Vasili Kanidiadis SMILE OF THE YEAR
2017
Got a question about dental health? ASK PROFESSOR MIKE PAGE 27
WIN! AN ANNUAL PASS TO ZOOS VICTORIA, DETAILS ON PAGE 3 HOW WELL DID WE DO? IMPROVING THE DENTAL HEALTH OF VICTORIANS DENTAL HEALTH SERVICES VICTORIA / QUALITY ACCOUNT 2016
For more information visit www.dhsv.org.au
FEATURES
Like us on Facebook www.facebook.com/DentalHealthVic www.facebook.com/RoyalDentalHospitalMelbourne Follow us on Twitter www.twitter.com/VicDental
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Smile of the Year: Vasili Kanidiadis
Quality and safety at The Royal Dental Hospital of Melbourne
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Working with our communities to improve dental health
Got a dental question? Ask Professor Mike
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Healthy and delicious recipes by Masterchef Australia’s Matt Hopcraft
Children’s corner Puzzles and more for the waiting room
We acknowledge the traditional owners of Australia and we welcome all Aboriginal and Torres Strait Islander peoples to our services. Where the term “Aboriginal” is used it refers to both Aboriginal and Torres Strait Islander peoples. Indigenous is retained when it is part of the title of a report, program or quotation.
WIN
HAMPER OR A ANFRUIT ANNUAL PASS TO ZOOS VICTORIA!
Tell us what you think about this Quality Account and you stand a chance to win a prize. Go to www.dhsv.org.au/QA-feedback Entries close 31 May 2017.
From the CEO What an amazing year it has been at Dental Health Services Victoria (DHSV). In our 2015–16 Quality Account, we reflect on some of our achievements over the year and we open the door to look at what exciting plans lie ahead. We are now on the road to realising our new five-year Strategic Plan which is focused on improving the experience of our patients, staff and consumers. We want to make sure that people who are most in need of our care are aware of the services available to them and how they can access care. We also want to transform the way we provide public dental services in Victoria. This will be done through a culture of respect, collaboration and accountability.
Some highlights This year, The Royal Dental Hospital of Melbourne (RDHM) became the first public hospital in Australia to have a Changing Places bathroom facility. Now people with a disability and their carers have a space that meets their needs without compromise. I was extremely proud of the way DHSV worked with families and local partners to make it happen. It is important that we give patients the respect and dignity that they deserve. Read more about our Changing Places bathroom on page 18.
In this issue, you can also read about our performance – what we have done well and what we still need to focus on. I am delighted to introduce our 2017 Smile of the Year ambassador, Vasili Kanidiadis. Vasili is the TV host of the popular Vasili’s Garden and he truly shows how a healthy lifestyle can have a positive outcome on dental health. Welcome Vasili, we look forward to working on some interesting projects with you. All the important information about taking care of your dental health is back in this issue. Professor Mike answers your frequently asked questions on dental health. This year’s recipes page is also a real treat, featuring MasterChef contestant and clinical advisor from DHSV, Matthew Hopcraft, preparing delicious meals that are healthy and easy to make. Enjoy the magazine and let us know what you think of it. There are some amazing prizes to be won for your feedback including a Zoos Victoria membership. Based on your feedback from last year, we trust you will find this magazine easier to read, with more of what you are interested in and a bit of fun. It is my absolute pleasure to present to you the 2016 Quality Account, Oral Health for Better Health. This year’s magazine can also be found online at www.dhsv.org.au/qualityaccount
Dr Deborah Cole Chief Executive Officer, DHSV
DHSV QUALITY ACCOUNT 2016
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Smile of the Year Vasili Kanidiadis He has a great smile and gives a thumbs-up as he says “Maresi”, which is Greek for “I like it”. You might have seen celebrity gardener Vasili Kanidiadis on his TV show Vasili’s Garden, where he visits the amazing backyard gardens of everyday Victorians. Vasili has a passion for growing the fruit and veggies he eats and he inspires others to do the same. This makes him the perfect 2017 DHSV Smile of the Year.
For the past 14 years, Vasili’s Garden has been on Channel 31, giving viewers a glimpse of backyard gardens and their owners around Victoria. The show has recently moved on to 7TWO, which will see Vasili continue what he loves most. “I do the show to inspire people to get out in the garden when they see what the guests do in their gardens,” Vasili said. “As a society, in Australia, we’re just starting to catch up to the ideas of sustainability and organics.
“If, through the show, we can change at least one garden in every street, then we’re doing our bit.” With a connection to his Greek Australian roots, Vasili said he wanted to preserve gardening techniques of Australia’s first European migrants for future generations through the show.
VASILI’S TIPS
“We’re starting to lose the first generation of European migrants that came to Australia after the Second World War.
How to start your own edible garden
“These people have some of the best gardens you’ve ever seen and it’s because they’re using time-tested techniques that they’ve brought with them from the old country.” Vasili’s journey to gardening was accidental – he was on his first job as a structural engineer when he was asked to go onsite to design an extension to the old Essendon Garden Centre on Mount Alexander Road.
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lways start by growing your favourite A foods to eat. Branch out from there.
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earn what conditions each plant likes L before you plant and get it right the first time.
“What was to take one afternoon’s worth of time to measure and draw took me at least four visits to complete because I had fallen in love with the space, the plants and the surroundings,” Vasili said.
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earn about companion planting. L It will save you a lot of trouble with pests and diseases.
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llow space for your plants. Proper airflow A cuts down on places that pests can hide.
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lant some flowers for the bees. P No pollination equals no fruit.
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ake the most of every bit of space you M have, even the front yard.
“That was my last project before I resigned and went on the journey to open my own garden centre.” Vasili hasn’t looked back and he’s been busy filming Vasili’s Garden while tending to his nursery café of the same name. As DHSV’s Smile Ambassador, Vasili said it was an opportunity to spread the message that diet plays an important role in dental health.
Ways to keep your garden in top form
“They say that most diseases start in the mouth. “If you’re not looking at what goes into your mouth, then the problems are starting from your teeth, right through your body. “By eating healthy you remove a lot of processed sugar from your diet, because just about every packaged food product is loaded with it in one form or another.”
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P repare your soil properly with well-rotted compost and manure. Healthy soil equals healthy plants.
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Spray once a week with a garlic and chilli spray. This will prevent most pests.
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Don’t forget to water! Allow the soil to dry first before watering again. If soil sticks to your finger when you touch it, it is moist enough.
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Fertilise your plants with a liquid feed. Plants need to eat too.
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When planting anything new, always water it in with a seaweed garden tonic to help it survive root shock.
Find out more about Vasili’s Garden. Visit www.vasilisgarden.com
DHSV QUALITY ACCOUNT 2016
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Quality and safety
At RDHM, we aim to provide the best quality of care to our patients. We collect data on our services and measure ourselves against the National Safety and Quality Health Service (NSQHS) Standards to help us provide excellent care. In the next few pages, read about how we achieved safety and quality at the hospital in 2015–16.
Your say counts We place our patients and consumers at the heart of our service delivery. Through our feedback process, we capture your experiences to help us to improve the planning and delivery of our services.
207
COMPLIMENTS RECEIVED IN 2015–16
ACCESS 07 Any compliment received relating to accessing services. This may include waiting times, access to staff via the telephone, patient eligibility to care and appointment scheduling.
TREATMENT 154 Any compliment received in which the patient is happy with the care provided or treatment outcome.
COMMUNICATION 20 Any compliment received relating to good communication about the patient's dental care that resulted in a positive experience.
CUSTOMER SERVICE 22 Any compliment received in which the patient perceives the staff as helpful, caring and patient centred.
CARE COORDINATION 04 Any compliment received in which the patient perceives the staff as encouraging the patient, family and/or carers to participate in planning their care.
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HOW WE USE YOUR FEEDBACK We record all the feedback that we receive in the Victorian Health Incident Management System (VHIMS) database.
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RDHM has a responsibility to be responsive and sensitive towards the rights, needs or complaints expressed by consumers (or someone on their behalf). We also aim to manage your response in a timely and sympathetic manner. When we receive feedback from patients who are dissatisfied with the service, it is forwarded to the relevant manager who will work with the patient to resolve their issue within 28 days. We collect information about patients to help us with monitoring actions and outcomes of complaints. It also helps the hospital improve our services to patients.
COMPLAINTS
RECEIVED IN 2015–16 ACCESS 168 Any complaint received relating to accessing services. This may include waiting times, access to staff via the telephone, patient eligibility to care and appointment scheduling.
TREATMENT 125 Any complaint received in which the patient is unhappy with the care provided or treatment outcome.
COMMUNICATION 48 Any complaint received relating to good communication about the patient's dental care that resulted in a positive experience.
CUSTOMER SERVICE 48 Any complaint received in which the patient perceives the staff as being rude or dismissive.
COST 27 Any complaint relating to the cost of treatment.
FACILITIES 08 Any complaint received relating to our facilities. These may include facilities within the building such as chairs in the waiting area.
People Matter Survey
VICTORIAN HEALTH EXPERIENCE SURVEY 97% OF PATIENTS HAPPY WITH HOSPITAL CARE
The People Matter Survey is an employee opinion survey run by the Victorian Public Sector Commission. In July 2015, DHSV achieved 68 per cent in relation to patient safety at RDHM.
Positive workplace culture We want to make DHSV a great place to work where our staff feel safe, valued and respected. DHSV has worked with staff to create a new set of values with the launch of our new strategic plan. Through these values staff will work together to: • transform ourselves and the organisation to achieve better health outcomes for the community • act with respect towards every person or idea that we encounter • be accountable to the people we care for and those we work with • embrace collaboration with all partners that help us achieve our goals. Earlier this year the Auditor-General released a report into bullying and harassment in the health sector. This was prompted by numerous cases of discrimination, bullying and harassment coming to light. DHSV will be holding Respectful Workplace Learning Day for all staff to discuss what it takes to build a respectful workplace and how we can achieve it together.
The Victorian Health Experience Survey (VHES) seeks to discover the experience of people, aged 16 and over, who have been admitted to one of 116 Victorian public hospitals. Potential respondents are randomly selected from people who were discharged from RDHM’s Day Surgery Unit. Our VHES scores have been improving over the year and we reached a high of 97 per cent in the final quarter. The scores below show the percentage of patients who rated their overall experience at the Day Surgery Unit as either 'very good' or ‘good'.
Apr–Jun 2016
97%
Jan–Mar 2016
96%
Oct–Dec 2015
95%
Jul–Sep 2015
91%
Read the DHSV Strategic Plan 2016–21 on www.dhsv.org.au/ strategicplan
DHSV QUALITY ACCOUNT 2016
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YOU SAID IT!
Thanks for the excellent care of my 8-year-old daughter, who chipped her front tooth while swimming on New Year’s Eve. A worrying situation was quickly handled extremely competently. I couldn’t have asked for anything better. – Emma
Recently had a complete set of wisdom teeth extracted here under local anaesthetic, and the experience was as pleasant as possible, given the situation. The dentists and nurses were very eager to do whatever it took to put me at ease, even complying with almost all of my (somewhat strange, I’ll admit) requests. All up one of my more positive dental experiences. Thank you for making my visit a good one DHSV! Not nearly the nightmare I was preparing for. – Anonymous
Very impressed. Came in for an assessment and they fixed a tooth that lost its filling while I was here. Professional approach – doctor reviews every step. Thank you all! – Norm
OUR PATIENTS RETURN WITH A SMILE
I’m very happy with your service. Staff are very good and understanding. They feel the pain of every patient. I am very happy and satisfied. – HZ
Thank you for your fantastic care of my 82-year-old father who presented at Emergency. The waiting times were more than reasonable and the staff were friendly and answered all our questions. – Scott
Christine Waters is a Patient Liaison Officer at RDHM. When patients visit us, our friendly patient liaison officers help make sure they are in the right clinics for their appointments. Christine said that achieving patient satisfaction was about making sure that patients waiting in line get served as quickly as possible so that they come back with a smile. "When our patients are happy, we are happy too,” said Christine. “We have a computer on wheels. When the line gets too long, we wheel out a computer on a trolley to take appointments of those standing in line so they don’t have to queue for too long.” Having worked in RDHM for about 10 years, Christine said the best part of the job was being able to meet people of different nationalities and walks of life. “It makes my day when they recognise me and come back with a smile to say thank you.”
Ways to give feedback Your feedback is important in helping us improve, so please take the time to tell us how we are doing. Here are a few ways that you can do so.
FEEDBACK FORM When you visit RDHM, fill out one of our feedback forms located throughout the hospital.
ONLINE Provide your feedback online via • our website: www.dhsv.org.au/feedback • Facebook page: www.facebook.com/ RoyalDentalHospitalMelbourne
PETs If you visit RDHM, you may have noticed our Patient Experience Trackers, or PETs as we call them. These computer terminals are located throughout RDHM to collect feedback from our patients and visitors. In 2015–16 you told us that your level of satisfaction when • receiving treatment in the clinic was 94 per cent • accessing our services by telephone or presenting at reception was 88 per cent.
DO YOU WANT TO GIVE FEEDBACK ABOUT A COMMUNITY DENTAL CLINIC? • To give feedback about a community dental clinic, please contact the clinic directly You can find contact details of our clinics on www.dhsv.org.au/clinics • Find out more about accessing public dental care on page 25.
Our Patient Experience Trackers are located throughout RDHM to collect feedback from our patients and visitors.
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Meeting accreditation HOSPITAL ACCREDITATION SCORECARD In December 2015, RDHM was measured against three out of 10 of the NSQHS standards as part of our threeyear accreditation cycle. The standards were: Standard 1 – Governance for safety and quality in health service organisations Standard 2 – Partnering with consumers Standard 3 – Preventing and controlling healthcare associated infections. This was a successful review with the surveyors praising us for a number of improvements such as:
CLINICIAN SCORECARD The clinician scorecard helps clinicians share feedback and discuss ways to improve care to patients.
CONSUMER TICK OF APPROVAL We seek consumer feedback on every new or amended publication. If consumers are happy with the content and design, it is awarded the consumer tick of approval.
ANTIMICROBIAL STEWARDSHIP Antimicrobial resistance (AMR) is when an organism develops resistance to the medicine that is used to treat it. Our antimicrobial stewardship program has been fully compliant with national standards.
Not only that, the surveyors acknowledged our efforts in redesigning systems and processes to ensure that the hospital is a coordinated, safe and quality healthcare organisation. The surveyors congratulated us on our level of consumer engagement in these activities.
PRESSURE INJURIES REPORTED: 0 We had no reports of pressure injuries in 2015–16. Pressure injuries are localised areas of damage to the skin or underlying tissue, caused by unrelieved pressure or friction. They occur most commonly over bony prominences such as the sacral area (the area at the base or bottom of the spine) and heel, but they can develop anywhere on the body.
FALLS REPORTED: 4 We are working hard to prevent falls and harm from falls. We have a falls policy and procedure based on best practice and we are compliant with the Australian Commission on Safety and Quality in Healthcare requirements for falls.
MEDICATION INCIDENTS REPORTED: 15 At RDHM we make sure that all medications are stored, prescribed, dispensed and administered in accordance with relevant legislation and current best practice. We aim to provide the best patient outcomes by minimising the number of medication incidents. We monitor medication incidents through the Medication Safety Working Group and the Board Safety and Quality Committee.
INCIDENTS REPORTED: 482
FULL ACCREDITATION FOR DIAGNOSTIC IMAGING UNTIL 2020
Clinical incidents reported
In June 2016, the hospital achieved full accreditation against the Diagnostic Imaging Accreditation Scheme (second edition).
2015–2016 2014–2015
482 565
This data includes both clinical and non-clinical incidents. Non-clinical incidents can include issues relating to equipment, facilities or administration processes. How we manage incidents RDHM makes sure that when an incident occurs, we have the systems and processes in place to be as prepared as we can be. An incident is an event or circumstance that could have or did lead to unintended and/or unnecessary harm. We have a clinical incident and risk management system which includes the management of adverse clinical events, sentinel (or unexpected) events, and near misses if they occur. When an incident occurs: 1. We make sure that the patient and/or carer knows by following the open disclosure, or open discussion process. This will occur as soon as possible and lets everyone know what happened and what the next steps will be to ensure patient safety. 2. We conduct an investigation and where appropriate, we make recommendations for continuous improvement to prevent reoccurrences. We also keep our patients informed during the process. 3. We record the details in the VHIMS database so that we can monitor the resolution of incidents, their outcomes, and continue to provide a safe and quality service to patients.
What does this mean? This means that we met all the standards required to provide safe and quality care in diagnostic imaging such as X-rays. Dental professionals use these tools to help them diagnose patients and manage their care. How we did it This Accreditation Scheme was established by the Commonwealth Department of Health and Ageing. We submitted evidence to the Quality Innovation Performance (QIP), a national accreditation body that assesses general practices. QIP assessed the hospital against the required standards and we met all of them successfully.
Helping public dental clinics meet accreditation DHSV is leading the way in the new NSQHS standards. Since these standards were introduced, we have provided resources, advice and ongoing support for community dental agencies around Victoria who have now all achieved accreditation for their dental clinics. DHSV has also played a major role as a member of the NSQHS dental forum, providing advice on the revision of the National Standards Guide for Dental Practices and the reclassification of some of the actions in the standards. All suggestions were included in the recently published Standards Guide. DHSV then conducted a self-assessment and contributed feedback to the Australian Commission for Safety and Quality in Health Care, along with many other organisations around Australia.
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INFLUENZA IMMUNISATION
The Infection Control team, Nina Christofi and Wendy Bacalja, provide flu vaccinations to hospital staff and students.
RDHM has been on the campaign to prevent the spread of infection through staff vaccinations. Every year, the infection control team travels around the hospital to give influenza vaccinations to staff and students.
77%
STAFF AT THE DENTAL HOSPITAL VACCINATED IN 2015–16. UP BY 3% FROM LAST YEAR.
INFECTION CONTROL
HAND HYGIENE
Effective hand hygiene is important in preventing healthcare-associated infections. RDHM promotes hand hygiene to new and existing staff through annual mandatory online education modules. Since the start of the year, all students and demonstrators have also been required to complete these modules. RDHM has continued to achieve an excellent compliance rate for hand hygiene. The Victorian target was 80 per cent and we have consistently been above target. Hand hygiene results
Apr–Jun 2016
81%
Jan–Mar 2016
83%
Jul–Oct 2015
82%
Keeping our dental tools clean and free from infection Patients rarely get to meet staff from the Central Sterilising Service Department (CSSD), but this team plays a vital role in infection control at RDHM. They work behind the scenes to make sure that all dental instruments are properly packed and sterilised and ready for patients.
“The new washers are more efficient as some processes will be automated. For example, staff will no longer need to remove and add loads manually,” Ms Turner said.
New washers
New electronic tracking system
In January 2016, CSSD installed brand-new washers. This has helped with • improving the hospital’s infection control processes • increasing staff output • reducing energy usage in CSSD.
In June 2016, RDHM implemented a new system to track the dental instruments we use electronically across the hospital, complete with barcode scanners, fully washable computers and Wi-Fi.
RDHM Executive Director Leanne Turner said that the washers were a significant investment and a welcome addition.
“We had been using the old washers for 12 years and we were having a backlog of washing due to their limited capacity. “It was time we retired these washers and replaced them with the latest technology.”
The new tracking system has helped RDHM to improve inventory management. Now it is easier for staff to tell what instruments are needed and where they need to go. The system also lets us know how often instruments are used and when they need to be replaced.
CSSD Instrument Technician Romelito Agustin loads instruments into the washer.
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Consumer, carer and community participation
DHSV’s Aboriginal Liaison Officer, Carleen Miller, with grandparents David McEwan and Robyn Donald and granddaughters Ruby 6, and MacKenzie 3, at The Gathering Place. Read more on our work on Aboriginal oral health on page 20.
Your feedback is important to us. In the next few pages, read about the ways we have extended our reach to provide care to our patients, especially the ones who need it most.
One-of-a-kind overnight dental service for Victoria’s patients with intellectual disability Through our feedback channels, staff and carers of patients with special needs told us that due to complex medical needs and behavioural issues, these patients require overnight care. As RDHM offers a day surgery unit, we worked with Western Health to develop a clinic in Williamstown Hospital, one where we could refer patients requiring specialist treatment and overnight care to. For parents Brian and Debra Trayler, it was a relief when their son Flynn was accepted as the first patient at DHSV’s specialist dental clinic at Western Health for patients with intellectual disability and complex medical illnesses. Flynn was diagnosed as severely intellectually disabled just 23 days after he was born in March 1984. Among other issues, Flynn has dextrocardia, a rare congenital defect, is epileptic and has recently suffered from keratoconus, a degenerative disorder of the eyes. DHSV’s overnight specialist dental service, located at Western Health’s Williamstown Hospital is the first of its kind in Victoria for patients like Flynn. It is a one-stop-shop for eligible patients with special needs to access specialist treatment, for those with complex medical conditions to be treated and have access to overnight care, as well as in-house oral maxillofacial interns to provide surgical treatment if needed.
“A small fraction of our patients may need to be admitted overnight after their treatment. Although the number is small, their need is great,” Dr Shnider said. “The patients who require overnight care are those with complex medical reasons such as uncontrolled diseases, severe behavioural issues that require longer care, or those who live far away and are not well enough to travel home”. Associate Professor Arun Chandu has played a key role in making the overnight service a reality. As a Senior Oral and Maxillofacial Surgeon at RDHM and head of Faciomaxillary Surgery at Western Health, he helped create the partnership between Western Health and the dental hospital. "The partnership has allowed our special needs patients, who have great needs and high-level requirements, to access inpatient hospital care for the first time in many years." Mrs Trayler said the specialist dental service was much needed.
Specialist dentist Dr Warren Shnider was one of the strongest advocates for an overnight dental service.
“Parents of special needs offspring have enough to cope with without having to battle long and hard for even basic dental needs.”
He said that the service was “born out of need” to treat this group of patients in an appropriate theatre facility.
“We are so pleased that this partnership between DHSV and Western Health is available for families like us.”
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Win for disability patients and carers in an Australian first for public hospitals
Changing Places started with a letter from the parents of Michael Cummins, an RDHM patient with severe intellectual and physical disabilities. When Gail and David Cummins brought their son to the hospital for a dental appointment, they found that there was no suitable place for Michael to be changed after needing the bathroom. They wrote a letter to DHSV requesting an upgrade to the facilities. RDHM embarked on a project to install a fully accredited Changing Places bathroom, and became the first public hospital in Australia to do so.
DHSV CEO, Dr Deborah Cole, said the facility, which is now double its original size, was not only a win for patients of the hospital but for the wider Melbourne population. “It will be open to the general public which means people with a disability and their carers will have access to state-of-the-art facilities,” she said. “The project shows our commitment to patientcentred care and our dedication to listening to what is important to our patients and their families.” Parents Gail and David Cummins were pleased with DHSV's efforts to install the facility. “It was important to us to have respectful facilities where he can be changed after needing the bathroom,” Gail said. “The result following our correspondence was beyond what we expected and this marks an important day for people with disabilities, their carers and volunteers.”
What are Changing Places bathrooms? Accredited Changing Places bathrooms feature • height-adjustable change tables • tracking hoist systems • sufficient circulation space for carers • a centrally placed toilet. In addition to these features, the RDHM facility also has a shower. From left, standing: At the Changing Places launch: Parents David and Gail Cummins, Association for Children with a Disability CEO, Eddie Chapman, Parliamentary Secretary for Carers and Volunteers, Gabrielle Williams MP, DHSV Board Member, Kathy Bell, and patient Michael Cummins (seated)
TELEDENTISTRY MAKES CYBER DENTAL CHECK-UPS A REALITY It can be hard for people living in regional and rural Victorian communities to access specialist dental services and advanced dental care near home. We have been working hard to address this through our teledentistry project, which connects rural and regional patients to specialist dentists at RDHM from the comfort of their local dental clinic. The project is currently running in Rosebud, Portland, Shepparton and the Latrobe Valley.
“We were able to examine patients with the help of the local dental professionals and offer diagnoses, advise on continued management, arrange for biopsies and procedures under general anaesthetic at RDHM,” Dr Engelbrecht said.
In June 2016, Shepparton residents were the first group of patients to receive care through our teledentistry project. The launch saw specialist dentists at the hospital conduct examinations with patients through a live video stream from Melbourne to Goulburn Valley Health’s dental clinic in Shepparton.
“Some of the elderly patients find it stressful and a bit of an ordeal to get to RDHM and they have really appreciated having appointments in Shepparton.”
With state-of-the-art intra-oral cameras and web-based conferencing to stream consultations, RDHM specialist dentist Dr Hanlie Engelbrecht said the team has consulted patients on oral surgery, oral medicine, endodontics and orthodontics.
“Teledentistry has allowed my colleagues and me to form stronger professional relationships with the specialists at RDHM who we can consult with regularly.
TELEDENTISTRY is the use of information technology and telecommunications to provide dental care. The project has been beneficial for both staff and patients, especially for those who have difficulty travelling long distances.
“We’re very excited about the ongoing growth of teledentistry and look forward to providing better care for Victorians.” Graduate dentist, Dr Aditya Athale at Goulburn Valley Health said patients have been grateful to be part of the project. “It has saved them from having to travel to Melbourne without compromising on the quality of care received,” Dr Athale said.
As a first year graduate clinician, Dr Athale also said that teledentistry has helped him improve his skills in diagnosis and patient management.
“We have gained experience in multiple cases and have worked together with the specialists to treat patients or organise referrals where necessary. “We are really grateful for being part of this program and we’ve learnt a lot from it."
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Closing the gap
At DHSV we are passionate about reducing the gap that exists between the health of Aboriginal people and the rest of the population. This year, we continued our outreach efforts to provide care to even more Aboriginal families in Victoria. We have worked with local Aboriginal health workers and developed our workforce to make sure that the care we provide is culturally responsive to the needs of our Aboriginal patients.
10,122
Aboriginal patients received dental care in community dental clinics and RDHM in 2015–16. Up by 8.8% from last year.
Above: Dental Assistant Charlene Kiikoro educate Jasmine 9, and Zachary Heywood 12, on good oral health at The Gathering Place.
OUTREACH DENTAL PROGRAM DHSV has been taking its mobile dental van out to The Gathering Place at Werribee to provide dental care to Aboriginal residents living in Melbourne’s west. The Gathering Place provides services and programs to the Aboriginal community residing within Maribyrnong, Hobson's Bay and the Shire of Melton, Brimbank, Wyndham and Moonee Valley. DHSV Aboriginal Liaison Officer, Carleen Miller, said the van operated four times a year and visits coincided with school holidays. “We started this outreach service because there was a need to provide a dental service closer to home,” Ms Miller said. “Many children in this area are in out-of-home care and quite a number are looked after by their grandparents.” Hoppers Crossing residents, David McEwan and Robyn Donald, bring their grandchildren to The Gathering Place for dental appointments. “It has such a homely atmosphere and people can drop in anytime,” Ms Donald said. “The dentists checked their teeth and also showed us how to brush properly and what to eat and drink for healthy teeth.”
Werribee mum Roula Heywood, was also at the clinic with children Jasmine and Zachary who had dental appointments. “It’s good to have the children seen during the school holidays so they are not missing school.” Specialist Care Clinical Coordinator, Tracy Forrester said that staff from RDHM and The Gathering Place have worked closely together to make the service happen. “We have built effective referral pathways so that patients who need further treatment are taken care of,” Ms Forrester said. “We also rostered staff efficiently to make sure we stayed within budget while fulfilling this important service.
Bendigo and District Aboriginal Co-operative staff ready to share their oral health knowledge with their community.
“Before we started we didn’t even have power onsite for the dental van but we have worked hard to get the van out here. We now use a power generator to make it work.”
BIGGER BETTER SMILES MAKES ITS MARK IN VICTORIA
DEVELOPING OUR ABORIGINAL WORKFORCE We believe that our Aboriginal staff play an important role in improving dental access to Aboriginal patients and their families. So as part of the DHSV Indigenous Employment Program, we have expanded our Indigenous traineeship opportunities. We included a patient liaison traineeship program to assist patients coming to RDHM for treatment. We have also continued with our successful Indigenous Dental Assistant Program. In November 2015, the Australian Human Resources Institute awarded DHSV with the Indigenous Employment Award. This Award recognised our Indigenous Employment Program as a way of creating an emerging talent pipeline in clinical and non-clinical roles for our Aboriginal workforce.
RDHM Dental Assistants Aisha Mansfield and Eloise Charles
Our Health Promotion team, through the Healthy Families Healthy Smiles program, is taking Bigger Better Smiles to even more communities in Victoria. Bigger Better Smiles is an oral health education program aimed at building knowledge, skills and confidence among staff working in Aboriginal services that see pregnant women and families with young children. Bigger Better Smiles first started in the Mallee District Aboriginal Services in May 2014. In 2015, we delivered Bigger Better Smiles to Aboriginal Community Controlled Health Organisations (ACCHOs) in Bendigo and Gippsland. In 2016, Bigger Better Smiles was also delivered at Peninsula Health, supporting their “Koolin Liang” project aimed at promoting oral health and improving access to community dental services for its local Aboriginal population.
EFFECTIVE REFERRALS HELP US GET TO KNOW OUR PATIENTS The Victorian Aboriginal Oral Health Information System project has been created to help us understand how Victoria’s Aboriginal patients use our services. It provides important information such as the oral health status of the patient and how often they access the service. Through this project we have been able to routinely collect clinical data for Aboriginal patients attending public dental services in Victoria. The main outcome measures include: • oral health status of the patient • number of visits • reason for visit • clinic location • number and type of treatment received.
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COMMUNITY ADVISORS HELP SHAPE THE QUALITY OF CARE Our community advisors are made up of patients and visitors from all walks of life. They provide a patient and visitor perspective of our services and their feedback helps us to improve. Meet one of our community advisors, Rebekah Kaberry.
Having been afraid of going to the dentist as a child, Tarneit mum Rebekah Kaberry wants to make dental visits a positive experience for her children. “I overcame my fear of the dentist as an adult and I have been taking my kids for dental check-ups from a young age because I want them to feel safe when they visit a dental clinic,” Rebekah said. Rebekah and her family have been visiting RDHM for about seven years. “As consumers of public dental care, I wanted to find a way to give back and also speak up for other consumers.” Rebekah found that opportunity in 2011 when she saw a sign calling for new members to join the Board Safety and Quality Committee. The committee makes sure that quality monitoring activities are systematically performed and quality standards are maintained. She is also a member of the Population Health Committee and was previously involved in the Patient Flow Project Control Group. “Being a stay at home mum, it meant that even though I wasn’t in paid employment, I could still be involved in the community and have a say in improving public health services.” “I believe that I can share my experiences as a service user to ensure that the focus and direction of the organisation remains in the interest of the consumer.”
We have been working with consumers from the Community Advisory Committee and Board Safety and Quality Committee to create this Quality Account. DHSV would like to thank our consumers for their time and valuable feedback. Are you interested in being involved as a consumer representative? Register your interest on www.dhsv.org.au/consumer_rep
ANSWERS TO CROSSWORD 1. MARESI 2. TICK 3. BRUSH 4. FRUIT 5. VACCINATION 6. WASHER 7. CARLTON 8. INFECTION 9. FLOSS 10. HYGIENE 11. APPOINTMENT 12. SUGAR 13. PRIORITY ACCESS 14. REFERRAL 15. ABORIGINAL 16. TELEDENTISTRY 17. PETS 18. TOOTHPASTE 19. EVERYONE
COMMUNITY ORAL HEALTH CHAMPION
DIANA BROWN
Our 2016 Community Oral Health Champion, Diana Brown, is an all-rounder. Diana is not only the Smiles 4 Miles coordinator at EACH Social and Community Health, she also works as a receptionist, providing administrative and customer service support at the clinic. With an interest in health promotion, Diana took on the coordinator’s role at Smiles 4 Miles in 2010. Since then, the number of preschool-aged children visiting EACH dental clinic has tripled. “It feels amazing. I enjoy being involved in Smiles 4 Miles and I have loved every minute of it,” Diana said. EACH Reception Team Leader, Eva Saris, said that Diana has also been committed to helping educators at the 60 early childhood services. “Diana has been tireless in her commitment to the program and to improve the oral health of preschoolaged children and their families.
NUTRITION IN THE SPOTLIGHT OF DENTAL HEALTH
“She makes sure that the educators understand what is required and helps them to implement healthy eating and oral health policies,” Ms Saris said. “Diana has also created ways to improve family engagement using Smiles 4 Miles’ key messages: Drink well, Eat well and Clean well. “Diana is a true champion for her contribution to ensure our youngest population's oral health is developed healthily. “It’s also done while contributing to the provision of high quality, efficient and effective community and oral health services to clients and staff through reception, clerical and administrative support.”
Eating well is good for your teeth and for the rest of your body. If you eat well, there’s a good chance your dental health will improve. In October 2015, DHSV and the Dietitians Association of Australia (DAA) launched its joint position statement on oral health and nutrition. The position statement emphasises the important role of dietitians in promoting good oral health as part of their day-to-day work. It includes practical information for Accredited Practising Dietitians, including information on • oral health risk factors • protective features of the diet • oral health and nutrition through the life stages. The joint position statement can be found here: www.dhsv.org.au/professionals/dietitians
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Community dental clinics – metropolitan Victoria Western metro
Northern metro
Eastern metro
Southern metro
Whittlesea Craigieburn
Sunbury
Epping Broadmeadows
Melton
Eltham Niddrie East Reservoir Heidelberg Preston Brunswick Northcote Kensington RCH VAHS Footscray Fitzroy Box Hill Ozanam Carlton North Richmond Altona Meadows Prahran Ashburton Sth Melbourne Hoppers Crossing Clayton Bentleigh St Albans
Kingston
Lilydale Ringwood East Ferntree Gully
Springvale
Dandenong Hospital Dandenong Berwick
Parkdale
Pakenham
Carrum Downs Cranbourne Frankston
Hastings Rosebud
Community dental clinics – rural Victoria Barwon South Western
Grampians
Loddon Mallee
Hume
Gippsland
Mildura Robinvale
Ouyen Swan Hill
Rainbow
Cobram Boort
Kaniva
Nhill
Wangaratta Shepparton Mooroopna Benalla
Dimboola
Goroke
Horsham
St Arnaud
Edenhope
Bendigo Maryborough
Ararat Wendouree
Wodonga
Echuca
Seymour
Omeo
Daylesford Creswick Ballarat
Hamilton
Portland
GEGAC Corio Camperdown Wathaurong Newcomb Belmont Point Lonsdale Colac
Warrnambool Gunditjmara
Warragul Moe
Wonthaggi
Morwell Churchill
Sale
Bairnsdale
Orbost
How do I get public dental care? Public dental care is provided through RDHM and community dental clinics located throughout metropolitan Melbourne and rural Victoria. To access public dental care, you need to have a healthcare or pension concession card to use most of the public dental services in these clinics.
What is priority access? Priority access means that you do not have to go on the waiting list to receive general dental treatment.* You will receive the next available appointment. The following groups can get priority access at RDHM. • Aboriginal and Torres Strait Islander peoples • children (0 to 12 years) and young people • homeless people and people at risk of homelessness • pregnant women
If you do not have one of these cards, you can still get emergency dental treatment at RDHM, but you will need to pay a fee similar to what you would be charged at a private clinic.
How much does it cost? The amount you pay for public dental care depends on your situation and the type of treatment you need. You may be able to get treatment for free or there may be a cost involved.
UNABLE TO MAKE YOUR APPOINTMENT AT RDHM? That's OK, just let us know as soon as possible so we can give your appointment to another patient. That way you will not have to wait as long for your next appointment. You can rebook your appointment online: www.dhsv.org.au/appointments
• refugees and asylum seekers • registered clients of mental health and disability services, supported by a letter of recommendation from their case manager or staff of special developmental schools. *General dental treatment includes routine dental examinations or check-ups, oral health advice, scale and cleans, extractions, fillings, X-rays, fissure sealants and root canal treatments.
Travelling for treatment? Victorians living in rural and regional areas can receive government assistance when travelling long distances for specialist medical treatment at the hospital. Visit www.dhsv.org.au/travelhelp
Need an interpreter? Interpreter services are available for all patients. When you make your appointment please tell us if you need an interpreter and what language you prefer to speak.
Find out more about our services on www.dhsv.org.au. Contact details can be found on the back cover.
These services need to be booked before you come to RDHM for your appointment. Telephone interpreters can be arranged for emergency patients.
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YOUR RIGHTS AND RESPONSIBILITIES AS A PATIENT We encourage you to take an active role in looking after your dental health and working with us to give you the care you need. Just as you have your rights, you also have responsibilities. You have the right to:
You have the responsibility to:
• Participate in decisions on how you are treated. Your options should be discussed with you so you can agree or refuse treatment if you wish.
• Give accurate information about your previous medical and dental treatment. Work with your dental professional by sharing information about your health, social circumstances and emotional wellbeing.
• Ask for a family member, carer, friend, advocate or interpreter to help you understand about your care and treatment. • Refuse the presence of anyone not directly involved in your care, including health workers, family members, students or researchers.
• Attend appointments on time and tell the clinic in advance if you are unable to attend. This will allow other patients to use the appointment.
• Get a second opinion from another qualified dental professional if you are unsure about your treatment.
• Follow advice provided for the management of your own oral health, or discuss this with your dental professional if you do not wish to do so.
• Refuse to have examinations, tests or dental work at any time.
• Ask for information if you do not understand what you have been told.
• Ask for an accredited interpreter. You should advise staff of this need when an appointment is made so that they can arrange this for you.
• Tell us if you are unhappy with the care you receive, or have family member or friend contact the manager of the department where you are receiving treatment.
• Confidentiality. Everyone involved in your treatment and care has a professional and legal duty to keep your personal information confidential.
More information about your rights and responsibilities can be found at www.dhsv.org.au/rights
Through Suha, Alaa told us that they lived in Lebanon for three years before arriving in Australia. “We left Syria when our son was one. We faced difficulties in Lebanon but we survived,” Alaa said. “Now, we just want to live a normal and happy life, learn the language and build our family.” With Arabic being the hospital’s most spoken language after English, Suha helps patients like Alaa’s family every day.
Syrian refugees Alaa Atiyeh and his family recently visited RDHM. As they spoke little English, our Arabic interpreter, Suha Dajani, was there to help them get around the hospital.
“When patients are in pain and are not able to explain their problems to the dental professional, it can be a stressful experience,” Suha said. “It’s satisfying to be able to help and to make a big difference to their care.” From left, Alaa Atiyeh, Isa 4, and Marie Bishara with Arabic interpreter, Suha Dajani.
If you have a dental question that has not been covered here, email Professor Mike at healthysmiles@dhsv.org.au
WHEN SHOULD I START CLEANING MY BABY’S TEETH? Start cleaning as soon as they appear.
ASK PROFESSOR MIKE Professor Mike Morgan is our resident dental expert and he is here to answer your questions on dental health. WHEN SHOULD I FIRST TAKE MY CHILD FOR A DENTAL CHECK-UP? Children should have a dental check-up by the time they are 2 years old. Having regular check-ups can help to spot problems early. Early stages of tooth decay can be treated. The first dental check-up can be provided by a dental professional, or through “lifting the lip” by a maternal and child health nurse or doctor. TIP: Find out more about free or low-cost public dental services for children on www.dhsv.org.au
• Cleaning and brushing teeth removes plaque (the build-up on teeth) that causes tooth decay. • You can start cleaning your baby’s teeth by wiping with a soft cloth or brushing with a small soft toothbrush and water. • At 18 months of age start using a pea-sized amount of low-fluoride toothpaste to brush your child’s teeth. Encourage your child to spit out toothpaste after brushing, but not rinse. • Clean all surfaces of the teeth and gums twice a day (after breakfast and before bed). • Children will need an adult to help them brush their teeth until about 7 or 8 years of age.
WHAT IS TOOTH MOUSSE? Tooth Mousse is a water-based crème containing Recaldent™, an important ingredient for strong teeth and gums. It was developed by scientists at the Melbourne Dental School at the University of Melbourne. Tooth Mousse provides extra protection to teeth and prevents tooth decay. It helps to neutralise acid challenges from bacteria in plaque and other acid sources. It is available in a range of flavours. Tooth Mousse is available at your dental clinic. Speak to your dental professional for advice on using it.
SHOULD WE FLOSS OUR TEETH? DOES BREASTFEEDING “ON DEMAND” CAUSE TOOTH DECAY? Breastfeeding is best for babies and, provided it is not “at will” nocturnal feeding, does not cause tooth decay. Your baby’s main source of food in the first 6 months of life is breast milk, or infant formula as an alternative if you are partially or no longer breastfeeding. After 6 months of age, do not let your baby go to sleep with a milk bottle or get into the habit of nocturnal breastfeeding. Once your baby has finished feeding, remove them from the breast or bottle.
Flossing your teeth removes food debris and plaque from between the teeth that a toothbrush can't reach. This may reduce the risk of gum disease. But there is not a lot of evidence that regular flossing can lower the risk of tooth decay. For healthy teeth, it may be enough to simply: • brush teeth and along the gum line twice a day with a soft brush • use a suitable fluoride toothpaste. Speak to your dental professional about whether flossing is recommended for you.
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Healthy recipes
Clinical Associate Professor Matthew Hopcraft is DHSV’s clinical advisor. Outside dentistry, he has a passion for cooking. You might have seen him on TV in the 2015 season of MasterChef Australia. Try these quick and easy recipes from Matt. For more of his favourite recipes, visit www.matthewhopcraft.com
Minestrone
ZUCCHINI SLICE This is a great slice for lunch boxes or as a healthy snack. It is also quick and easy, and fun to make with the kids. Serves 6 to 8. Ingredients
Zucchini slice
Beetroot, goats’ cheese and quinoa salad
• • • • • • • • •
2 large zucchinis (about 400g), grated 1 onion, diced 2 rashers bacon, diced (optional) 25g butter 50g grated tasty cheese 50g grated Parmesan cheese 4 eggs 1/2 cup plain flour salt and pepper
Directions 1. Preheat oven to 180C. 2. Sauté the onion in butter over medium heat for 4 to 5 minutes until translucent. Add the bacon and cook for a few more minutes. Remove from heat and cool. 3. Crack the eggs in a bowl and beat lightly. Add the zucchini, onion, bacon, flour and tasty cheese and mix together. 4. Pour into a greased shallow tin (27 x 17 x 4cm), sprinkle with Parmesan cheese and bake for 20 to 30 minutes until golden.
BEETROOT, GOATS’ CHEESE AND QUINOA SALAD
MINESTRONE
This is a tasty and healthy salad that you can eat on its own, or use as a side dish – perhaps with a nice piece of crispy skin salmon. Serves 4 to 6.
This is a great winter warming soup, and makes plenty for leftovers the next day. Serves 6 to 8.
Ingredients
• • • • • • • • • • • • • • • • • •
• • • • • • • • • • • •
4 large beetroot 2 cloves of garlic, unpeeled 200ml extra virgin olive oil 50ml balsamic vinegar 1 teaspoon of salt 2 red onions 1 cup quinoa 2 cups vegetable stock ½ cup hazelnuts 1 handful of rocket leaves 100g goats’ cheese salt and pepper
Directions 1. Preheat the oven to 200C. 2. Place beetroot and garlic in a large baking dish, drizzle with 50ml of oil and balsamic vinegar and sprinkle with salt. Cover with foil and bake in the oven for about 1 hour, until the beetroot is tender (but not overcooked). When the beetroot has cooled, carefully peel off the skin and cut into segments. Retain the juices from the roasting pan. 3. Meanwhile, peel the onions whole and cut into 8 segments, keeping the base intact. Place in a baking dish and drizzle with 60ml of olive oil. Season with salt and roast in the oven for about 20 to 30 minutes, turning occasionally until cooked. Allow it to cool and retain the juices from the roasting pan. 4. To make the quinoa, heat about 40ml of olive oil in a small saucepan. Toast the quinoa for 2 to 3 minutes, then add the vegetable stock. Bring to boil, then reduce the heat and cover the saucepan. Simmer for about 15 minutes until cooked. Drain the excess stock, fluff with a fork and allow to cool. 5. Roast the hazelnuts in the oven on a tray for about 5 minutes until the skins begin to split. Rub hazelnuts in a tea towel to remove skins, and chop roughly. 6. To make the vinaigrette, mix the juices from the roasting pan with about 2 to 3 tablespoons of extra virgin olive oil, salt and pepper. Adjust with extra balsamic vinegar if required. 7. To serve, place the quinoa in a large bowl and top with beetroot, onions, hazelnuts and rocket. Crumble goats’ cheese over and drizzle with vinaigrette.
Ingredients
•
60ml extra virgin olive oil 4 slices bacon 2 onions, diced 2 sticks celery, diced 2 carrots, diced 1 leek, diced 3 cloves garlic, crushed 1 small bunch fresh basil 400g crushed tomatoes 1 zucchini, diced 400g tin cannellini beans 1 handful green beans, sliced 250ml red wine 1L vegetable stock 2L water 150g dried pasta 1 handful of spinach leaves 5cm piece of Parmesan cheese, grated and rind reserved salt and pepper
Directions 1. Heat the oil in a large saucepan and add the bacon, onion, celery, carrot, leek, garlic and finely sliced basil stems and a good pinch of salt. 2. Sauté the vegetables over low heat for around 15 to 20 minutes until soft, but not brown. Add the tomatoes, zucchini, cannellini beans, green beans and red wine and simmer gently for 15 minutes. 3. Add the stock and water and bring to the boil. Add the pasta, reduce to a simmer, and cook for 10 minutes. 4. Add the spinach, basil leaves and Parmesan cheese rind and simmer for another 5 minutes. Remove from the heat and season to taste with salt and pepper. 5. Serve with some grated Parmesan cheese on top. The pasta will absorb a lot of the liquid overnight, so add some extra water when you re-heat. Throw in some Parmesan cheese rind for a pleasant savoury hit to the minestrone – keep leftover rind in the freezer until you need it to make some soup.
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Puzzles and more
WHAT A TANGLE It’s a maze in here! Can you help Super Tooth get to the bottom of the floss?
What has teeth but cannot eat? A comb
What did the dentist see at the North Pole? A molar bear
COMPLETE ME Brush your teeth twice a day and keep plaque away. Use the grid as a guide to finish the picture and see his BIG sparkling smile!
What does a dentist do on a roller coaster? What game did the dentist play when she was a child?
What did the dentist do when the judge came in for an appointment?
He braces himself
Caps and robbers
He looked at his tooth, the whole tooth and nothing but the tooth... 3
14
13 4 1
11
18
12 7
15
16 19
5
2
17 8
6
9
CROSSWORD
10
The words can be found throughout this magazine. Read through the magazine for hints. Across
Down
1. Greek for “I like it� 2. Patient-friendly brochures get the Consumer ______ 3. Do this twice a day 4. Eat two serves of this every day 5. Flu shot 6. It cleans dental instruments 7. The suburb that RDHM is located in 8. Washing your hands prevents ______ 9. Clean between your teeth 10. A general term referring to any action of hand cleansing. Hand ______
11. A dental booking 12. A lot of processed food contains this 13. Pregnant women, homeless people and children have this (2 words) 14. Sends a patient to someone for help or advice 15. Closing the Gap for these patients 16. Cyber dental check-ups 17. You can give RDHM feedback using these 18. Use this to clean your teeth with a brush 19. Who can get emergency care at the hospital? Answers on page 22.
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Contact us THE ROYAL DENTAL HOSPITAL OF MELBOURNE (RDHM)
CONTACTING YOUR LOCAL COMMUNITY DENTAL CLINIC
There are over 80 community dental clinics located throughout metropolitan Melbourne and rural Victoria. To access services from these clinics, you need to be eligible to receive public dental care.
If you have a dental emergency Call: 03 9341 1000
educe your waiting time – call first to make R an appointment Monday to Friday: 8:00am to 8:30pm Weekends and public holidays: 8:30am to 8:00pm
o find a clinic near you, visit T www.dhsv.org.au/clinics or call 03 9341 1000
OPEN HOURS Monday to Friday: 8:15am to 9:30pm Weekends and public holidays: 8:45am to 9:30pm
LOCATION 720 Swanston Street, Carlton VIC Australia 3053
Don't forget to send in your feedback for a chance to win a fruit hamper or an annual pass to Zoos Victoria. See page 3 for details.
GENERAL ENQUIRIES
Call: 03 9341 1000 or 1800 833 039 (country call)
OPEN HOURS Monday to Friday: 8:30am to 5:00pm Weekends and public holidays: closed
SERVICES FOR ABORIGINAL PEOPLES Aboriginal Liaison Officer (Tuesday, Wednesday, Thursday)
Call: 03 9341 1163 Email: aboriginal.services@dhsv.org.au
For more information visit www.dhsv.org.au Like us on Facebook www.facebook.com/DentalHealthVic www.facebook.com/RoyalDentalHospitalMelbourne Follow us on Twitter www.twitter.com/VicDental