2 0 1 9 A N N U A L R E V I E W W O R K I N G T O G E T H E R F O R C H I L D R E N

AC K N OW L E D G E M E N T O F CO U N T RYThe Sydney Children’s Hospitals Network respectfully acknowledges Aboriginal people as the traditional custodians of the land on which our health facilities are located and the areas from which our patients are spiritually connected to.

We acknowledge the strength, wisdom, compassion and care Aboriginal people have for their kinship, language, culture and spiritual connection to country.

We pay our respects to the Elders, community members, our Aboriginal staff, and the Aboriginal services and organisations who work closely with us to improve the health and wellbeing of Aboriginal children and young people.

Network facilities rest on the traditional lands of the Gadigal and Bidjigal people of the Eora nation in Randwick, the Burramattagal people of the Dharug nation in Westmead, the Guringai people in Manly and the Daruk nation in Bankstown.

Artwork: ‘Over our tracks’ by Sandon Gibbs-O’Neill

The painting reflects the target of the Sydney Children’s Hospitals Network Aboriginal Health Strategic Plan 2018-2021 that Aboriginal children and their families live their healthiest lives.

Working together for children

O U R I D E N T I T Y

O U R VA L U E S

Helping children and young people live their healthiest lives

O U R P U R P O S E

International leaders in children’s health

O U R A M B I T I O N

ollaborationC

pennessO

espectR

mpowermentE

A A R E N ( T H R E E W E E K S ) , N E O N ATA L PAT I E N T, T H E C H I L D R E N ’ S H O S P I TA L AT W E S T M E A D

C O N T E N T S

C O V E R I M A G E : L A N I ( 1 9 M O N T H S ) , R E S P I R ATO R Y PAT I E N T, S Y D N E Y C H I L D R E N ’ S H O S P I TA L , R A N D W I C KI M A G E O N R I G H T : R O C C O ( 4 Y E A R S ) , O N C O L O G Y PAT I E N T, S Y D N E Y C H I L D R E N ’ S H O S P I TA L , R A N D W I C K

AC T I V I T Y DA S H B OA R D 1

F O R E WO R D 2

W H O A R E W E ? 4

S T R AT E G I C P L A N 6

2 018 -19 F O C U S A R E A S 81. Delivering child and family-centred care 102. Applying great research 323. Building a solid foundation 424. Supporting staff, empowering families 525. Expanding our reach 62

N E T WO R K L E A D E R S H I P 7 2Board 73Executive 73Clinical Council 74Committees 75

F I N A N C I A L OV E RV I E W 76

S Y D N E Y C H I L D R E N ’ S H O S P I TA L S F O U N DAT I O N

O U R S U P P O RT E R S 8 2

78

K AT H E R I N E ( F I V E D AY S ) , N E T S T R A N S F E R

D A S H B A R DA C T I V I T Y

N O N - A D M I T T E D P AT I E N T

O C C A S I O N S O F S E R V I C E

1,080,936

C O M M U N I T Y A N D H O M E D E L I V E R E D

O C C A S I O N S O F S E R V I C E

336,578

A D M I T T E D P AT I E N T

O C C U P A N C Y

87.1%

SCH: 78.9% CHW: 91.6%

E D P R E S E N TAT I O N S

98,165

SCH: 36,739 CHW: 61,426

T O TA L N U M B E R O F B E D D AY S

155,456

SCH: 49,495 CHW: 105,961

O P E R AT I O N S

20,146

(Elective and non-elective)

SCH: 6,110 CHW: 14,036

AV E R A G E L E N G T H O F S TAY ( D AY S )

4.8

(Excluding day cases)

SCH: 4.7 CHW: 4.9

H O S P I TA L A D M I S S I O N S

51,464

SCH: 17,397 CHW: 34,067

N O . O F C H I L D R E N C A R E D F O R A C R O S S

T H E N E T W O R K

TOTAL (both hospitals) 159,229

SCH: 72,226 CHW: 87,003

% O F E D P AT I E N T S A D M I T T E D O R D I S C H A R G E D

W I T H I N F O U R H O U R S

66.6%

P A G E 1

Created to deliver excellence in healthcare for children and young people, Sydney Children’s Hospitals Network is proud to report on the 2018-19 outcomes for our patients and their families.

While 2019 has brought both challenges in relation to future plans and great opportunities to strengthen the Network, our focus continues, as always, on advocating for and delivering the very best care for children, young people and their families. The Network Governance Review in June 2019 was a welcome and highly productive experience, with expected outcomes which will only enhance the provision of paediatric care across the whole state.

We have seen some extraordinary outcomes over the past year. For example, our liver transplant team successfully completed 11 transplants in one month, our researchers made life changing genetic discoveries which will help to transform personalised medicine and a rare bone marrow donation by a big brother saved a patient’s life.

Our hospitals experienced amplified pressure on services during 2018-19. There were approximately 98,000 presentations to our emergency departments (up by more than 2000 on last year) and our teams cared for more than 157,000 children and young people. We also delivered more than one million occasions of service in a non-admitted patient setting.

The children and young people who received our care included inpatients and outpatients from across New South Wales and Australia - and sometimes further afield, such as New Caledonia and parts of Asia.

Our staff rose to the challenge during one of the busiest starts to winter on record and our IT teams worked around-the-clock to complete ‘Integration’ – the roll out of a single digital paediatric Electronic Medical Record system (eMR). This enabled a

Network-wide view of patient records for the first time. This innovative project was three years in the making and is a major deliverable and final link of the Network’s Memory strategy. The goal of this strategy is to strengthen patient safety, efficiently deliver patient care, improve real time access to patient electronic data and close the data loop for researchers to support evidence, implementation and outcomes.

We thank all members of our clinical and administration teams for their flexibility and adaptability during the rollout, and for a smooth transition to this major change in 2018-19. We are pleased to report that the Network can now design and modify the eMR to ensure that care remains aligned with patient progress and best paediatric practice.

Our aim is to continue to build a foundation for the future of paediatric health care. In addition to upgrading our IT systems, we secured unprecedented infrastructure funding in 2019 to continue our capital works program.

An additional $1.2 billion was committed for major redevelopments at both The Children’s Hospital at Westmead and Sydney Children’s Hospital, Randwick – including the exciting Comprehensive Children’s Cancer Centre. The total investment in capital works programs for the Network is now $1.3 billion.

These capital works projects represent co-investments with university and research partners for exciting future health precinct collaborations. Securing this funding for both Westmead and Randwick was a significant success story in 2018-19.

With Stage 1 of the Westmead Redevelopment already underway this year, we recently celebrated the topping-out of the shared Central Acute Services Building, due to open in October 2020.

F O R E W O R D

Other highlights from our capital works program include a refurbishment and expansion of oncology outpatient facilities at Randwick and a significant refurbishment of the mental health facility at Westmead. These developments not only improve the therapeutic environment but will bring world-class clinicians together in purpose-built facilities to support research, education and to care for children, young people and their families.

Research and advocacy efforts during 2018-19 saw more than 90,000 newborns receive diagnostic screening through our $2 million Spinal Muscular Atrophy (SMA) program, the launch of the Active & Safe Report for the prevention of unintentional injury among Aboriginal and Torres Strait Islander children and young people and numerous health education campaigns.

Our commitment to children, young people, their families and communities to help them live their healthiest lives possible is unwavering. We are honoured each and every day to be able to serve and work with them.

A special thanks goes to the dedicated and passionate staff of all disciplines who consistently go above and beyond for patients and families across the Network. The impact you have on the future lives of children and young people is the reason we are here.

We hope you enjoy reading the many extraordinary stories of our patients and staff who continue to shape the way evidence-based paediatric health care is delivered across our state.

Sydney Children’s Hospitals Network Executive Team and Board Members

P A G E 2

K H L O E ( S I X Y E A R S ) S P I N A L PAT I E N T, S Y D N E Y C H I L D R E N ’ S H O S P I TA L , R A N D W I C K

P A G E 3

W H O I S S Y D N E Y C H I L D R E N ’ S H O S P I TA L S N E T W O R K ?

Inpatient and outpatient care provided in the eastern suburbs of Sydney with more than 1700 staff members.

Inpatient and outpatient care provided in the western suburbs of Sydney with more than 3500 staff members.

A very special place on Sydney’s northern beaches, dedicated to caring for children with life-limiting conditions. Bear Cottage in Manly is the only children’s hospice in NSW and provides paediatric palliative care 24 hours a day.

A number of entities make up the Network, the largest provider of paediatric health services in Australia.

P A G E 4P A G E 4

Located at both hospital sites in Sydney’s east and west, 600 researchers, support staff and students are dedicated to discovering new ways to improve the health of children.

A service that works to improve the quality and safety of maternal and neonatal care in NSW, especially for women and their families at high risk of an adverse outcome.

A statewide service of NSW Health, hosted by Sydney Children’s Hospitals Network. The only of its kind in Australia, NETS provides 24 hours a day clinical advice, coordination and emergency treatment and transportation to sick babies and children across NSW.

Located in Parramatta, the Clinic undertakes independent clinical assessments to help magistrates and judges in NSW Children’s and District Courts make a decision in the best interest of children.

P A G E 5P A G E 5

W O R K I N G T O G E T H E R F O R C H I L D R E N

S Y D N E Y C H I L D R E N ’ S H O S P I TA L S N E T W O R K

S T R AT E G I C P L A N 2 0 1 7 - 2 0 2 2

O U R S TA F F W I L L B U I L D A S O L I D F O U N D AT I O N U N D E R P I N N E D B Y T H E F O L L O W I N G P R I N C I P L E S A N D V A L U E S :

W E W I L L A C H I E V E G R E AT O U T C O M E S :

P A R T N E R S H I P SS T R E N G T H E N E D B Y :

E N A B L E D B Y : F I N A N C I A L S U S TA I N A B I L I T Y

SE

TT

ING

UP

F

OR

SU

CC

ES

SB

UIL

DIN

G O

UR

FU

TU

RE

EX

TE

ND

ING

OU

R

INF

LU

EN

CE

C O L L A B O R AT I O N O P E N N E S SO U R S TA F F E M B O D Y T H E C O R E VA L U E S

Maximise the potential of every child

Delivering better patient experiences for children

and their families

Collaborating with our partners to provide care that is seamless, close to home, well coordinated

and accessible

W E W I L L D E L I V E R C H I L D A N D F A M I LY C E N T R E D C L I N I C A L C A R E AT T H E S A F E S T A N D B E S T L E V E L T H R O U G H :

Getting the basics right the first time, every time

Care that fits around patient’s and families’ lives

Intervening early to prevent poor health

Engaging children and their families to shape the care we provide

Educating families to empower decision making

The translation of research to enrich clinical care

Children first and foremost: both in what we do,

and what we advocate for

Safe, reliable and effective care

Partnering with children and families

S T R AT E G I C P L A N

P A G E 6

I N T E R N AT I O N A L L E A D E R S I N

C H I L D R E N ’ S H E A LT H

O U R S TA F F W I L L B U I L D A S O L I D F O U N D AT I O N U N D E R P I N N E D B Y T H E F O L L O W I N G P R I N C I P L E S A N D V A L U E S :

W E W I L L A C H I E V E G R E AT O U T C O M E S :

R E A L I S E T H E F U L L P O T E N T I A L

O F O U R I N F L U E N C E

C O M P R E H E N S I V E P A E D I AT R I C

H O S P I TA L S O N T W O W O R L D -

C L A S S H E A LT H , E D U C AT I O N

A N D R E S E A R C H P R E C I N C T S

S U P P O R T I N G O U R P E O P L E T O

B E C O M E T H E B E S T I N T H E I R

F I E L D C R E AT I N G O P P O R T U N I T I E S

T O A D V A N C E R E S E A R C H

G R O W O U R N E T W O R K C U LT U R E A N D

R E L AT I O N S H I P S

I N F R A S T R U C T U R E

A D V O C A C Y

S Y S T E M S A N D P R O C E S S

R E S E A R C H A N D E D U C AT I O N

R E S P E C T E M P O W E R M E N T

Engaged and high performing workforce built from our culture

of continuous improvement

Game changing research and education

Co-designing infrastructure that enables care now and in the future for our community

W E W I L L D E L I V E R C H I L D A N D F A M I LY C E N T R E D C L I N I C A L C A R E AT T H E S A F E S T A N D B E S T L E V E L T H R O U G H :

Clinical and non-clinical staff working in collaborative ways

Sustainable and ethical healthcare

Using infrastructure and technology that supports our agility

Making best use of funding frameworks and resources

Value based: focusing on what makes the difference

Equity in access, with a focus on the vulnerable and at risk children and young people

The Sydney Children’s Hospitals Network Strategic Plan 2017-2022 has laid down the foundation for the future direction of the Network.

Through a regularly reviewed and consolidated implementation plan, the Network will deliver on the strategies described, to make the

Network an international leader in children’s health, providing our children and young people with the opportunity to truly live their healthiest lives possible, now and into the future.

You can view the Stategic Plan in full by visiting schn.health.nsw.gov.au

P A G E 7

2 0 1 8 - 2 0 1 9 F O C U S A R E A S

A DVO C AC Y

Page 66

Spread of innovative cleft palate dolls help more parents

I N F R A S T RU C T U R E

Page 44

Unprecedented funding commitments for Network redevelopments

C L I N I C A L C A R E

NETS retrieval no ordinary mission

Page 25

R E S E A RC H Network leads world first

clinical trials for children with aggressive brain cancer

Page 37

E D U C AT I O N Asthma e-book for parents – first of its kind in the world

Page 59

P A G E 8

PA RT N E R S H I P A N D N E T WO R K S

Improving mental health care outcomes for children and young people

Page 30

E A R LY I N T E RV E N T I O N An Australian first –

SMA added to newborn heel prick test

Page 36

Digital Integration – a bespoke paediatric system

Page 48

S YS T E M S A N D P RO C E S S E S

F I N A N C E 2018/19

Page 76

P E O P L E A N D

C U LT U R E Eid celebrations bring hospital

communities together

Page 60

S O F I YA ( E I G H T Y E A R S ) , S U R G I C A L PAT I E N T, T H E C H I L D R E N ’ S H O S P I TA L AT W E S T M E A D

P A G E 9

D E L I V E R I N G C H I L D A N D FA M I LY- C E N T R E D C A R E AT T H E S A F E S T A N D B E S T L E V E LSydney Children’s Hospitals Network strives for a truly child and family-centred approach, less waiting and more time at home and school with family and friends. This means orienting the way we provide care around the needs and outcomes that matter to children and their families.

P A G E 1 0

N E T S H E L I C O P T E R R E T R I E V A L

P A G E 1 1

Q U A L I T Y O F C A R E – I N E V E RY T H I N G W E D O

Quality and safety is central to all of the services and programs delivered across Sydney Children’s Hospitals Network – and guides everything we do.

The Clinical Governance Unit of Sydney Children’s Hospitals Network drives our work to reduce risk, improve patient safety and the experience of our children and their families.

All staff members are united with a focus on one goal – to provide care of the highest standard for every patient, every time.

By working together to deliver the best quality care we make our Network SAFER, SMARTER, and STRONGER.

I N D I A N A ( E I G H T M O N T H S ) , L I V E R PAT I E N T, T H E C H I L D R E N ’ S H O S P I TA L AT W E S T M E A D

P A G E 1 2

D A S H B A R DS A F E T Y

R A P I D R E S P O N S E S

Teams responded to 4674

Rapid Response Calls *The Network’s average rate for Rapid Response calls is 90.6

per 1000 acute separations

11 Rapid Response Calls were activated by parents

*7 of the 11 were from wards actively promoting the REACH program

C A R D I O R E S P I R AT O R Y A R R E S T S

TOTAL (both hospitals)

13

*The Network’s cardiorespiratory arrest rate

is 0.26 per 1000 acute separations

N E T W O R K H O S P I TA L A D M I S S I O N S

51,464

2741 medication incidents

260 reported pressure injuries

150 reported

falls incidentsI N C I D E N T S R E P O R T E D

TOTAL (both hospitals)

6137

R O O T C A U S E A N A LY S I S ( R C A )

I N V E S T I G AT I O N S

TOTAL (both hospitals)

11

7 SAC 1 incidents (Severity Assessment

Risk – Extreme)

No SAC 1 or 2 events regarding

medication safety at either Hospitals

(into the death or serious harm of a patient)

P A G E 1 3

Q UA L I T Y AC A D E M Y P RO J E C T S I G N I F I C A N T LY R E D U C E S M E D I C AT I O N E R RO R S

A review of reported medication incidents via the Network’s new Incident Information Management System (IIMS) identified the need for a renewed focus on reducing potentially harmful medication errors.

Initiated through the Network’s Quality Academy, the Children’s Intensive Care Unit (CICU) at Sydney Children’s Hospital, Randwick, led the Marvellous Medication (Safety) Project with the aim of ‘reducing the number of errors by 50 per cent.’

Data evaluation has demonstrated a significant reduction in pump programming errors and a reduction in the number of harmful medication incidents.

P A G E 1 4

T R A I N I N G A N D S U P P O RT I N PAT I E N T S A F E T YEducation and training provided by the Patient Safety Team seeks to empower staff to be involved in patient safety processes.

During 2018-19 we saw an increased culture of incident reporting, following IIMs ‘notifier’ and ‘manager’ training. The training aimed to improve staff ’s understanding of the incident reporting processes and its importance in improving outcomes for patients.

N U R S E S A R A H U S I N G T H E I N C I D E N T I N F O R M AT I O N M A N A G E M E N T S Y S T E M AT T H E C H I L D R E N ’ S H O S P I TA L AT W E S T M E A D

All staff received a summary of reported incidents every 24 hours via the new IIMs.

2018-19

clinical staff attended IIMs

notifier training

clinical staff attended IIMs

manager training

71 34

P A G E 1 5

N E T WO R K Q UA L I T Y I M P ROV E M E N T AC A D E M Y A N D AWA R D S P RO G R A M

Embedding a culture of safety requires the education of as many staff as possible in quality improvement science.

The aim of the SCHN Quality Improvement Academy is to build the confidence and capability in Network staff to lead medium scale improvement projects and foster a culture of staff led, continuous improvement.

The Academy Faculty run two courses per year that last four months. Each Academy includes a two day intensive workshop, dedicated Quality Improvement coach, a full day progress review, final presentation and graduation day. All proposed projects are congruent with the Network’s Strategic Plan.

staff members graduated from the

Quality Improvement Academy in

2018-19

86 25improvement projects were developed and implemented across

the Network

SCHN Quality Improvement Academy

K E E P I N G P E O P L E H E A LT H Y W I N N E R – R E S P I R ATO R Y A D M I S S I O N A V O I D A N C E P H Y S I OT H E R A P Y

V O L U N T E E R O F T H E Y E A R , LY N P E E K ,

S Y D N E Y C H I L D R E N ’ S H O S P I TA L , R A N D W I C K

P A G E 1 6

Academy Projects 2018-19:

CHW Supporting families to prepare their child for cardiac surgery

CHW Restraint in mental health

CHW Critical results notification

CHW Radiation safety SCH Neonatal care package

CHW Policy search SCH Contaminated blood samples

SCH Allied health mapping project SCHN Transfusions – bone marrow transplant

CHW Safe meals for food allergic patients CHW Striving to improve outpatient billing practices

CHW Continuing care over the team CHW Dysphasia

SCHN Pharmaceutical guidelines CHW Continuing care over the team

SCH Neurodevelopmental care Children’s Intensive Care Unit SCH A review of the Parenteral Nutrition Service

CHW Acute kidney injury SCHN Hospital in the Home (HITH)

CHW Infant feeding in Neonatal Intensive Care Unit

SCH Reducing variation in the management of developmental dysplasia of the hip

SCH Child life in radiotherapy: Reducing the need for general anaesthesia

SCH Improving care coordination for children attending Rehab2Kids Botulinum Toxin Injection Clinic and Hand Clinic

SCHN junior medical officer app SCH Children’s Intensive Care Unit nurse checklist

SCHN Quality and Innovation Awards

The SCHN Quality and Innovation Awards are held each year to recognise innovation and excellence in the delivery of health programs and services for children across NSW.

For the year 2018-19, we received a record number of submissions into the 10 team awards (35 teams entered) and three individual awards (15 individuals were nominated).

D E L I V E R I N G I N T E G R AT E D H E A LT H C A R E W I N N E R – L I T T L E W I N G S

P A G E 1 7

C LO S E D LO O P M E D I C AT I O N M A N AG E M E N T P RO J E C T (C L M M )The introduction of a pilot Closed Loop Medication Management system (CLMM) has seen the implementation of technology to improve patient safety. These new technologies also aim to improve pharmacy and nursing workflows to ensure clinicians are able to spend more time on patient care.

Key benefits:

• Unit Dose Packaging – Medications are individually packaged, labelled and barcoded prior to dispensing to patient care areas. This initiative has been implemented to support barcoded medication administration to ensure each patient receives the right medication.

• Barcoded Medication Administration – The scanning of medication barcodes at the patient bedside confirms that the medication matches the medication order and verifies the medication strength and dosage.

• Positive Patient Identification – Ensures medication is administered to the correct patient by scanning the patient’s wristband which also confirms the medication is due for administration.

These technologies provide additional checks to reduce errors in medication administration. Preliminary studies have suggested the use of barcodes on unit dose packaging of medications can help to reduce medication error rates by 41%.

The CLMM project has also introduced Automated Dispensing Cabinets (ADCs) to a number of wards at The Children’s Hospital at Westmead (Paediatric Intensive Care Unit, Clancy Ward, Close Observation Unit and Hall Ward).

The ADCs use biometric technology (fingerprint) to enable nursing and pharmacy staff to access medications in a safer manner by guiding staff to the required medications that are prescribed for their patients. This ensures the correct medication goes to the right patient.

N E W S C H N M E D I C AT I O N S A F E T Y CO M M I T T E E2018-19 saw the establishment of a Network Medication Safety Committee to promote and advance a culture of medication safety as a priority across SCHN. The Committee are actively involved in the review of medication-related incidents.

There has also been a revitalisation of Medication Safety Walk Rounds throughout clinical areas, to assess the safe storage and handling of medications, as well as assess any gaps in knowledge. This aims to ensure staff are informed and empowered to safely and correctly prescribe, dispense and administer medications to patients.

B E T W E E N 2 018 -19 27 5 6 M E D I C AT I O N - R E L AT E D I N C I D E N T S W E R E R E C O R D E D I N I I M S . M O R E T H A N 9 9 % O F T H E S E I N C I D E N T S I D E N T I F I E D L I T T L E O R N O H A R M TO O U R PAT I E N T S .

B E L L A ( 1 1 Y E A R S ) , O R T H O PA E D I C PAT I E N T, T H E C H I L D R E N ’ S H O S P I TA L AT W E S T M E A D

P A G E 1 8

ACCREDITATION As part of the Network’s commitment to improving its services, we have now contracted the services of Quality Innovation Performance (QIP) to be our accrediting agency.

QIP offers its health organisations a transparent and modern approach to accreditation. An online self-assessment portal is available for all staff to see how SCHN meets the eight areas of the National Safety and Quality Health Service Standards (second edition) and what work is being progressed to help improve the care we provide to our patients, families and consumers.

This online portal will enhance the accreditation process and reinforce to all staff that accreditation is everyone’s business and is part of our day-to-day operations.

SCHN will undergo an organisation-wide accreditation survey in March 2020. Changes that are currently being implemented to help support this survey are sustainable and will help SCHN embrace and excel for any short notice assessment surveys in the future.

M E D I C AT I O N

P A G E 1 9

PA RT N E R I N G W I T H O U R PAT I E N T S , F A M I L I E S A N D C A R E R S

“If it is important to you, it is important to us.”

Sydney Children’s Hospitals Network is proud to partner with our patients, parents, carers and families in ways that use their experience to directly influence change.

E M I LY ( T W O Y E A R S ) , L I V E R PAT I E N T, T H E C H I L D R E N ’ S H O S P I TA L AT W E S T M E A D

P A G E 2 0

PAT I E N T A N D FA M I LY E X P E R I E N C E

S U G G E S T I O N B O X F E E D B A C K

504 suggestion box feedback forms received from families

(electronic or hardcopy)

C A R E R S U P P O R T P R O G R A M S

More than 22 Carer Support Programs and activities delivered

8143 visits

V I S I T S T O T H E P A R E N T A N D C A R E R R E S O U R C E C E N T R E

C O M P L A I N T S

745 complaints received and managed, with feedback provided to each family

100% of complaints were acknowledged

within five days

A C K N O W L E D G E D C O M P L A I N T S

R E S O LV E D C O M P L A I N T S

93% of complaints received were resolved in 35 days

(target 100%)

D A S H B A R D

E M I LY ( T W O Y E A R S ) , L I V E R PAT I E N T, T H E C H I L D R E N ’ S H O S P I TA L AT W E S T M E A D

P A G E 2 1

The NSW Health Patient Reported Measures (PRMs) program is in the planning stage across SCHN. The program will use surveys to collect and report on patient reported experience and patient reported outcome measures.

• Patient reported experience measures capture the patient’s perception of their experience with healthcare or services.

• Patient reported outcome measures capture the patient’s perspectives about how their illness or care impacts on their health and well-being.

A full-time project officer commenced with the Network in April 2019 to implement the program. The program has commenced on a very limited basis, with expansion opportunities available in 2020.

PAT I E N T R E P O RT E D E X P E R I E N C E M E A S U R E S

“Thank you to the amazing SCH staff that cared for my daughter in

emergency when we were transferred by NETS from Nepean Hospital. Indie

was then in ICU with bronchiolitis caused from RSV virus. The help my little girl received was exceptional! We had

the most beautiful nurse, Antonia, caring for my girl and her care has just made this difficult time a little more bearable.

Dolly was amazing too! Indie is now better after her stay in June. She’s now

a healthy little four-month-old.”

Indie’s mum, Kiah

“I’d like to acknowledge all of the staff at CHW who so wonderfully

have been looking after my daughter Mathilde these past weeks.

Everyone from Kate Hurle to Dr Ken Peacock, Dr Mark Dexter, Dr Webster, Dr Chin and Dr Emily Horsley have all been brilliant in

managing the care plan for Tilly since we were medivaced home from France on 1 August into the care

of Westmead Kids.

We are relatively new to the world of kids health as we have been blessed

with three healthy children, however the service and care from our first point of contact, as it continues has been

exceptional and we, as a family, are very grateful!”

Mathilde’s mum, Fiona

PA R E N T E N J OY S N E W L O U N G E S , PA R E N T A N D C A R E R R E S O U R C E A R E A , S Y D N E Y C H I L D R E N ’ S H O S P I TA L , R A N D W I C K

P A G E 2 2

Our Patient Experience team, Network Families and Consumer Council and the Youth Advisory Council play an integral role in ensuring the Network understands the needs of our most important stakeholders.

In 2018-19, some of the improvements delivered following feedback from patients and carers were:

Sydney Children’s Hospital, Randwick:

• The SCH Patient Friend was instrumental in securing a donation of 12 replacement lounges for the Parent and Carer Resource area as well as public areas across the hospitals.

• Mid-meal snacks are being provided three times a day to eligible patients at SCH, in addition to breakfast, lunch and dinner meals.

• Introduced larger posters to highlight the Patient and Family Activated Response process for parents and carers on all wards.

• Corporate Services works included repainting the Care By Parent bathroom, installing keypad locks in patient rooms in Care By Parent, re-grouting in C3W parent shower and installing additional hooks in the C2S parent bathroom.

CO N S U M E R G RO U P I M P ROV E M E N T S

The Children’s Hospital at Westmead:

• Patients and families were involved in the refurbishment and redesign of the adolescent mental health facility – Hall Ward.

• Refurbishment and relocation of the Parent Hostel, with improvements including new paint, bar fridges for each room and blinds, all generously donated by Mirvac based on feedback from families.

• Involvement of families and community organisations to develop a proposal for a CHW community garden.

• Installation of phone chargers for families in the Emergency Department, Paediatric Intensive Care Unit, Outpatients, Theatres and Recovery.

P A G E 2 3

C L I N I C A L H I G H L I G H T S

To support NSW Health policy that all children admitted to a health facility must have their height and weight recorded, the Network led a statewide push to ensure health workers were educated.

Complementing the new e-learning modules Weight 4 KIDS developed by our Network Population Health team, they also launched an extensive online paediatric weight management resource centre for health professionals in NSW – Healthy Kids for Professionals.

Closer to home, a number of actions were taken across both hospitals in the Network:

• Height and weight equipment was upgraded

• New measurement stations installed

• Prompts in eMR were developed to remind staff to enter height and weight

• Alerts introduced in eMR if a child is above a healthy weight

• 64 Health4KIDS champions across the Network to support staff

With early recognition and simple intervention we can tackle obesity.

To learn more visit pro.healthykids.nsw.gov.au

CO M B AT T I N G O B E S I T Y – H E A LT H Y W E I G H T C H E C K S F O R C H I L D R E N AC RO S S N S W

O U T PAT I E N T H E I G H T C H E C K AT T H E C H I L D R E N ’ S H O S P I TA L AT W E S T M E A D

H AY D E N ( O N E D AY ) , C A R D I A C PAT I E N T, P R I O R TO N E T S T R A N S F E R

P A G E 2 4

2019 saw our Newborn & paediatric Emergency Transport Service (NETS) attempt a transfer like never before – to save little Hayden. For the first time, a team of perfusionists, cardiac surgeons, intensivists and nurses rallied to accompany NETS to Canberra to urgently perform ECMO during a NETS neonatal retrieval.

The use of Extra Corporeal Membrane Oxygenation (ECMO) on newborn Hayden, achieved via a complex and highly specialised machine that takes over the role of the heart and lungs – saved his life. ECMO meant he could be transferred to Sydney for much needed surgery to correct an unsuspected heart defect.

After surgery, Hayden recovered and finally went home with his family for the first time.

N E T S R E T R I E VA L N O O R D I N A RY M I S S I O N

A broad but practical and novel infection prevention strategy was implemented to better protect CF patients from an increase in the prevalence of the major pathogen M. absecessuss.

The project was a collaboration between the Respiratory, Cystic Fibrosis, Infection Control and Infectious Diseases teams and led to the development of the strategies which aim to reduce child morbidity, mortality and use of hospital resources for extensive treatment periods (12-18 months).

PR E V E NT I N G M YCO B AC TE R I U M A B SC E S S U S S C ROS S - I N F EC T I O N I N C YS T I C F I B ROS I S (C F ) PAT I E NT S

Allied health teams at SCH worked to help critically ill patients in the CICU reach energy goals sooner after developing an innovative enteral feeding algorithm.

The feeding algorithm improved nutrition intake for patients, ventilated for more than 48 hours.

O P T I M I S I N G N U T R I T I O N FOR CRITICALLY I L L C H I L D R E N

At four months old baby Levi was in need of a life-saving bone marrow transplant to treat the rare genetic condition he had been diagnosed with – Wiskott-Aldrich Syndrome (WAS). Doctors needed to find the right donor match to save Levi. His big brother Torren stepped in. With only a 25 per cent

L I F E - S AV I N G B O N E M A R R O W T R A N S P L A N T

chance of a sibling match and the assurance Torren wasn’t also carrying the gene, Levi received the support his immune system needed, thanks to the help of his brave brother and the specialist teams at Sydney Children’s Hospital, Randwick.

O U T PAT I E N T H E I G H T C H E C K AT T H E C H I L D R E N ’ S H O S P I TA L AT W E S T M E A D

H AY D E N ( O N E D AY ) , C A R D I A C PAT I E N T, P R I O R TO N E T S T R A N S F E R

P A G E 2 5

In the last 12 months we have progressed to the implementation stage of the SCHN Aboriginal Health Strategic Plan (AHSP). Many initiatives have been actioned, many more are in progress and many others are being planned for the future, which will improve the health outcomes of Aboriginal and Torres Strait Islander patients and their families.

So far we have implemented an Aboriginal Flag icon for all identified Aboriginal people whom come into our services. We are also in the process of employing new staff members including:

• Aboriginal Health Unit Manager

• Aboriginal Public Health Trainee

• Senior Aboriginal Health Worker

• Aboriginal Care Coordination Team – Central and Eastern Sydney Primary Health Networks partnership project

• Aboriginal Health Worker – Aboriginal Care Coordination Team – Central and Eastern Sydney Primary Health Networks partnership project

• Aboriginal Health Worker (SCH)

• Aboriginal Physiotherapy Assistant

• Aboriginal Speech Pathologist trainee

Improving the cultural safety of our organisation for Aboriginal families and staff is a priority for SCHN. In working towards this we are focusing on building greater awareness within SCHN of our AHSP and key priorities. We have completed two ‘Grand Rounds’ presentations, organised SCHN Aboriginal Health Steering Committee presentations and clinical team presentations on the implementation of the AHSP, where it is at, how it will be implemented and an action plan of ongoing work to be done. There is also an SCHN AHSP evaluation framework being developed and near completion.

The implementation of a SCHN Aboriginal Health Unit is a key part of growing and supporting our Aboriginal Health Worker positions as well as the Aboriginal Staff Support Network across both sites which brings together all Aboriginal staff across SCHN.

I M P L E M E N TAT I O N O F T H E N E T WO R K’ S F I R S T A B O R I G I N A L H E A LT H S T R AT E G I C P L A N

P A G E 2 6

The Transplant Unit at The Children’s Hospital at Westmead entered new territory in 2018-19 with a record breaking month of liver transplants. In one month the team performed almost the same number of liver transplants they would typically do in a year.

Eleven children received a life-saving organ over a period of four weeks.

Among the 11 were five babies, two toddlers and 14-year-old Patrick (pictured).

R E CO R D B R E A K I N G N U M B E R O F T R A N S P L A N T S

SCH’s Kids Cancer Centre implemented the first public oncofertility service for young adult cancer patients. Due to the equitable and timely access to the service there was a 63 per cent increase in the number of patients in NSW receiving oncofertility care.

O N C O F E R T I L I T Y S E R V I C E F O R Y O U N G A D U LT C A N C E R P AT I E N T S

63%

Chronic respiratory patients with frequent hospital admissions were the focus of a physiotherapy intervention program to ensure better health outcomes once children were discharged.

Two thirds of children referred to the new Respiratory Admission Avoidance Physiotherapy (RAAP) avoided readmission as an inpatient in the six weeks following discharge.

Typically, admitted patients require a 14-day course of intravenous antibiotics and physiotherapy. For each patient who avoided a 14-day admission, it is calculated that this project saved 140 days for the hospital and family.

E A R LY P H YS I OT H E R A P Y INTERVENTION FOR CHRON IC R E S P I R ATO RY PAT I E N T S

P H OTO C R E D I T : D A I LY T E L E G R A P H

P A G E 2 7

B E A R COT TAG E

Our children’s hospice Bear Cottage welcomed Beau the golden Labrador in 2018-19.

His sensitive and ‘gentle giant’ nature has proven an invaluable addition to the service in Manly.

Specially trained and donated by Guide Dogs Australia, he is always available for a cuddle and is a great source of comfort for our patients and families. Staff and volunteers also love him and his full-time carer is a staff member at Bear Cottage.

His favourite activity is playing tug-o-war and being rewarded with a carrot when he has been especially good.

P E T T H E R A P Y F O R B E A R COT TAG E G U E S T S

Received 90 new referrals from

across NSW 133 volunteers gave their time

Farewelled 42 children

Cared for more than 200 children and their families

P A G E 2 8

Bear Cottage now has a physiotherapist available eight hours per week. This has made a significant difference to the care provided to children with very special needs. It allows a continuum of care from home, hospice, hospital and has been very well received by the families.

The initiative was led by the Bear Cottage Family Consumer Advisory Group.

A D D I T I O N A L A L L I E D H E A LT H S U P P O RT

The opening of a special reflective space for patients and families at Bear Cottage was realised in 2019 during National Palliative Care Week.

The Garden of Remembrance was unveiled in May, featuring a custom made Australian bronze statue of two children, creating a space of love and serenity to remember children who have lived and died at Bear Cottage. Bereaved families joined staff and volunteers to officially open the first garden of its kind at the health facility in Manly.

N E W G A R D E N O F R E M E M B R A N C E AT B E A R COT TAG E

R E S I D E N T T H E R A P Y D O G , B E A U , B E A R C OT TA G E

P A G E 2 9

Being Mindful project

Incidents involving deliberate self-harm or aggression were reduced at The Children’s Hospital at Westmead in 2018-19 after the implementation of the Being Mindful project.

This work was an important collaboration with young people to improve their experience in the Emergency Department and while receiving treatment in the adolescent mental health ward.

Our mental health teams worked with young people to determine what they believed helped their recovery. New processes were implemented to improve outcomes for for consumers of our acute mental health services at CHW.

Reducing seclusion and restraint

The Network is committed to reducing and where possible, eliminating seclusion and restraint, and providing the best possible mental health care in the least restrictive environment.

In 2018-19, the Network completed the implementation of all actions from the NSW Health ‘Mental Health Safety and Quality in NSW: A plan to implement the recommendations of the Review of seclusion, restraint and observation of consumers with a mental illness in NSW Health facilities’.

To see improvements to our therapeutic environment see page 47.

I M P ROV I N G M E N TA L H E A LT H C A R E O U TCO M E S F O R C H I L D R E N A N D YO U N G P E O P L E

P I C T U R E D L - R : A N N A L E S T E R , H E L E N H E D G E S , V A N E S S A W E R N E R

P A G E 3 0

Nineteen-month-old Lani has spent most of her life in Hospital. Born extremely premature, at just 24

weeks, Lani weighed less than a bag of sugar and was no bigger than a tub of butter. She had chronic lung disease and a bowel obstruction, which required surgery and for

some time, her future was unknown. Thanks to expert care at Sydney

Children’s Hospital, Randwick, Lani came out stronger than ever and is

well on the road to recovery.

L A N I

Five-year-old Finn Carroll (pictured) became the youngest boy in Australia to have his pancreas removed, when doctors at The Children’s Hospital at Westmead performed a special

total pancreatectomy with islet autotransplantation (TPIAT) operation

for the first time in August 2018. Three months in the planning,

the transplant involved extracting insulin-producing cells (‘islets’) from Finn’s pancreas and injecting them

into the liver.

Y O U N G E S T B O Y I N A U S T R A L I A T O H AV E H I S

P A N C R E A S R E M O V E D

S TA F F A N D PAT I E N T S I N N E W S H A R E D L I V I N G S PA C E S , H A L L W A R D , T H E C H I L D R E N ’ S H O S P I TA L AT W E S T M E A D

P A G E 3 1

A P P LY I N G G R E AT R E S E A R C H“Our research today will become the medicine that will transform lives tomorrow.”

In 2018-19 the research division of the Network, Kids Research, included more than 600 researchers, affiliated academic staff, support staff and students who were dedicated to discovering new ways to improve the health of children.

Many of our researchers are also clinicians treating children and their families every day. This not only informs their exploration of new treatments but enables our world-leading research to be quickly translated into life-saving treatments for their young patients.

Effective collaboration with universities, other research organisations and donors is key to the success of the Network’s research, which is undertaken at both our paediatric hospitals – The Children’s Hospital at Westmead and Sydney Children’s Hospital, Randwick.

We are committed to better understanding childhood diseases, finding cures and discovering innovative treatments to help children and young people live their healthiest lives.

P A G E 3 2

TA R N E E T, H O N O U R S S T U D E N T, K I D S R E S E A R C H

P A G E 3 3

K AT H E R I N E , P H D S T U D E N T, K I D S R E S E A R C H

P A G E 3 4

D A S H B A R DR E S E A R C H

S U P P O R T S TA F F

R E S E A R C H E R S

150

P O S T G R A D U AT E S T U D E N T S

CLINICAL ACADEMIC LEADERS

7040

330 total

180 full time

$29.2M

T O TA L R E V E N U E(Research grants and clinical trials, grants via

donations, government funding, investment income)

A C T I V E C L I N I C A L

T R I A L S213

P U B L I C AT I O N S

832

(2018)

P A G E 3 5

In October 2018 the Network secured funding from the NSW Government for a two-year pilot program to test for Spinal Muscular Atrophy (SMA) and Primary Immunodeficencies (PID), in the routine newborn heel prick tests already in place for 20 other conditions.

SMA is the leading genetic cause of infant death in Australia. Early detection in a number of babies in 2018-19 has given the newborns the chance to be treated early and have a healthy life.

In 2018-19 more than 90,000 babies were tested.

An internationally sponsored clinical trial led by our own Kids Research, to test a gene therapy to help prevent the onset and devastating progression of SMA, also got off the ground.

The first baby involved in the trial was the first infant outside of North America to receive the one-off gene therapy infusion for SMA.

A N AU S T R A L I A N F I R S T – S M A A D D E D TO N E W B O R N H E E L P R I C K T E S T

H E E L P R I C K T E S T, T H E C H I L D R E N ’ S H O S P I TA L AT W E S T M E A D

P A G E 3 6

Genetic research, led by SCHN and University of Sydney’s Prof Sandra Cooper, identified a new genetic testing mechanism leading doctors to the exact gene causing a pair of siblings’ rare disease.

The discovery enabled the right treatment to be identified – which in this case was the asthma medication ‘ventolin.’ Following treatment the siblings’ mobility was restored, giving them back the ability to stand, walk and now, drive.

N E W G E N E T I C D I S COV E RY R E S TO R E S S I B L I N G S ’ A B I L I T Y TO WA L K

2018-19 saw a number of world first clinical trials, to treat aggressive brain cancers, giving hope to families in NSW and across Australia.

Biomede

Led by Dr Geoff McCowage at the Cancer Centre for Children at CHW, the trial is delivered at both SCH and CHW, and other capital cities across Australia. Patients involved have been newly diagnosed with Diffuse Intrinsic Pontine Glioma (DIPG) a rare and currently incurable brain cancer.

Biomede is the first adaptive clinical trial in Australia to analyse a child’s tumour to identify which of the three drugs approved for the trial (erlotinib, everolimus and dasatinib) is most likely to be effective.

ACT001

Led by A/Prof David Zeigler at the Kids Cancer Centre at Sydney Children’s Hospital, Randwick, the trial is delivered through SCH and other capital cities across Australia.

DIPG research led by A/Prof Zeigler via the Children’s Cancer Institute (CCI) led to the identification of the top five drugs most likely to kill DIPG cells. ACT001 is one of those drugs.

Nivolumab

In an Australian first, experts from SCH and the CCI partnered with The Hospital for Sick Children in Toronto, Canada to begin an international clinical trial for nivolumab – a new immunotherapy drug. The trial is testing the drug’s effectiveness on children with hypermutated brain tumours.

Delivered out of CHW and other capital cities across Australia, up to 28 children will be involved in the trial.

N E T WO R K L E A D S WO R L D F I R S T C L I N I C A L T R I A L S F O R C H I L D R E N W I T H AG G R E S S I V E B R A I N C A N C E R

P A G E 3 7

In the past two years, 50 per cent of children who have received a personalised treatment as part of the Zero Childhood Cancer Program, have had a complete or partial response which has stabilised the disease.

Z E R O C H I L D H O O D C A N C E R

As of 30 September 2019, 250 children with high-risk cancers from all over Australia had been enrolled in this state-of-the-art trial, led by the Kids Cancer Centre at Sydney Children’s Hospital, Randwick and Children’s Cancer Institute (CCI).

The first stage of the Zero Childhood Cancer program began in 2016 with a pilot study for children with high-risk cancer being treated in New South Wales. During this pilot, the platform required to create a personalised medicine pipeline was established and tested. This involved multiple steps, including developing a reception process for cancer samples being sent from all over Australia to a centralised tumour bank, and establishing the best possible methods for molecular profiling, drug screening and drug efficacy testing.

Z E RO C H I L D H O O D C A N C E R P RO G R A M

Following successful completion of the pilot study, the national clinical trial was then launched in 2017.

16-year-old Eleni was diagnosed with a low grade brain tumour in March this year. She was enrolled on the PRISM trial which falls under the Zero Childhood Cancer program. Through this trial her tumour was found to have a rare BRAF mutation offering the potential for treatment with new targeted agents. Eleni is currently undergoing treatment.

E L E N I ( 1 6 Y E A R S ) , O N C O L O G Y PAT I E N T, S Y D N E Y C H I L D R E N ’ S H O S P I TA L , R A N D W I C K

50%

P A G E 3 8

A new laboratory platform was created by experts at Sydney Children’s Hospital, Randwick, and UNSW, Sydney to test how children with Cystic Fibrosis would respond to various treatments.

The new ‘Australian CF Avatar Platform’ means numerous medicines can be tested on the actual gut and lung ‘avatars’ of the child, in a petri dish in the laboratory.

The reactions in the lab predict how a child will respond to a particular drug, making treatment more accurate and comfortable for the patient.

N E W R E S E A RC H S E T TO T R A N S F O R M C YS T I C F I B RO S I S T R E AT M E N T S

R U B Y ( 1 2 Y E A R S ) , C Y S T I C F I B R O S I S PAT I E N T, S Y D N E Y C H I L D R E N ’ S H O S P I TA L , R A N D W I C K

P A G E 3 9

Progress of Australia’s first prevalence study of Fetal Alcohol Spectrum Disorder (Liliwan Project)

Kids Research Prof Elizabeth Elliot is Chief Investigator for the Liliwan Project. Initiated in 2009 by Indigenous communities in the Kimberley’s Fitzroy Valley in Western Australia and a collaboration between two Aboriginal organisations, University of Sydney and The George Institute for Global Health, the project cohort is now engaged in further research with a focus on eye and ear, vision and hearing abnormalities in 2018-19.

Research includes; investigations into health service usage, the Jandu Yani U project focused on positive parenting, the Bigiswun Kid project on health and wellbeing of youth, and the Marurra-U project which is enabling the development of a wrap-around, trauma-informed model of care for children with fetal alcohol spectrum disorder.

Data from these studies will inform service development, allow Aboriginal communities to advocate for better access to health and mental health care, increase Aboriginal community awareness about the harms of alcohol in pregnancy, improve identification of children at risk and improve mental health.

Study of Environment on Aboriginal Resilience and Child Health (SEARCH)

SEARCH is Australia’s largest long-term study of the health and wellbeing of urban Aboriginal children. SEARCH has partnered with four Aboriginal Community Controlled Health Services (ACCHS) across NSW for the last decade and a half, with plans to continue the relationship for decades

H E A LT H R E S E A RC H C LO S I N G T H E G A P F O R A B O R I G I N A L C H I L D R E N

The Network’s Human Research Ethics Committee (HREC) has consistently achieved above statewide benchmark results. As a result, Sydney Children’s Hospitals Network has been accredited as an Early Phase Trial HREC, the only public organisation committee to achieve this in New South Wales.

E A R LY P H A S E T R I A L H R E C

All children in NSW diagnosed with cancer in the next two years will be screened as part of a world leading precision diagnostic and preventative program.

S C R E E N I N G

to come. The Network’s involvement has been through a CIA and Early Childhood focus, and also includes staff housed in our Centre for Kidney Research at Kids Research.

In 2018-19 NSW Health and private donors provided nearly $5M for Ear, Nose and Throat (ENT) services and speech pathology through the HEALS initiative (Hearing Ear health and Language Services).

HEALS also funded two soundproof rooms in ACCHSs to enable ongoing audiology testing and speech pathology intervention services on site.

PACER Network

Established in 2018, The PACER Network was created to address and improve the gap in health outcomes between indigenous and non-indigenous Australians. Through patient-centred outcomes research and patient involvement in research, PACER aims to facilitate knowledge exchange, cross-disciplinary collaboration and innovation.

In 2018-19, PACER successfully hosted 10 webinars related to patient involvement, including two webinars on co-production in Aboriginal health research and working with Aboriginal communities to develop and implement community health programs. It has also facilitated workshops focusing on consumer involvement in health research, conducting qualitative health research and has offered travel grants to patients/caregivers (both domestic and international) for research-related activities.

PACER is a joint initiative of the Network’s Kids Research, The University of Sydney, Westmead Hospital and the Westmead Institute for Medical Research.

N A I D O C C E L E B R AT I O N S , T H E C H I L D R E N ’ S H O S P I TA L AT W E S T M E A D

P A G E 4 0

N U R S I N G R E S E A RC H U N I T AC H I E V E M E N T S 2 018 -19

4 new nurse-led research projects began

(9 running in total) 4 partnered research projects supported

20 research presentations within the Network and 14

drop-in sessions conducted

7 conference presentations

(4 were international conferences)

1 peer reviewed publication

Leadership of the Australian Paediatric

Nurse Scientists (AusPaNS)

Supervision of 7 higher degree

research students

Participation as co-investigator in

3 external national/international research

projects

The Network’s Big Brain research collaboration was launched in 2018-19. Led by Prof Russell Dale, Michelle Farrar and Adam Guastella, the project aims to improve our understanding and treatment of neurodevelopmental and other neurological and psychiatric disorders in children. The Ainsworth Foundation has assured its continued support after providing a three year funding grant through the Sydney Children’s Hospitals Foundation.

‘ B I G B R A I N ’ W O R K S T O I M P R O V E O U T C O M E S F O R C H I L D R E N W I T H N E U R O D E V E L O P M E N TA L D I S O R D E R S

S I A N N A ( F I V E M O N T H S ) , L I V E R PAT I E N T, T H E C H I L D R E N ’ S H O S P I TA L AT W E S T M E A D

P A G E 4 1

B U I L D I N G A S O L I D F O U N D AT I O NSystems and Processes l Infrastructure l Finances

Infrastructure and information technology upgrades have seen significant progress in 2018-19.

$1.2 billion was committed, in addition to the $95 million committed, for The Children’s Hospital at Westmead as part of the Westmead Redevelopment project. This funding is across the Network to build bigger and better children’s hospitals for patients, families and staff.

Meanwhile, the continued rollout of the Network’s Integration IT program has seen the introduction of an Electronic Medical Records (eMR) system now complete at Sydney Children’s Hospital, Randwick and The Children’s Hospital at Westmead. Staff met the many challenges of the project, and it has meant we were able to begin streamlining processes for frontline staff caring for our kids.

P A G E 4 2

L I A M ( F O U R Y E A R S ) , H O N O U R A R Y B U I L D I N G I N S P E C TO R ,

T H E C H I L D R E N ’ S H O S P I TA L AT W E S T M E A D

P A G E 4 3

In 2018-19 Sydney Children’s Hospitals Network saw unprecedented funding commitments made to build and expand our specialist paediatric health facilities, while existing infrastructure projects hit significant milestones.

As a result of these new funding commitments, Sydney Children’s Hospital, Randwick will be redeveloped as part of the Randwick Campus Redevelopment project and an additional hospital building will be constructed at The Children’s Hospital at Westmead.

Both hospitals are located on two thriving world-class health and education precincts and the new builds will significantly improve the way we care for current and future generations of sick and injured children.

From enabling the rapid translation of research discoveries to the patient’s bedside and improving the overall patient and family experience, to fostering health partnerships, these redevelopments will transform paediatric care in NSW.

R E D E V E LO P M E N T S

A R T I S T I M P R E S S I O N , R A N D W I C K C A M P U S R E D E V E L O P M E N T

P A G E 4 4

Sydney Children’s Hospital, Randwick The Children’s Hospital at Westmead

2018-19

• $608m – future funding commitment to Stage 1 of redeveloping SCH and creating Australia’s first Comprehensive Children’s Cancer Centre (CCCC) was made. Contributors include the NSW and Federal Governments, Sydney Children’s Hospitals Foundation, the Children’s Cancer Institute and UNSW Sydney (March 2019)

• Finance released in the 2019-20 State Budget to begin pre-planning for SCH Stage 1/CCCC project

• Staff and community survey completed• SCH Clinical Service Planning prioritisation • Architects and project managers for Stage 1

appointed to undertake pre-planning

2018-19

• $619 million committed by NSW Government and $35 million committed by Sydney Children’s Hospitals Foundation for : » Stage 2 – Paediatric Service Building

(March 2019) » Stage 1 Central Acute Services Building (CASB)

topping out (June 2019)• Architects and project managers for Stage 2

appointed

Beyond 2019

Stage 1 includes an integrated state-of-the-art building, proposed to be 50 per cent larger than SCH’s existing size, housing:

• New Emergency Department and patient drop off zone from Botany Street

• Short Stay / Medical Assessment Unit• Comprehensive Children’s Cancer Centre

(SCH and Children’s Cancer Institute) bringing the latest research from the laboratory bench to the bedside

• Front of house services• Other clinical areas and inpatient units as

determined by priorities in the Clinical Service Plan

Beyond 2019

Stage 1 will see the opening of the Central Acute Services Building in late 2020, which will include:

• New Emergency Department • 32 bed short stay inpatient unit• Additional perioperative capacity • Medical imaging• Pharmacy facilities

Stage 2 will include a new Paediatric Services Building, housing:

• Operating theatres• Neonatal Intensive Care Unit (NICU)• Paediatric Intensive Care Unit (PICU)• Cancer services• Pharmacy Department • Pathology services expansion • Mental Health inpatient and ambulatory care• Additional inpatient units (IPU)• As well as other services to be determined

O F F I C I A L TO P P I N G O U T C E R E M O N Y, C E N T R A L A C U T E S E R V C I E S B U I L D I N G ,

W E S T M E A D R E D E V E L O P M E N T

P A G E 4 5

Oncology Outpatients at Sydney Children’s Hospital, Randwick

To support the delivery of the Zero Childhood Cancer personalised medicine clinical trial program, program, the oncology outpatient ward (C2 North) was refurbished and expanded.

Improvements across the wards included some larger waiting areas, more clinic rooms, increased isolation spaces for immune-compromised patients, creation of a dedicated personalised medicine space and improved staff facilities.

R E F U R B I S H M E N T S

Full implementation of our new incident software, developed in-house for Network staff, was completed in 2018-19. The Patient Safety Incident

Dashboard enables trends to be observed and indicates opportunities for improvement projects to increase

the safety and quality of care for patients.

P AT I E N T S A F E T Y T O O L L E A D I N G

T H E WAY I N N S W

10,000 parents and carers now use the Network’s My Health Memory phone app, helping parents track their child’s medical appointments and documents. Telehealth capability has also been built

into the app and is documented in our electronic Medical Records (eMR). 94% of parents and carers felt more connected with their clicnial teams

when using the app.

P H O N E A P P H E L P S P A R E N T S K E E P T R A C K

O N C O L O G Y O U T PAT I E N T S , S Y D N E Y C H I L D R E N ’ S H O S P I TA L , R A N D W I C K

P A G E 4 6

2018-19 has seen a number of major achievements in the Network’s data Analytics Program. The most significant being the development of a number of dashboards to enhance the reporting capabilities of the Clinical Governance Unit.

Staff now have timely and reliable access to live data relating to incidents, policies and audit results – as opposed to receiving monthly Excel based reports that were circulated on the Hospital intranet pages.

Q UA L I T Y A N D S A F E T Y DATA A N A LY T I C S P RO G R A M

Improving the therapeutic environment to encourage recovery, and reduce incidents of seclusion and restraint, was the aim of a major refurbishment of CHW’s acute mental health unit ‘Hall Ward.’

The new sensory room, improved common areas (including outdoors), and the relocation of interview rooms and clinical spaces were completed in June and opened to patients and staff the following month.

The project was coordinated with a co-design approach – that is, consumers and carers were involved in all aspects of the design. This methodology is underpinned by principles of early engagement, inclusivity, transparency, shared power and equity of knowledge and responsibility.

Acute Mental Health Unit at The Children’s Hospital at Westmead

A C U T E M E N TA L H E A LT H U N I T, T H E C H I L D R E N ’ S H O S P I TA L AT W E S T M E A D

P A G E 4 7

Despite the two children’s hospitals being physically located 50km apart, clinical care and operational systems have united.

The final aspect of integration, a work in progress since 2016, was realised in June 2019 when the Integration Program brought together the electronic medical records from both hospitals into a single digital paediatric system, called the ‘Network’ eMR.

The vision for the bespoke paediatric system was a single, locally governed, electronic medical record for all children utilising our services. It was essential that it be accessible to all clinicians, helping to maximise collaboration, cooperation and efficiencies while minimising the risks associated with two site specific, separate, in part comparable, hybrid and/or satellite records.

‘Digital Integration’ was achieved on 1 June 2019 when SCH went live with the ‘Network eMR’ and Patient Management (PM) module.

D I G I TA L I N T E G R AT I O N – A B E S P O K E PA E D I AT R I C S YS T E M

Major benefits of the Network eMR

• Access to clinical documentation from other Network facilities

• Electronic medical management (eMM) plans with automated alert creation*

• ‘Smart’ Discharge template pulls information already entered in the eMR and collates it into a Discharge Summary which can then be electronically distributed to GPs, HealtheNet, My Health Record, and My Health Memory

• Upgraded documentation functionality with auto-text, ‘smart’ copy/paste and spellcheck

• Paediatric specific protocols enabled by PowerPlans

• MyPortal which is a screen custom built by the Network where staff can see theatre lists and their recent activity in one place, including an up-to-date discharge summary dashboard

• Tap On/Tap Off quick access to the eMR, saving clinicians up to 45 minutes per day by eliminating the need to enter usernames and passwords

• Access to the collective data of all children in our care helps us create better care, and enables research of large cohorts for complex patient conditions

*“Medical management plans are now front and centre in the new system. This means staff no longer have to look through the 450 scanned documents or review the one from mum’s handbag (which may be out-of-date)” – SCH Medical CRMO

T H E N E T WO R K E M R C R E AT E S A V I E W O F PAT I E N T S AC RO S S O U R FAC I L I T I E S . I T I N C LU D E S T R E AT M E N T I N F O R M AT I O N T H AT C A N B E ACC E S S E D BY T H E VA R I O U S C A R E P ROV I D E R S I N T H E W I D E R N S W PA E D I AT R I C C O M M U N I T Y. I T A L S O S U P P O RT S S A F E R T R A N S I T I O N S O F C A R E B OT H W I T H I N T H E N E T WO R K A N D E X T E R N A L LY.

eMR enables service provision to be streamlined, treatment protocols to be evidence-based and reduces unnecessary duplication.

Prescribing Error Rates – 12 months post eMM

Significant decrease in 3 largest

error categories (wrong dose, route

and frequency)

Significant decrease in clinical prescribing

errors rated as potentially severe

Significant decrease in overall

rate of clinical prescribing

errors

P A G E 4 8

In 2018-19 the Network supported the full implementation of The Foundation to drive fundraising projects across all Network entities.

E S TA B L I S H M E N T O F T H E S Y D N E Y

C H I L D R E N ’ S H O S P I TA L S F O U N D AT I O N

Free drinking water fountains were installed at The Children’s Hospital at Westmead to encourage visitors and staff to use reusable drink bottles. The initiative aims to reduce the amount of plastic waste from buying water bottles.

F R E E D R I N K I N G WAT E R F O U N TA I N S

A new robotic digital radiography system at Sydney Children’s Hospital, Randwick has delivered a 40 to 70%

radiation reduction to patients needing x-ray services.

R O B O T I C D I G I TA L R A D I O G R A P H Y S Y S T E M

E L E C T R O N I C M E D I C A L R E C O R D S S Y S T E M I N U S E , S Y D N E Y C H I L D R E N ’ S H O S P I TA L , R A N D W I C K

P A G E 4 9

The level of awareness and engagement in the Network’s Sustainable Hospitals program increased in 2018-19, with more staff than ever interested in getting involved to see improvements with waste, particularly in the clinical setting.

PVC Recycling

PVC recycling was a new recycling stream introduced. It has meant the diversion of IV bags, tubing and masks from landfill to make into useful products such as garden hoses and children’s play mats.

Green Champions

This year the number of Green Champions across the Network grew to more than 100. We are well on our way to reaching our target of green champion representation in each department to help us achieve our sustainability goals.

Re-use campaign

To encourage a culture of re-use an awareness campaign was launched across the Network to remind staff and guests to bring their own water bottle and coffee cups instead of using disposables. Polystyrene cups were also removed from the ordering system at CHW, with SCH to follow.

The Network continues to work with not-for-profit organisations to find solutions to extend the life of our medical equipment and furniture that is no longer required by our hospitals, but could be of use at other health facilities in need locally and overseas. In 2018-19 these items included; hospital beds, trundle beds, portable ventilators, laryngeal face masks, portable incubators, resmed machines and neonatal heat lamps.

S U S TA I N A B I L I T Y

P V C R E C Y C L I N G , T H E C H I L D R E N ’ S H O S P I TA L AT W E S T M E A D

P A G E 5 0

D A S H B A R DS U S TA I N A B I L I T Y

R E C Y C L E D T H E AT R E WA S T E

7.7 tonnes

28% increase on previous year

WAT E R U S A G E

8.5% reduction

H O S P I TA L V E H I C L E K M S D R I V E N

8% reduction

P V C R E C Y C L I N G

500kg

*New in 2018/19

T O N E R C A R T R I D G E S R E C Y C L E D

961kg

M O B I L E P H O N E R E C Y C L I N G

175.69kg of mobile phones have been recycled at CHW since 2010

K I M G U A R D S T E R I L E W R A P S

P L A S T I C SS U R G I C A L

I N S T R U M E N T S

P A G E 5 1

S U P P O RT I N G S TA F F, E M P O W E R I N G F A M I L I E SPeople and Culture l Education

We are a ‘learning organisation’ where learning and teaching are core to what we do.

We aim to improve the health literacy of families – empowering them with information and understanding that enables better decision making and delivery around their children’s health, and better engagement with us in designing care.

Upskilling our workforce, by enhancing professional and vocational training is important to us so our staff are continuously delivering better care and are better equipped to work with evolving models of care.

P A G E 5 2

E L I ( T W O M O N T H S ) , O N C O L O G Y PAT I E N T, S Y D N E Y C H I L D R E N ’ S H O S P I TA L , R A N D W I C K

P A G E 5 3

S I M U L AT I O N T R A I N I N G , PA E D I AT R I C I N T E N S I V E C A R E U N I T, T H E C H I L D R E N ’ S H O S P I TA L AT W E S T M E A D

P A G E 5 4

D A S H B A R DW O R K F O R C E

N U M B E R O F S TA F F W H O

U N D E R T O O K T H E H E A LT H L E A D E R S H I P

P R O G R A M54

(Total over the life of the program – more than 200)

N E T W O R K S TA F F (per site)

Workforce increased with 151 new positions across

the Network.

*Bear Cottage, Children’s Court Clinic, Pregnancy and

Newborn Screening Network, Mental Health Children and

Young People and Child Health Network

SCHN: 6070 CHW: 3585 SCH: 1738 NETS: 92

Research Directorate: 229 SCHN Services located

at other sites*: 96 Network Directorate: 330

STAFF WITH NON-WORK

RELATED HEALTH ISSUES SUPPORTED

AT WORK

177

H I R E

1273

S T U D E N T P L A C E M E N T S

2275

N E T W O R K S TA F F(including Volunteers)

7860

35%

M A N D AT O R Y S TA F F T R A I N I N G

C O M P L I A N C E

79%

E M P L O Y E E C O S T S

$555M – employee related expenses

68% of Network budget ($817M)

% O F S TA F F W H O H AV E B E E N

W I T H T H E N E T W O R K F O R M O R E T H A N

1 0 Y E A R S

P A G E 5 5

Open disclosure training

End of life planning and care

Clinical supervision

Communication

Over 2018-19 the Network’s Education Service has made significant achievements including the completion of an implementation plan to ensure delivery of strategic objectives and enhanced marketing and communications strategies for more effective education. There has also been the creation of further education opportunities in 2020 through the development of a collaborative partnership within the Westmead Precinct Education Hub and university partners.

Our Clinical Nurse Educators continue to support our staff at the frontline and consistently deliver education through numerous activities such as assessment at the bedside, accrediting staff for clinical skills, supporting mandatory training, and developing education packages.

E D U C AT I O N

Simulation service – improving realism and safety

Junior Medical Officer Training

2018-19 JMO’s

2018-19: 645 nursing students did clinical placements at the Network and strong collaborations

continue with our university partners.

NSW trains the largest number of paediatric specialists in the country.

Year on year, paediatric trainees at the Network exceed performance Australia-wide in both written and clinical exams.

Critical to this success is having the ability to rotate across our hospital facilities and access a far wider range of patients and teachers.

87 candidates

Pass rate

*5% higher than the Australian average

of 89%

94%

More than 4000 staff, students and external health practitioners

received hands-on simulation

experiences.

More than 350 simulation based events across the

Network, including 12 new paediatric simulation-

based training courses.

Allied Health Education

2018-19 focused on:

P A G E 5 6

Allied Health Education Health Leadership Program

The NSW Health Leadership Program is a hospital-based, nine-month training program designed to build leadership capacity across the Network. The program aim is to grow our people to be the best leaders they can be to help us achieve our local goals and ambitions.

The Program is based on the NSW Health Leadership Framework which focuses on five different domains, each of them looking at a separate set of skills.

Over the last four years nearly 200 members of staff have participated in the program. Doctors, nurses, allied health professionals and managers have participated in the program.

We are just coming to the end of the fourth cohort of the program with our 52 future leaders preparing for their final presentation to showcase their new skills. We wish them luck and look forward to welcoming our next group of staff members as we start recruitment for the next cohort for 2020.

S I M U L AT I O N T R A I N I N G , PA E D I AT R I C I N T E N S I V E C A R E U N I T, T H E C H I L D R E N ’ S H O S P I TA L AT W E S T M E A D

P A G E 5 7

The Kidsburns’ team at The Children’s Hospital at Westmead was selected as a finalist in the HESTA Australian Nursing & Midwifery Awards.

Kidsburn provides 24-hour statewide burns referral and consultation to clinicians anywhere in NSW – helping to keep kids closer to home.

N E T W O R K R E C O G N I S E D F O R A U S T R A L I A’ S O N LY N U R S E - L E D O U T P AT I E N T B U R N S C L I N I C F O R K I D S

Communication

Recognising the need for ongoing and transparent communication across the SCHN we:

• Continued Team Talk to facilitate conversations around the safety and care coordination needs of our patients.

• Continued to improve the staff intranet to ensure it is user-friendly, interactive, dynamic and information-rich.

• Developed a ‘Strategy on a Page’ to clearly convey and present the strategic direction of our Network.

• Introduced improved processes for completing, submitting and responding to briefs.

• Held regular all-staff forums.

Flexible work practices

Recognising the need to for flexible work options in our 24/7 service delivery:

We’re committed to reviewing our current ways of working and improving methods for fulfilling flexible work practices that fit within our 24/7 service delivery structure.

Actions from 2017-18 NSW Health ‘People Matter’ Employee Survey results

In 2018-19 we undertook a number of actions in response to the 2017-18 ‘People Matter’ Employee Survey results.

More staff

Acknowledging the need for more staff across various areas of our Network:

In the past year, we’ve created an additional 116 roles with 113 in frontline services.

Once complete, the new Westmead and Randwick precincts will create more career opportunities to deliver services for our communities.

Setting up for success

We understand that setting career goals provides direction and is essential to workforce development and sustainability. We are committed to making SCHN a safe place to work and continue to support our Framework for the Prevention and Management of Inappropriate Behaviour.

• We have revised the staff appraisal system to enable staff to reflect on the year that was and set realistic goals for the year ahead.

• We offer coaching for managers to support them to have those difficult discussions with their staff around appraisals.

• We introduced and rolled out ‘Custodians of Culture’ workshops and training sessions.

• We continue to review our information on how to report bullying and where to get advice and support.

• We have ‘A Safe Place to Work’ on our intranet with tools and resources.

L U C A S ( F O U R Y E A R S ) , R E S P I R ATO R Y PAT I E N T, S Y D N E Y C H I L D R E N ’ S H O S P I TA L , R A N D W I C K

P A G E 5 8

Improving health literacy in culturally and linguistically diverse communities

The Network’s Kids Health team undertook an extensive project to improve the quality of translated health information available to parents.

Around 70 staff members from non-English speaking backgrounds brought their language expertise to review translated English fact sheets and ensure the accuracy of information being distributed to parents through various sources, such as Fact Sheets and the website.

Establishment of the Resus4Kids4Parents program

This program was developed in 2018-19 as an extension of the Parent CPR eLearning found on our KidsHealth health information website for parents.

Resus4Kids4Parents are new hands-on practical sessions offered to parents and carers involved with the Network to give them an opportunity to practice life-saving paediatric basic life support skills.

Prof Richard Cohn was awarded the prestigious Ashleigh Moore Award at the annual Clinical Oncology Society of Australia (COSA) Survivorship Group Conference in April 2019.

The award acknowledges the ongoing care of cancer patients and game-changing research, which has influenced cancer survivor care across Australia.

N E T W O R K S P E C I A L I S T R E C O G N I S E D F O R P I V O TA L W O R K I N C A N C E R S U R V I V O R S H I P

Asthma exerts at the Network launched a new, free asthma e-book in 2018-19.

For the first time, parents and carers have access to life-saving support in the palm of their hands. The free resource is conveniently available to download on iPhone or iPad and is soon to be available on Android devices.

The multimedia, interactive digital resource arms the user with critical information that could save a child’s life and is available on asthmainchildren.org.au.

Aiming for Asthma Improvement in Children (AAIC) is a statewide program coordinated by Clinical Nurse Consultants from SCH’s Respiratory Department.

Asthma e-book for parents – first of its kind in the world

P A G E 5 9

PEO PLE A N D C U LT U R E

2018 NAIDOC Week Celebrations #BecauseofHerWeCan

In line with the 2018 theme ‘Because of her we can!’ both hospitals held official ceremonies and events to celebrate the active and significant role Aboriginal and Torres Strait Islander women have and continue to play in our communities.

Staff Celebration Week

Each year the Network holds Celebration Week, hosting a number of small activities and gestures to show our appreciation for the extraordinary efforts and passion our staff bring to work every day. In September 2018 staff enjoyed BBQs, cupcake deliveries, giveaways and massage days.

Eid celebrations bring hospital communities together

With many patients unable to leave hospital during Eid al-Fitr, the celebration was instead brought to them. Both hospitals across the Network hosted mornings teas for the occasion, with patients, families and staff from all cultures and religions encouraged to take part.

P A G E 6 0

Celebrating 100 years of volunteers

More than 150 volunteers were treated to a special high tea at The Children’s Hospital at Westmead during National Volunteer Week in May 2019. This was a particularly important function as 2019 marked 100 years since the establishment of the Voluntary Helpers Department in 1919 at the Royal Alexandra Hospital for Children, Camperdown.

Sydney Children’s Hospital, Randwick celebrates 21st Birthday

June 2019 marked 21 years since the ‘Prince of Wales Children’s Hospital’ was formally renamed Sydney Children’s Hospital, Randwick. Staff and patients took part in a number of celebrations to acknowledge this historic milestone.

P A G E 6 1

E X PA N D I N G O U R R E A C H Advocacy l Early Intervention l Partnerships

Through prevention focused initiatives, advocacy and partnerships with other health services, we have been building capacity and networks to ensure our care is accessible, seamless and close to home.

Encouraging our staff to be ‘Children’s Champions’ in health care continues to be a focus at the Network, to make a difference to the wellbeing of children inside and outside the health system.

P A G E 6 2

A I D E N ( 1 3 Y E A R S ) , G A S T R O E N T E R O L O G Y PAT I E N T, S Y D N E Y C H I L D R E N ’ S H O S P I TA L , R A N D W I C K

P A G E 6 3

Saved 6228 acute inpatient bed days in 2018-19 (an increase of 28% from the previous year).

The HITH team have been working closely with our Emergency Department teams to develop new models of care which support direct admission to HITH from the Emergency Department, for a select group of conditions.

H O S P I TA L I N T H E H O M E ( H I T H )

The NSW Study of Drowning and Near Drowning was released in December 2018, just in time to form the basis of the Network’s summer drowning prevention campaign targeting parents and carers.

The study reconfirmed drowning or near drowning events are most likely to happen:

• In a home swimming pool or bath

• To children who are unsupervised as opposed to children who are closely and actively supervised while in or near water

• With children under five years of age

Further insights from the study found parents and carers were surprised at how silent and quick the incidents were, and parents were often distracted by an everyday task at the time of the incident.

The campaign involved posters, billboards, social media posts, advertisements on internal digital screens across both hospitals, and information on the Kids Health website.

N E W D ROW N I N G S T U DY R E L E A S E D A N D 2 018 -19 S U M M E R C A M PA I G N

28%

P A G E 6 4

I N J U RY P R E V E N T I O N F O R A B O R I G I N A L C H I L D R E N I N N S W The Network was very proud to assist in the design and launch of the evidence-based resource Active & Safe: Preventing unintentional injury to Aboriginal children and young people in June 2019.

The Active & Safe guidelines recognise that effective injury prevention for Aboriginal children requires appropriate engagement with Aboriginal communities and involves many groups working together to ensure coordination, leadership and sustained commitment.

As health practitioners we need to work alongside and be guided by Aboriginal communities, building on community strengths and promoting the resilience of Aboriginal children, families and communities in injury prevention.

N A I D O C C E L E B R AT I O N S , S Y D N E Y C H I L D R E N ’ S H O S P I TA L , R A N D W I C K

P A G E 6 5

In 2018-19, a doll created by the Cleft and Craniofacial team at SCH attracted worldwide attention as a valuable teaching tool for parents.

The doll was being used to show parents how to tape a cleft lift on a newborn during prenatal consultations.

Word spread and soon enquiries were made by health professionals in the UK, USA, and at home in Melbourne and Canberra. The SCH team has since created a doll for the outreach clinic at Canberra Hospital and developed information to support other health professionals.

I N N OVAT I V E C L E F T PA L AT E D O L L S H E L P M O R E PA R E N T S

P A G E 6 6

Among other work by the NSW Pregnancy and Newborn Services Network, doctors launched a media campaign to raise awareness about the spread of Parovirus and how pregnant women can protect their unborn baby.

Messaging included what the virus is, how it is contracted and what women can do to minimise the serious risk it poses to their child.

P ROT E C T I N G U N B O R N B A B I E S F RO M PA ROV I RU S

Warnings by the NSW Poisons Information Centre, based at The Children’s Hospital at Westmead, attracted widespread media coverage after a spike in reported poisonings from deadly mushrooms.

The third quarter of 2018-19 saw the Centre receive 39 mushroom ingestion-related calls in one week.

The NSW Poisons Information Centre Hotline is available to parents and health professionals 24 hours a day, seven days a week on 13 11 26.

S P I K E I N W I L D M U S H RO O M P O I S O N I N G S P RO M P T S WA R N I N G

R A F F E R T Y ( F I V E M O N T H S ) , C L E F T PA L AT E PAT I E N T, S Y D N E Y C H I L D R E N ’ S H O S P I TA L , R A N D W I C K

P A G E 6 7

Our Kids Health department led a Network wide change to make the healthy choice an easy choice for staff and visitors at both our hospital sites.

In 2018-19 the Network successfully removed sugar-sweetened drinks from all vending machines and retail outlets and performed above the NSW statewide results for majority of the Healthy Food and Drink in NSW Health Facilities for Staff and Visitors Framework’s 13 practices.

Highlights across the three practice focus areas included:

• Availability: increasing everyday (healthy) options to at least 75 per cent of the offering

• Product size: providing (healthy) sized options; and

• Marketing: making sure everyday (healthy) foods and drinks are favourably marketed.

N E T WO R K D E L I V E R S P H A S E 2 O F N S W ’ S H E A LT H Y F O O D A N D D R I N K F R A M E WO R K

P A G E 6 8

ChIPS is an innovative peer support group for young people aged 12-25 who are living with a chronic condition. It gives young people an opportunity to connect with others who have a similar health experience. Following the success of the ChIPS program at CHW, the program is now being run at SCH with the introduction of a ChIPS coordinator in 2018.

C H RO N I C I L L N E S S P E E R S U P P O RT (C H I P S ) P RO G R A M I N T RO D U C E D AT S C H

ChIPS now has 11 Peer Leaders and

1 Peer Mentor

5 x Two-Day Introductory Groups were run across

both hospital sites, recruiting 37 new ChIPS members

Annual camp had 24 ChIPS members

in attendance

100% of respondents reported feeling included, that their medical needs

were met and would recommend others to

attend camp.

PAT I E N T S E M B R A C E H E A LT H Y F O O D A N D D R I N K F R A M E W O R K ,

T H E C H I L D R E N ’ S H O S P I TA L AT W E S T M E A DD A N I E L A F E U E R L I C H T, A D O L E S C E N T C O M P L E X C A R E C O - O R D I N AT I O N

A N D T R A N S I T I O N M A N A G E R A N D M E L I S S A M I L L E R , C H I P S C O O R D I N ATO R , S Y D N E Y C H I L D R E N ’ S H O S P I TA L , R A N D W I C K

P A G E 6 9

Mid-meal snacks are now arriving three times a day to eligible patients at SCH, in addition to breakfast, lunch and dinner meals. The initiative was developed by the newly formed SCH Food Service Committee to optimise the nutritional intake of our patients.

Launched in March 2019, the initiative has ensured SCH is now exceeding the 2011 Nutrition Standards for Paediatric Inpatients in NSW hospitals (ACI).

N E W PAT I E N T M E A L S E RV I C E O P T I M I S I N G N U T R I T I O N

L O W A N N A ( 1 7 M O N T H S ) , G E N E R A L PA E D I AT R I C S PAT I E N T, S Y D N E Y C H I L D R E N ’ S H O S P I TA L , R A N D W I C K

P A G E 7 0

The Network’s Integrated Care Team finalised the Integrating Care for Children evaluation report in 2018-19.

The report (available on our website) highlights the achievements of our vital Integrated Care (IC) Program from July 2015 to June 2018, and presents opportunities to sustain and extend the Network’s IC Program.

The Program focuses on achieving comprehensive system transformation for our patients and families, helping them feel safe wherever they access care in the health system.

The program team works in partnership with consumers, local health districts (LHDs), primary health networks (PHNs), consumer support organisations, general practitioners (GPs) and community services to improve access to health care.

2018-19 projects include; HealthPathways, Telehealth, Southern Kids TLC, Paediatric Access Support Service (PASS), and Kids Health Buddy.

A B E T T E R C A R E E X P E R I E N C E F O R C H I L D R E N A N D FA M I L I E S – E VA LUAT I O N R E P O RT R E L E A S E D

P A G E 7 1

N E T W O R K L E A D E R S H I P

P A G E 7 2

B OA R D

The Sydney Children’s Hospitals Network Board brings together expertise in the fields of health, paediatrics, management and finance, in order to advise on planning, policy development and management across the Network.

Chair

Prof Christine Bennett AO (July 2018 – April 2019)Mr David Nott (Acting) (April 2019 – )

Deputy Chair

Mr David Nott (July 2018 – April 2019) Prof Donna Waters (April 2019 – )

Board Members

Prof Louise Baur AMMs Jane Freudenstein (January 2019 – )Mr Bruce MacDiarmidMr Jack FordDr Elizabeth McEntyre (January 2019 – ) Dr Abby Bloom FAICDEmeritus Prof Kim Oates AMProf Donna WatersMr Jeremy Wright Emeritus Prof Les White AMMrs Renata Kaldor (July 2018 – December 2018)Dr Robyn Shields (July 2018 – December 2018)

E X E C U T I V E

Chief Executive

Dr Michael Brydon OAM (July 2018 – April 2019)Adjunct A/Prof Cheryl McCullagh Interim Chief Executive (April 2019 – )

Director of Clinical Operations

Dr Emma McCahon (July 2018 – February 2019)Dr Joanne Ging (February 2019 – )

Director of Clinical Integration

Adjunct A/Prof Cheryl McCullagh (July 2018 – April 2019)Mr Michael Dickinson (April 2019 – )

Director of Clinical Governance and Medical Administration

Dr Glen Farrow

Director of Nursing, Midwifery and Education

Ms Sally Whalen

Director of Finance and Corporate Services

Mr Brian Jackson

Director of Workforce

Mr Ian Fuller

Director of Community Relations and Marketing

Ms Gilly Paxton (July 2018 – April 2019)

Director of Strategic Communications and Public Relations

Mr Matthew Hillard (April 2019 – )

Director of Research

Prof Chris Cowell

Executive Medical Director

Dr Mary McCaskill

Director of Allied Health

Ms Ruth Baker

Director of Mental Health

Dr Michael Bowden

TAY L A ( S I X Y E A R S ) , R A R E D I S E A S E S PAT I E N T,

S Y D N E Y C H I L D R E N ’ S H O S P I TA L , R A N D W I C K

P A G E 7 3

Chair

Dr Mary McCaskill Executive Medical Director

Executive Members

Ms Ruth Baker Director of Allied HealthDr Michael Brydon OAM Chief Executive Adjunct A/Prof Cheryl McCullagh Interim Chief Executive Ms Sally Whalen Director of Nursing, Midwifery and Education Adjunct A/Prof Glen Farrow Director of Clinical Governance and Medical Administration Dr Emma McCahon Director of Clinical Operations Dr Joanne Ging Director of Clinical Operations Mr Michael Dickinson Director of Clinical Integration

Clinical Council Members

Ms Angela Casey Clinical Program Director – Critical Care (SCHN)Dr Bruce Currie Head of Department – General Surgery (SCH)Dr Jacqueline Dalby-Payne Medical Staff Council Representative (CHW)Ms Lexi Dengler Clinical Nurse Consultant (CHW)Mr Michael Doumit Physiotherapist (SCH)Dr Andrew Dunn Paediatric Registrar (CHW)A/Prof Carolyn Ellaway Staff Specialist – Biochemical Genetics (CHW)Ms Elizabeth Giles Nursing Unit Manager – Short Stay Surgical Ward (SCH)Dr Shihab Hameed Staff Specialist – Paediatric Endocrinologist (SCH)Dr Donald Hannah Director of Anaesthesia (SCH)Dr David Isaacs Senior Staff Specialist – Infectious Diseases and Microbiology (CHW)Dr John Lawson Medical Staff Council Representative (SCH)Dr Luke Lowes Advanced Trainee (SCH)

C L I N I C A L CO U N C I L

This key leadership group provides advice to the Board and Executive on clinical matters affecting the Network. Some key responsibilities of this group include: planning efficient allocation of clinical services, assisting to implement new clinical strategies, translating national and international best practice into local delivery of services and communicating to clinical staff.

Ms Melissa Mroz Nursing and Midwifery Workforce Project NM (SCHN) Dr Duncan Nass Community Paediatric Registrar (SCH)Dr Alex Nicholls VMO Orthopaedic Surgeon (CHW)Dr Pamela Palasanthiran Staff Specialist Immunology (SCH)Dr Hiran Selvadurai Head of Department – Respiratory Medicine (CHW)Ms Lisa Siladyi Nurse Manager – Outpatient Department (CHW)A/Prof Davinder Singh-Grewal Senior Staff Specialist – Paediatrics and Rheumatology (SCHN)Dr Michael Stormon Senior Staff Specialist – Gastroenterology (CHW)Ms Justine Trpezanovski Chief Nuclear Medicine Scientist (CHW)Mr Andrew Wallis Eating Disorder Coordinator (SCHN)Ms Kerry West Physiotherapist (CHW)Dr John Widger Staff Specialist – Respiratory (SCH)Dr Susan Woolfenden Senior Staff Specialist Community (SCH)

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H E A LT H C A R E Q UA L I T Y CO M M I T T E E

The Health Care Quality Committee is the peak safety and quality committee within Sydney Children’s Hospitals Network.

Chairs

Donna Waters, Board MemberJeremy Wright, Board Member

Board Members

Joanna Capon, Board MemberMichael Morris, Consumer Cheryl McCullagh Interim Chief Executive Ruth Baker Director of Allied Health Glen Farrow Director of Clinical Governance and Medical AdministrationJoanne Ging Director of Clinical Operations Brian Jackson Director of Finance and Corporate Services Sally Whalen Director of Nursing, Midwifery and EducationMary McCaskill Executive Medical Director Chrissy Ceely Head of Clinical Governance Hala Kaft Deputy Director of Clinical Governance and Medical Administration (SCH)Johanna Newsom Physiotherapist (CHW)Amanda Marsden CRMO (CHW)Luke Lowes CRMO (SCH)David Lester-Smith General Medicine (CHW)Kirsty Ross Critical Care Program (CHW)Andrea Worth Psychological Medicine (SCH)Kathryn Weir Nurse Manager Medical Program (CHW)Shanti Briggs NUM Recovery (SCH)

F I N A N C E A N D P E R F O R M A N C E CO M M I T T E E

Chair

Mr Bruce MacDiarmid, Board Member

Members

Dr Abby Bloom (Board Observer)Dr Michael Brydon OAM Chief ExecutiveAdjunct A/Prof Cheryl McCullagh Interim Chief ExecutiveMr Brian Jackson Director Finance and Corporate ServicesProf Chris Cowell Director ResearchMs Sally Whalen Director Nursing, Midwifery and Education Dr Emma McCahon Director of Clinical Operations Dr Joanne Ging Director of Clinical Operations Mr Matthew Hillard Director of Strategic Communications and Public Relations Dr Glen Farrow Director of Clinical Governance and Medical AdministrationMr Ian Fuller Director of WorkforceMr Michael Dickinson Director Clinical Integration Mr Mark Cartwright Internal Audit ExecutiveMr Colin Murray Associate Director Clinical and FinanceMr David Loy Manager Corporate Services – SCHMr Paul Gissel A/Associate Director of Finance

AU D I T A N D R I S K M A N AG E M E N T CO M M I T T E E

Independent Members

Ms Dianne Hill Committee ChairMr Stephen Horne

SCHN Board Representative

Mr David Nott

SCHN Attendees

Dr Michael Brydon OAM Chief Executive Adjunct A/Prof Cheryl McCullagh Interim Chief Executive Dr Emma McCahon Director of Clinical Operations Dr Joanne Ging Director of Clinical Operations Mr Brian Jackson Director Finance and Corporate ServicesMr Alan Ching Internal Audit Executive Mr Mark Cartwright Internal Audit Executive Ms Tamara Petty Manager of Risk Insurance and Governance

Audit Office of NSW

Ms Renee Meimaroglou Director Financial Audit Services Sally Bond Director Financial Audit Services Mr Chris Harper Audit Leader Cassie Malone Audit Leader

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F I N A N C I A L Operating results

For the financial year 2018-19 Sydney Children’s Hospitals Network’s overall Net Result was $8.6 million favourable compared to budget. The General Fund Net Result was $10.4 million favourable and the Special Purpose and Trust Fund Net Result was $1.8 million unfavourable.

The 2018-19 year marked the seventh year of operation in an Activity Based Funding (ABF) environment. The Network was funded according to activity determined by the efficient price across a range of program areas.

E M M A N U E L ( 1 6 M O N T H S ) , L I V E R PAT I E N T, T H E C H I L D R E N ’ S H O S P I TA L AT W E S T M E A D

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AC T I V I T Y TA RG E T S 2 018 -19 ( N WAU * )

Finance Management to June 2019 YTD Result YTD Target

Acute Inpatient Services (excl. Mental Health) 74,970 73,962

Acute Inpatient Mental Health Services 2217 2073

Emergency Department 10,416 10,552

Non-Admitted Patient Services 19,602 19,747

Sub and Non-Acute Inpatient Services 2219 1838

Non-Admitted – Dental Services 102 68

Non-Admitted – Mental Health Services 1033 1340

*National Weighted Activity Unit

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W

S Y D N E Y C H I L D R E N’S H O S P I TA L S F O U N D AT I O N

M E S S AG E F RO M N I CO L A S TO K E SChief Executive Officer, Sydney Children’s Hospitals Foundation

When Sydney Children’s Hospitals Foundation expanded its fundraising portfolio last year, we had a unique opportunity to reimagine our purpose.

Our ambition is to raise even more funds to ensure extraordinary healthcare is available to every child, wherever and whenever they need it.

Many of our donors have a special connection with the Hospitals and paediatric services we support and we wanted the Foundation’s expansion to inspire them with optimism. Thanks to their generosity, we were able to contribute $32.8 million1 in the last Financial Year.

This was invested in equipment and technology, Fellowships, research projects and scholarships, capital works and ward refurbishments. In addition, we raised significant funds for the Zero Childhood Cancer program and the Molecular and Integrative Cystic Fibrosis (miCF) Research Centre for Personalised Medicine.

The Foundation also committed to raising $25 million for the redevelopment of Sydney Children’s Hospital, Randwick, part of a collaborative investment of $608 million from the NSW and Federal Government, UNSW, and the Children’s Cancer Institute. This will fund a new Emergency Department, Short Stay Unit and a Comprehensive Children’s Cancer Centre – a first in Australia.

The Foundation has also pledged to raise $35 million towards the current redevelopment of The Children’s Hospital at Westmead to deliver state-of-the-art paediatric facilities at the Westmead campus.

None of this would be possible without the continued commitment of the whole community, for which we remain eternally grateful.

When we work together, amazing things happen.

1 The contribution amount shown here is for 12 months. However, the Foundation’s Financial Year recently changed so we will be reporting on an 18 month period in our 2018 Annual Report, showing a contribution of $41.7 million during the period 1 January 2018 to 30 June 2019.

Sydney Children’s Hospitals Foundation is an independent charity with Item 1 DGR status (Health Promotion Charity). To find out more and make a donation online visit schf.org.au

Healthy Kids – whatever it takes

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D A S H B A R DF U N D R A I S I N G

F E L L O W S H I P S

C A P I TA L W O R K S / WA R D

R E F U R B I S H M E N T S

R E S E A R C H P R O J E C T S

$1,897,752

$11,187,207

P E O P L E

$4,699,560

Clinical, education, patient and family support

2 0 1 8 - 1 9 T O TA L

$32,767,402

$6,077,541

M E D I C A L E Q U I P M E N T A N D I T P R O J E C T S

$8,905,341

J O H N PA U L ( N I N E Y E A R S ) , R E H A B I L I TAT I O N PAT I E N T, T H E C H I L D R E N ’ S H O S P I TA L AT W E S T M E A D

P A G E 7 9

Every year children account for one million admissions to hospitals in Australia. They may be there for a day, a week or even months, and for many different reasons, but there’s something all kids in hospital suffer from: homesickness.

“Homesickness, or the distress of being away from home, is very real. Severe homesickness in children can lead to social and behavioural problems, anxiety and coping issues, and feelings of helplessness. Studies also show that severe homesickness symptoms only worsen in children the longer they are away from home. The cure for homesickness is home,” says Dr Michael Bowden, Head of Department, Psychological Medicine at Sydney Children’s Hospitals Network.

Homesickness isn’t always recognised as a serious complication or illness. That changed this year when the Foundation launched Curing Homesickness, a new initiative bringing children’s hospitals and paediatric services from across Australia together to get kids home from hospital sooner.

Coles, a generous and longstanding supporter of the Foundation played a key role in the success of the campaign. We asked them to develop a unique pasta sauce under the name Mum’s Sause that tasted just like mum’s cooking with no added sugar with no artificial nasties. Coles are donating 50c from every jar sold to help kids in hospital across Australia and more than 400,000 jars have been sold and it is the number one pasta sauce sold nationally across all Coles stores.

This is the first time that homesickness has been the focus of a fundraising and awareness campaign. Visit curinghomesickness.org to find out more.

TO G E T H E R W E C A N C U R E H O M E S I C K N E S S

P A G E 8 0

Caleb Medulloblastoma – Brain cancer

Then: 9 years old (2016) Now: 12 years old (2018)

“The photo from back then reminds me of Caleb being incredibly ill and very anxious about the future. After his brain cancer diagnosis, we didn’t really know what the future would hold for him and it was very scary. We now see a future for Caleb. He has been given a chance to be like any other child his age and to live an inspiring life.”

Suzanne, Caleb’s mum

Renowned photojournalist and the Foundation’s resident photographer, Jimmy Pozarik, collaborated with the Foundation’s Art Program to produce a powerful and moving exhibition “Then and Now”, which involved revisiting 25 patients who featured in his previous exhibitions.

He captured the unique moments that reflect their hospital journey at Sydney Children’s Hospital, Randwick and offers us a glimpse into the incomprehensible world of seriously ill children.

Eve Osteosarcoma – Bone cancer

Then: 9 years old (2015) Now: 12 years old (2018)

“To me, the original photo reflects the incredible care that Eve received at SCH. It was taken close to the end of a year of challenging treatment, with lots of rehabilitation still to come - yet she is happy and positive. So many people contributed to Eve’s care and they always used their great skills with such kindness and humour.”

Rebecca, Eve’s mum

T H E N A N D N OW

Emilia (Millie) Complications from Ischemic trauma in utero

Then: 12 months old (2012) Now: 6 years old (2018)

“Looking at the photo from then makes me smile, it makes me think of that point being the start of her cheeky nature. Since then Emilia has gone from strength to strength, like many other amputees her resilience and courage are demonstrated on a daily basis. We feel blessed that SCH saved her life because it is a life that is truly worth knowing.”

Sharon, Emilia’s mum

Each set of photos tells a different story, demonstrating the positive impact of the Foundation’s work and the generous support we receive from the community, which ensures all children can access the amazing care delivered every day by the Network’s brilliant doctors, nurses and allied health professionals.

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O U R S U P P O RT E R SWe couldn’t achieve the level of care and service offered to our patients and families without the generous donors, volunteers and supporters who so passionately believe in our mission – to help children live their healthiest lives.

Thank you for working with us to achieve great outcomes in 2018-19 for the children, families and carers who come to us for help.

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H E L E N A ( T H R E E Y E A R S ) , O R T H O PA E D I C PAT I E N T, T H E C H I L D R E N ’ S H O S P I TA L AT W E S T M E A D

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schn.health.nsw.gov.au

Locked Bag 4001 Westmead NSW 2145 AustraliaPhone: (02) 9845 0000Email: schn-mail@health.nsw.gov.auABN 53 188 579 090

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