Research + Innovation Volume 09. December 2016
Inside this issue:
1. END OF LIFE CARE
2. VICTIMS SUPPORT UPDATE
3. BACK PAIN CLINIC SUCCESS
4. ENGAGING CARERS THROUGH CO-DESIGN
In this issue: 3 End of life care 3 Fresh success 4 Focussing on male carers 4 Victims support update 5 CarerLinks North adopts co-design process
Welcome
6 Back pain clinic success
Our commitment to health care isn’t restricted to providing services. We pride ourselves on being an active participant and contributor to undertaking research and evaluation.
7 Count Me In 7 Planning for a more inclusive future 8 Social workers support
Merri Health @MerriHealth
Research and Innovation is Merri Health’s biannual publication that highlights some of our recent and current achievements in the areas of research and evaluation. By conducting ongoing reviews of our programs and services, we ensure that they are based on best practice, are evidence-based and aligned to the population health needs of our community.
Research and Innovation highlights current research and provides the opportunity to identify new opportunities for collaboration, share our learnings and contribute to evidence base for population health and wellbeing. In this edition you will find information on our expansion to the Hume region with our Victims Assistance Program, results of our recent GLBTIQ
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Inclusive Practice Staff Survey, Aphasia project, and more. We’d also like to take this opportunity to congratulate our Puberty and Human Relations Program team who were recently recognised for their outstanding work by being shortlisted as a Victorian Disability Awards finalist. This newsletter is aimed at current and potential partners, stakeholders, funding bodies and key players in the community, health and primary care field, such as the Department of Health and Human Services, the Department of Health and Ageing, academic institutions, Medicare Local, Primary Care Partnerships and other community health organisations.
End of life care Merri Health participated in an Advance Care Planning (ACP) project as a member of the Inner North West Melbourne Health (INWMH) Collaborative, led by the Melbourne Primary Care Network (MPCN).
• Developed an organisation wide policy with procedures tailored to individual teams. • Developed an ACP education plan identifying the varying levels of training required to support staff in their different roles.
As part of the project, Merri Health worked with clients to discuss end of life care and systems that could be introduced to record and activate these preferences.
• Submitted a response to the Department of Health and Human Services (DHHS) draft Bill ‘Simplifying Medical Treatment Decision Making.
We undertook a mapping exercise of several of our teams, examining what is currently being done and what could be done in the future to move our services towards actively having conversations with clients around end of life care.
End of Life Care and ACP has become a priority item on the Government’s agenda and community health services are in constant contact with people (and their carers) who would benefit from these conversations.
With the funding we have:
We will continue to work with our Collaborative partners to support health professionals in their ACP roles. An internal Merri Health Working group will continue to meet twice a year to facilitate the implementation process and keep the momentum going.
• Worked with our Collaborative partners to develop a document which defines how ACP can be implemented across the different health sectors. • Clearly defined Merri Health’s staff roles and responsibilities relating to different aspects of the ACP process.
Fresh success The Community Grocer Fawkner was originally planned to last 3 months as a pilot. One year later, and the grocer is still running, with an average of 100 customers a week. •
In its first year, Fawkner has seen over 50 markets had over 4,000 customers - many who return to do their weekly fruit and vegetable shopping.
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The Community Grocer finished as a finalist in the Minister for Health Volunteer Awards 2016.
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Since launching, we have developed partnerships with local food relief and community food security agencies such as Hope Cafe, Open Table, Fawkner’s Welcome Dinner for newly arrived community members, and the Fawkner Community House.
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The team behind the grocer have also run special events and extra markets as part of the Fawkner Food Festival and two local primary schools.
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The quantity of produce on offer has increased by 75%, and variety of produce on offer has expanded by 270%.
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14 volunteers have been active in working at the market, in a range of roles.
The market runs 9.30am-12.30pm at CB Smith Reserve every Wednesday with a free vegetable barbecue from noon. Any leftover produce is donated to relief agencies.
Research & Innovation December 2016 | 3.
Switching the focus to male carers CarerLinks North conducted a male carer focus group to find out how to better engage and assist them in their caring role. Knowing that 44% of carers in Australian are male and that only 31% of carers accessing our carer services are male, CarerLinks North have been looking at different ways to increase male carer participation in order to work through their hardships and decrease their stress levels. Coinciding with a broader community focus on men’s health throughout November by campaigns such as Movember, the Health and Wellbeing Coaching team at CarerLinks North conducted a male carer focus group. The objective of our male carer focus group was to: • Understand the caring role from a male perspective.
Victims Assistance Program update Merri Health has been providing the Victims Assistance Program (VAP) in the Hume region since July 2016, and during this period has experienced success. In the first quarter, the Victims Assistance Program has exceeded targets and new client and service hours surpass state-wide average.
• Identify services that CarerLinks North can provide to better meet the needs of males in a caring role.
The team have worked with 342 new clients in the Hume region as well as the 405 in the Northern Metropolitan region. This has prompted 1,772 services hours spent in the Hume region working on meeting their clients’ needs and 3,059 in the Northern metropolitan region.
The focus group was a success, with several male carers participating from diverse backgrounds and caring roles.
In the first two months alone, Merri Health took 875 intake calls for the Hume and Northern Metropolitan regions.
Key positives identified were that male carers appreciated the opportunity to share stories and information with other men and wanted practical tools to help with their day to day caring roles, as well as peer support.
Merri Health have demonstrated continued commitment to both police and co-locations and are actively involved in continued strategies to progress positively in the spirit of partnership and cooperation to support victims of violent crime.
The team is now working towards creating a service that addresses these needs.
We have received positive accounts of the Merri Health VAP service for the first quarterly report for the Hume region. One account comes from the Benalla Police Station, saying that transition into the colocation has been smooth and operating effectively.
• Understand the needs of male carers.
If you want to learn more about our Carer Health and Wellbeing coaching contact us on (03) 9495 2500 or carerlinksnorth@merrihealth.org.au
“To say that I’m impressed with this level of 4. | MerriNews December 2016
service is an understatement,” Benalla Police Officer said. “This is exactly how co-locating should work and I can see that we are going to have a very successful future together in providing great assistance to victims.” Another police officer in Wangaratta sent a letter expressing thanks for the support given to a client and described VAP staff as sympathetic, caring, professional and approachable. The team have also been engaged with non-client activity such as capacity building, networking and community education and engagement. We staff a core community education position which aims at enhancing awareness and understanding of victims services, facilitating access to services and responding to diverse community needs. As of 1 July, 2016, the Victims Assistance Program provided by Merri Health, extended to 12 municipalities in the Hume Region, in addition to the Northern metropolitan region which Merri Health have been providing in since 1999. To contact the Victims Assistance Program at Merri Health, call 1300 362 739.
CarerLinks North adopts carer engagement
This year CarerLinks North adopted a co-design process in celebration of National Carers’ Week. CarerLinks North facilitated working group sessions in the lead up to the week which resulted in the successful collaboration between carers and staff in service planning, delivery and evaluation. A small working group comprising staff and carers undertook brainstorming sessions in order to plan, implement and evaluate events happening throughout the week. The working group met each fortnight, with discussions held in pairs and larger groups. Having consumer participation meant that CarerLinks North could organise events that their clients would benefit from and enjoy. The feedback from CarerLinks North management overseeing the project was overwhelmingly positive. “The combination of carer and staff input and feedback into the process was invaluable. It meant we were able to take all perspectives into account. The carers brought to our attention things we never may have thought of, and so we were able to address these and so the events ran smoothly,” said CarerLinks North Manager, Vicki Down. At the conclusion of the carers week events, a final working group meeting was held in order to debrief and evaluate the work undertaken. Working group members who are carers also had the opportunity to confidentially debrief with the facilitator. After a successful and positive project CarerLinks North will continue to undertake the co-design process to involve carers for any future
events, activities and carer service development.. Carers were supported to attend these working groups by arranging respite, transport and lunch.
“It was very affirming to see their ideas and input were taken seriously and actually implemented.” - Carer involved in co-design process, 2016
Are you a carer? Would you like to work with us to improve services for carers? Join our carer engagement register by contacting Merina on 03 9495 2500 or carerlinksnorth@merrihealth.org.au
Research & Innovation December 2016 | 5.
No more pains; many gains Merri Health and Melbourne Health’s back pain clinic was awarded for their innovative and successful service. Merri Health and Melbourne Health’s Back Pain Assessment & Management Service (BAMS) was awarded for Excellence in providing alternative care paths, at the Victorian Public Healthcare Award. This project aligns with organisational priorities of delivering high quality care through local partnerships, innovation and transformation by challenging existing approaches.
1,267
The back pain project was established to provide improved patient access to evidence-based, non-surgical, multidisciplinary, individual and group therapy services in the community, a lot sooner than they would be seen in a hospital.
PATIENTS SEEN BY BAMS
Patients are seen in the BAMS within 10 weeks of referral, compared to 2 years wait with traditional spinal surgery clinics, and attendance rates have been high at 85%.
93% OF PATIENTS STRONGLY AGREED/ AGREED THAT BAC MEET THEIR EXPECTATIONS 94% WERE VERY SATISFIED/SATISFIED WITH THE SERVICE
Where relevant, the BAMS can also help treat that person on-site, which has helped reduce hospital and surgical wait lists significantly. neurosurgery waiting list has reduced from 1,501 to 621 patients and orthopaedic spinal surgery reduced from 139 to 35 patients 18 months post BAMS implementation. Results have been very positive, with 1,267 patients triaged into the BAC to date, and of these: •
52 % were referred for physiotherapy and 31% had medications altered, reflecting best practice of optimising non-surgical management.
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25% had further investigations (7% MRI, 5% x-ray, 4% bone scan) and 6% were referred for spinal injections. The low number of MRI scans represents a potential cost-saving of $90K per annum to the health system.
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4% were referred to chronic pain services, and 3% to neurosurgery or orthopaedics.
Most referrals were from general practitioners (90%) and were initially directed to neurosurgery (83%) or orthopaedics (12%). Most referrals were made for lower back pain (65%) and neck pain (23%). Close collaboration between tertiary and community partners has built trust and increased workforce capacity. The credentialing of a grade 3 physiotherapist in community health to work in an advanced practice assessment role is believed to be one of the first for primary care in Australia. The BAMS model commenced July 2014, and is supported by Workforce Innovation Project Grant funding awarded by the Victorian Department of Health and Human Services (DHHS).
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Planning for a more inclusive future We’ve developed a Diversity Plan in order to better support hard to reach groups in the northern metropolitan area of Melbourne. Merri Health provides a wide range of services and programs for older people and younger people experiencing functional decline and/or disabilities. As part of our commitment to ensuring access and equity, we have developed a Diversity Plan. Merri Health’s Diversity Plan reviews current commitments and also any gaps that could be addressed to respond to barriers to accessing our services.
Count Me In In collaboration with The University of Melbourne and Moreland City Council, Merri Health have established Count Me In; a project aiming to increase sports participation for refugees and migrants.
The Diversity Plan captures the work we have identified through our program plans, divisional plans and organisational strategic plan that is relevant to the target population. Key population groups include: • Aboriginal & Torres Strait Islander backgrounds • Culturally & linguistically diverse backgrounds • People with dementia
Count Me In is a partnership project between Merri Health, The University of Melbourne, Moreland City Council, local schools and local sports clubs and associations aiming to support sports participation for refugee and culturally and linguistically diverse (CALD), migrant children and young people.
participation rates.
Within the first four months of the project more than 130 children aged 2 – 15 years have joined a club to participate in Netball, Cricket, Futsal or Athletics.
It is currently being piloted and evaluated in the Moreland area and aims to address multiple barriers for participation by these groups in mainstream sports settings.
The project has engaged 94 families from 28 schools, with 7 different ethnic backgrounds.
Additional research is being conducted to refine the model and provide evidence for its benefits for children, their families and communities.
The project is based on evidence that sports participation improves physical and mental health and is a useful setting form building social connections and inclusion. Despite evidence for the lifelong benefits of sport participation for children, refugee and CALD migrant young people have low
Count Me In provides a promising model for addressing this. Key strategies for addressing these barriers are the employment of local bi-cultural community support coordinators and partnerships with local clubs and parent engagement.
The Merri Health Board have committed $20,000 of funding to support the project to continue from January – July 2017 and have been providing in-kind support.
• Financial disadvantage or socially disadvantage • Homeless or at risk of becoming homeless • LGBTIQ Diversity planning also includes other characteristics that may be a barrier to accessing services such as age, socioeconomic status, gender, faith or spirituality. The Diversity Plan for December 2016 - December 2017 is currently being collated across the organisation and will be finalised by early December this year. For further information please contact Nora Ruzzene on nora.ruzzene@ merrihealth.org.au
MerriNews December 2016 | 7.
Social workers support Merri Health secured a Departments of Health and Human Services Workforce Innovation Grant to introduce specialist psychosocial support services in community health. Under the Incorporating Advanced Psychosocial Support into Primary Health Care project, Merri Health has introduced an Advanced Practice Social Worker (Health) role to help support clients with psychosocial issues related to their chronic and complex health conditions, including persistent pain. Merri Health identified an absence of specialist social worker positions in the community health setting to provide psychosocial support for the growing number of clients with complex chronic diseases that require multidisciplinary management. The role will complement the existing primary health team in working with these
clients.
out of scope.
To support the new role and ensure quality and safety are maintained, Merri Health will partner with Melbourne Health to ensure appropriate measures are in place to manage clinical risk. This work will include:
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A competency and capability review with Melbourne Health social work & psychology staff
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Development of competency framework (informed by Australian Association of Social Workers (AASW) competency frameworks for interstate Advance Practice Social Work roles)
It is anticipated that the role will lead to reduced demand on specialist pain management services in the sub-acute setting, improved quality of care and clinical outcomes for clients with chronic and complex conditions and improved workforce satisfaction.
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Development of scope of practice documentation and guidelines for referral on when client presentation is
Development of peer supervision and support agreement with regular scheduled meetings between the AASW and Melbourne Health stakeholders.
The project will run from May 2016 – December 2017, with our Advanced Practice Social Worker (Health) beginning at the end of October 2016.
Brunswick
Brunswick West PAG
Fawkner
Thornbury
Chifley Drive, Preston
11 Glenlyon Road Brunswick VIC 3056
382–386 Moreland Road Brunswick West VIC 3055
79 Jukes Road Fawkner VIC 3060
298 Victoria Road Thornbury VIC 3073
Level 2, 110 Chifley Drive Preston VIC 3072
t: 03 9387 6711
t: 03 9386 3575
t: 03 9357 2444
t: 03 9484 5314
t: 03 9495 2500
Coburg
Harding Street, Coburg
Glenroy
Victoria Street, Coburg
Interchange North West
93 Bell Street Coburg VIC 3058
1st Floor, 368 Sydney Road Coburg VIC 3058
5D Cromwell Street Glenroy VIC 3046
21 Victoria Street Coburg VIC 3058
Shop 9E Anderson Street Pascoe Vale VIC 3044
t: 03 9350 4000
t: 03 8319 7400
t: 03 9304 9200
t: 03 9355 9900
t: 03 9350 4600
Disclaimer: The information contained in this publication is provided by Merri Community Health Services and is for general information purposes only. While information is current at the time of publication, subsequent changes to events may occur. MCHS ventures to provide current and accurate information and we make no representations or warranties, express or implied, about the completeness, accuracy, reliability, or availability, with respect to this publication. Any reliance you place on such information is therefore at your own risk. In no event will MCHS and its employees be responsible or liable for any loss or damage including without limitation, indirect or significant loss or damage, or any type loss or damage whatsoever, suffered by any person as the result of reliance on information contained in this publication.