fromacross the Area. During the first sixmonths of its tenure, the Council hasprovided the Chief Executive with adviceon a range of strategic planning projects,including the development of the AreaHealthcare Services Plan and CorporateStrategic Plan.Meetings have been held across the Areaas part of a program of site visits that willcontinue on a regular basis. The Councilalso held four Futures Planning forums– in Campbelltown, Canterbury, Concordand Liverpool – to provide an opportunityfor local communities to contribute tofuture health priorities.The Council is also participating in aresearch project being conducted by theUniversity of New South Wales, inpartnership with the Australian Councilon Healthcare Standards and industrypartners, into community and consumerinput into health services.The AHAC works in partnership withexisting advisory bodies, including theConsumer and Community Council.A work-plan showing the Council’s inputinto the strategic direction of SSWAHS,along with the Council’s charter andminutes of meetings, are available onthe SSWAHS website.Community ParticipationLocal Health ParticipationGroupsThe SSWAHS Area CommunityParticipation Unit aims to develop aculture supportive of community andconsumer participation by providingresources to the Area Health AdvisoryCouncil, and by providing both formaland informal training for all levels ofhealth service staff, including seniorexecutive staff.The Unit directly supports the Consumerand Community Council, which comprisesrepresentatives from the eight localcommunity participation networks,representatives of specific populationgroups, and members of the Area HealthAdvisory Council.Over the past year, there has been anumber of community participationstaffing changes both at the facility andArea level. In addition, new facilitieswithout established networks haveneeded to develop internal and externalpartners to help raise the profile of healthparticipation by the community.One key project has been the review of theCommunity Participation Framework thatwill now encompass the Area. The deliveryof orientation and training to ensure staffand community representatives areclear about their respective roles andresponsibilities has also been amajor focus.Patient feedbackFormal structures are in place at SSWAHSto facilitate community participation.All facilities have a Patient Liaison Officerfor patients and carers to approach withsuggestions, complaints and compliments.Complaint statistics are collected andregularly reported to the Clinical QualityCouncil and NSW Health for inclusion inthe statewide database.Facilities also use surveys and suggestionboxes for patient feedback. This allowsinformation to be exchanged freely andhelps to maintain a constructiverelationship between staff and patients.Ongoing consumer forums featuring keyspeakers are held regularly in order toimprove dialogue between SSWAHS andthe community we serve. Consumerrepresentatives are included in manycommittees throughout the service.Sydney South West Area Health ServiceYear in Review 05>06 47

Volunteers, Donations and BequestsVolunteersSSWAHS is indeed fortunate to work withhundreds of volunteers throughout ourhospitals and health care centres. Thesededicated people devote their time andtalents to serve and assist our patientsand their families and friends. Volunteerscome from diverse walks of life, and theirimportance in providing a warm sense ofcommunity cannot be overestimated.Our volunteers are involved in a widerange of activities, including fundraising,welcoming and guiding patients and theirvisitors around our facilities, organisingsocial functions, operating gift stores andvisiting patients throughout the hospitalsand the community.We would also like to express ourappreciation to the many pastoral workersand visitors who provide spiritual comfortto those in need. Our thanks also to themany community groups who visit onspecial occasions throughout the year.Donations andBequestsThank you to the following individuals andorganisations for providing $5,000 or morein support during 2005/06:AMGEN Australia Pty LtdBarclay MowlemBelmore Returned Services andCommunity Club LtdBulldogs Leagues Club LtdCabra-Vale Ex-Active Servicemen’s Club LtdCampsie RSL Sub-Branch Club LtdCampbelltown Catholic ClubCanterbury Hospital Pink LadiesCanterbury Hurlstone Park RSL LtdCelebration Royal Arch Chapter No 81Estate of Nancy May O'BrienThe Gidget FoundationJohnson & JohnsonKids of Macarthur Health FoundationLions Clubs NSWLiverpool Hospital AuxiliaryMacquarie Bank FoundationMoorebank Chipping Norton AuxiliaryPaul Wakeling Wheels for LifePunchbowl Ex-Services and CommunityClub LtdRelay for LifeRock for Recovery benefit in support ofYouth Mental HealthRotary Club of Liverpool GreenwaySmithfield Sydney Baseball Lions ClubLeo McCarthy Memorial Smithfield RSLSub-Branch ClubLeft: Liverpool Hospital volunteers Pam Cobleyand Elizabeth Winner donate their time to thehospital store.Above: Honorary RPA Museum Director HelenCroll (second from right) and some of her teamof dedicated volunteers who received a NSWGovernment Volunteer Heritage Award for theircuratorial care of the RPA Archives andMuseum, located on level 8 of the KGVbuilding in Camperdown.48 Year in Review

Financial SummaryThe Sydney South West Area HealthService (amalgamating the formerCentral Sydney Area Health Service andthe former South Western Sydney AreaHealth Service) was established on1 January 2005 and the audited financialstatements cover the 12 monthsended 30 June 2006.We spent $2.130 billion providing healthcare to the people of NSW. We also spent$66 million on our building program.Our money was mostly spent on people,$1.297 billion on our staff and $74 millionon visiting doctors. Goods and servicescost $567 million, including drugs,laboratory chemicals, X-ray film, sutures,needles and services provided to ourresidents by other NSW health services($171 million).ExpenditureWe spent $60 million on the maintenanceof buildings and the replacement ofequipment, $27 million in grants andpayments to non-governmentorganisations and $26 million to thirdschedule hospitals. Depreciation onbuildings and equipment accounted for$79 million.Our revenue included $99 million frompatient fees, $41 million from grants andcontributions (over $26 million was forthe special purposes and trust fundaccounts), $74 million from the sale ofother goods and services (with $14 millionmainly related to the transfer of fundwithin the special purposes and trust fundwas not available for use for generalexpenditure), $12 million frominvestments and $11 million fromother revenue.RevenueWe provided health services worth$171 million to residents of other NSWhealth areas (inflows) and our residentsreceived care worth $174 million in otherarea health services (outflows). The dollarvalue of the inflows and outflows areregarded as revenue and expenditurerespectively for accounting purposes, nocash or money actually changes handsbetween Area Health Services.Funding provided by the NSWGovernment for the period was$1.673 billion.Our complete audited financialstatements are in the 2005/06 SSWAHSStatutory Financial Report. It can beaccessed on the internetwww.SSWAHS.nsw.gov.au or byphoning (02) 9828 7501Funding from NSW HealthDepartment62% > Employee Related3% > Visiting Medical Officers29% > Other Operating Expenses4% > Depreciation85% > Sale of Goods andServices3% > Investment Income10% > Grants and Contributions2% > Other Revenue97% > NSW Health DepartmentRecurrent Allocations2% > NSW Health DepartmentCapital Allocations1% > Acceptance by the CrownEntity of SuperannuationLiability1% > Grants and Subsidies0% > Finance Costs1% > Payments to AffiliatedHealth OrganisationsSydney South West Area Health ServiceYear in Review 05>06 49

Health Service LocationsFor further information about our facilities, visit www.sswhealth.nsw.gov.auPublic HospitalsBalmain Hospital29 Booth StreetBalmain NSW 2041Ph: (02) 9395 2111Bankstown HospitalEldridge RoadBankstown NSW 2200Ph: (02) 9722 8000Bowral and District HospitalCorner Mona Road and Bowral StreetBowral NSW 2576Ph: (02) 4861 0200Camden HospitalMenangle RoadCamden NSW 2570Ph: (02) 4634 3000Campbelltown HospitalTherry RoadCampbelltown NSW 2560Ph: (02) 4634 3000Canterbury HospitalCanterbury RoadCampsie NSW 2194Ph: (02) 9787 0000Concord Repatriation General HospitalHospital RoadConcord NSW 2139Ph: (02) 9767 5000Fairfield HospitalCorner Polding Street and Prairievale RoadPrairiewood NSW 2176Ph: (02) 9616 8111Liverpool HospitalCorner Elizabeth and Goulburn StreetsLiverpool NSW 2170Ph: (02) 9828 3000Royal Prince Alfred HospitalMissenden RoadCamperdown NSW 2050Ph: (02) 9515 6111Rozelle HospitalCorner Church and Glover StreetsLeichhardt NSW 2040Ph: (02) 9556 9100Sydney Dental Hospital2 Chalmers StreetSurry Hills NSW 2010Ph: (02) 9293 3200Third Schedule FacilitiesTresillian Family Care CentresHead OfficeMcKenzie StreetBelmore NSW 2192Ph: (02) 9787 0800Web: www.tresillian.netCarrington Centennial Care90 Werombi RoadCamden NSW 2570Ph: (02) 4659 0590Braeside Hospital340 Prairievale RoadPrairiewood NSW 2176Ph: (02) 9616 8600KaritaneCorner The Horsley Drive andMitchell StreetCarramar NSW 2163Ph: (02) 9794 1800Queen Victoria Memorial Home615 Thirlmere WayPicton NSW 2571Ph: (02) 4683 6900Other ServicesDepartment of Forensic Medicine42-50 Parramatta RoadGlebe NSW 2037Ph: (02) 8584 7800Web: www.forensic.org.auSydney South West Pathology ServicesMissenden RoadCamperdown NSW 2050Ph: (02) 9515 7960Community Facilities –eastern zoneCommunity Health ServicesCamperdown Child, Adolescent andFamily Health ServiceLevel 5, King George V BuildingMissenden RoadCamperdown NSW 2050Ph: (02) 9515 9788Croydon Health Centre24 Liverpool RoadCroydon NSW 2132Ph: (02) 9378 1100Croydon Child, Adolescent andFamily Health ServiceCroydon Health Centre24 Liverpool RoadCroydon NSW 2132Ph: (02) 9378 1100Canterbury Child, Adolescent andFamily Health ServiceCanterbury Community Health CentreCorner Thorncraft Parade andCanterbury RoadCampsie NSW 2194Ph: (02) 9787 0600Canterbury CommunityNursing ServiceCanterbury Community Health CentreCanterbury HospitalCanterbury RoadCampsie NSW 2194Ph: (02) 9787 0599Canterbury Multicultural YouthHealth ServiceCanterbury Community Health CentreCorner Thorncraft Parade andCanterbury RoadCampsie NSW 2194Ph: (02) 9787 0600Youthblock Health and ResourceService142 Carillon AvenueCamperdown NSW 2050Ph: (02) 9516 2233Community HIV/AIDS Allied HealthRedfern Community Health Centre1 Albert StreetRedfern NSW 2016Ph: (02) 9395 044450 Year in Review

Community Nursing ServiceRedfern Community Health Centre1 Albert StreetRedfern NSW 2016Ph: (02) 9395 0444Mental Health ServiceRedfern Community Health Centre1 Albert StreetRedfern NSW 2016Ph: (02) 9395 0444Community NutritionLevel 6, King George V BuildingMissenden RoadCamperdown NSW 2050Ph: (02) 9515 9729Community Paediatric OccupationalTherapy ServicesCamperdown Child, Adolescent andFamily Health ServicesLevel 5, KGV BuildingMissenden RoadCamperdown NSW 2050Ph: (02) 9515 9788Community PaediatricPhysiotherapy ServicesCroydon Health Centre24 Liverpool RoadCroydon NSW 2132Ph: (02) 9378 1100Concord Community Nursing ServiceConcord HospitalHospital RoadConcord NSW 2137Ph: (02) 9767 6199Croydon Community Nursing Service24 Liverpool RoadCroydon NSW 2132Ph: (02) 9378 1100Eastern and Central SexualAssault ServiceLevel 5, KGV BuildingMissenden RoadCamperdown NSW 2050Ph: (02) 9515 9040Community Nursing ServiceMarrickville Health Centre155-157 Livingstone RoadMarrickville NSW 2204Ph: (02) 9562 0500Marrickville Child, Adolescent andFamily Health ServiceMarrickville Health Centre155-157 Livingstone RoadMarrickville NSW 2204Ph: (02) 9562 0500Migrant Health TeamRedfern Community Health Centre1 Albert StreetRedfern NSW 2016Ph: (02) 9395 0444Multicultural HIV/AIDS andHepatitis C ServiceLevel 1, Building 12Corner Grose Street and Missenden RoadCamperdown NSW 2050Ph: (02) 9515 5030Redfern Community Health Centre1 Albert StreetRedfern NSW 2016Ph: (02) 9395 0444The Sanctuary6 Mary StreetNewtown NSW 2040Ph: (02) 9519 6142Early Childhood HealthServicesEastern Sector CentresBalmain530A Darling StreetRozelle NSW 2039Ph: (02) 9810 1609CamperdownLevel 5, KGV BuildingMissenden RoadCamperdown NSW 2050Ph: (02) 9515 9944Dulwich Hill12 Seaview StreetDulwich Hill NSW 2203Ph: (02) 9560 2747Glebe/UltimoCorner Pyrmont Bridge andGlebe Point RoadsGlebe NSW 2037Ph: (02) 9660 3451LeichhardtPiazza level, Italian Forum23 Norton StreetLeichhardt NSW 2040Ph: (02) 9560 5604Marrickville Health Centre155-157 Livingstone RoadMarrickville NSW 2204Ph: (02) 9562 0444RedfernCorner Elizabeth and Redfern StreetsRedfern NSW 2016Ph: (02) 9698 1613Liverpool Hospital’s volunteer navigator TonyHyde assisting hospital visitor Jane Fleming infinding her bearings in the hospital.Sydney South West Area Health ServiceYear in Review 05>06 51

Bankstown nurse Brenda Peffer (left) won theinaugural Child and Family Health Nurse of theYear, a joint initiative of SSWAHS (western zone)and Karitane. She is seen here with runners upSue Morgan and Jenny Jones.Western Sector CentresAshfield260 Liverpool RoadAshfield NSW 2131Ph: (02) 9716 1853Concord57A Wellbank StreetConcord NSW 2137Ph: (02) 9743 1654Croydon24 Liverpool RoadCroydon NSW 2132Ph: (02) 9378 1156Drummoyne64 College StreetDrummoyne NSW 2047Ph: (02) 9181 2619Five DockCorner Park Road and First AvenueFive Dock NSW 2046Ph: (02) 9713 6140HomebushA2 Fraser StreetHomebush NSW 2140Ph: (02) 9746 7763Summer Hill Community Centre131 Smith StreetSummer Hill NSW 2130Ph: (02) 9716 1853Canterbury Sector CentresBelmore Senior Citizens HallRedman ParadeBelmore NSW 2192Ph: (02) 9718 0157Campsie143 Beamish StreetCampsie NSW 2194Ph: (02) 9718 3177EarlwoodCorner Homer and William StreetsEarlwood NSW 2206Ph: (02) 9718 4847Lakemba35 Croydon StreetLakemba NSW 2195Ph: (02) 9759 2034RoselandsL94, Level 1, Roselands Shopping CentreRoselands NSW 2196Ph: (02) 9750 7452Community Facilities –western zoneFairfield LGAPrairiewood Community Health CentreFairfield Hospital groundCorner Polding Street and Prairie Vale RoadPrairiewood NSW 2176Ph: (02) 9616 8169Cabramatta Community Health Centre7 Levuka StreetCabramatta NSW 2166Ph: (02) 8717 4000Fairfield Community Health Centre53-65 Mitchell StreetCarramar NSW 2163Ph: (02) 9794 1700Liverpool LGAMoorebank Community Health Centre29 Stockton AvenueMoorebank NSW 2170Ph: (02) 9602 6419Hoxton Park Community Health Centre596 Hoxton Park RoadHoxton Park NSW 2171Ph: (02) 9827 2222Miller Health CentreMission Australia88 Shropshire StreetMiller NSW 2168Ph: (02) 9607 8429Health Services BuildingCorner Campbell and Goulburn StreetsLiverpool NSW 2170Ph: (02) 9828 4844Bankstown LGABankstown Community Health Centre36-38 Raymond StreetBankstown NSW 2200Ph: (02) 9780 2777Primary Health NursingLevel 2, 27 Greenfield ParadeBankstown NSW 2200Ph: (02) 9205 4221Macarthur LGAIngleburn Community Health Centre59A Cumberland RoadIngleburn NSW 2565Ph: (02) 9605 8900Narellan Community Health Centre14 Queen StreetNarellan NSW 2567Ph: (02) 4640 3500Rosemeadow CommunityHealth Centre5 Thomas Rose DriveRosemeadow NSW 2560Ph: (02) 4633 4100Wollondilly Community Health Centre5-9 Harper CloseTahmoor NSW 2573Ph: (02) 4683 6000TraxsideLangdon AvenueCampbelltown NSW 2560Ph: (02) 4625 2525Wingecarribee LGABowral Community Health CentreBendooley PlaceBowral NSW 2576Ph: (02) 4861 800052 Year in Review

SSWAHS Year in Review 05>06 provides a summary of ouroperations and highlights significant achievements andevents for the year. The Year in Review also presentsperformance and outcome information in a readerfriendlymanner.It can be read together with the SSWAHS Statutory AnnualReport 05/06, which completes our annual reportingfor the year. Both reports are available on our websitewww.sswhealth.nsw.gov.au or by phoning(02) 9828 5700 or (02) 9515 9600.We welcome your feedback. You can contact us by email atarearecords@swsahs.nsw.gov.au, through our website atwww.sswhealth.nsw.gov.au or by phoning us on(02) 9828 5700 or (02) 9515 9600.Sydney South West Area Health ServiceHead OfficeLiverpool Hospital (Eastern Campus)Elizabeth StreetLiverpool NSW 2170Mailing AddressLocked Bag 7017Liverpool BC 1871Ph: 61 2 9828 5700Fax: 61 2 9828 5769Email: arearecords@swsahs.nsw.gov.auWebsite: www.sswhealth.nsw.gov.auRoyal Prince Alfred HospitalLevel 11, King George V BuildingMissenden RoadCamperdown NSW 2050Ph: 61 2 9515 9600Fax: 61 2 9515 9611AcknowledgementsDesign: Pro Bono Publico. Photography: SSWAHS Audio Visual Services. Printing: PLT Print Solutions.A publication of SSWAHS, produced by Public Affairs and Marketing.