2014-15 statement of prioritiesdocs2.health.vic.gov.au/docs/doc/3019be81f59efc18ca257dc6001… ·...

Department of Health

2014–15 Statement of Priorities Agreement between Minister for Health and Monash Health

Monash Health

Statement of Priorities 2014–15

Contents Background 3 Policy directions 3

Part A: Strategic overview 6 Mission statement 6 Service profile 6 Strategic planning 8 Strategic priorities 9

Part B: Performance priorities 12 Safety and quality performance 12 Financial sustainability performance 12 Access performance 13

Part C: Activity and funding 14

Part D 16

Accountability and funding requirements 17

Signature 17

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Background Statements of Priorities (SoP) are key accountability agreements between Victorian public health services and the Minister for Health. The annual agreements facilitate delivery of or substantial progress towards the key shared objectives of financial viability, improved access and quality of service provision. The content and process for preparation and agreement of the annual Statement of Priorities is consistent with sections 65ZFA and 65ZFB of the Health Services Act 1988 (Vic).

Statements of Priorities are consistent with the public health services’ strategic plans and aligned to government policy directions and priorities.

A Statement of Priorities consists of four parts:

• Part A provides an overview of the service profile, strategic priorities and deliverables the health service will achieve in the year ahead.

• Part B lists the key financial, access and service performance priorities and agreed targets. • Part C lists funding and associated activity. • Part D forms the service agreement between each health service and the state of Victoria for the

purposes of the National Health Reform Agreement (NHRA).

The mechanisms used by the Department of Health to formally monitor health service performance against the Statement of Priorities are outlined in the High Performing Health Services: Victorian Health Services Performance Monitoring Framework 2014–15.

Policy directions The Victorian Health Priorities Framework 2012–2022 (VHPF) sets out the following 5 key outcomes the health system should strive to achieve by 2022:

• People are as healthy as they can be (optimal health status) • People are managing their own health better • People enjoy the best possible health care service outcomes • Care is clinically effective and cost-effective and delivered in the most clinically effective and cost-

effective service settings • The health system is highly productive and health services are cost-effective and affordable

It also articulates seven priorities which reflect the Government’s policy ambition to build a strong health system for all Victorians. The focus is on:

• developing a system that is responsive to people’s needs • improving every Victorian’s health status and experiences • expanding service, workforce and system capacity • increasing the system’s financial sustainability and productivity • implementing continuous improvements and innovation • increasing accountability and transparency • making better use of e-health and communications technology

These priorities are fundamental to Part A of the SoP and are required to be addressed by health services.

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Government commitments Victoria’s health system continues to lead the nation in providing responsive, integrated and innovative health care options. To support a growing population and increased demand for services, the Government has a clear plan to provide quality health care for all Victorians. The Government also recognises that improving patient access to health services is fundamental to Victorians’ quality of life.

In this context, the department will work with service partners to build a health system that is integrated and responsive to the changing needs of the community.

Specific commitments made by the Government in 2014–15 relate to:

Growing health services

• Growing essential hospital services including capacity for critical care, emergency department presentations and maternity services across the system.

• Boosting health service capacity over the winter months in order to improve patient access during periods of significant increase in demand.

• Boosting elective surgery capacity to meet increasing levels of demand and treat more Victorian elective surgery patients sooner.

• Increasing funding to meet growth in demand for ambulance services. • Growing the Victorian Patient Transport Assistance Scheme to enhance access to health services

for rural and regional Victorians. • Increasing funding to emergency departments to better identify, respond and intervene early in

instances of family violence and sexual assault. • Improving bariatric patient care and access to services through consolidating services and

increasing the number of bariatric procedures undertaken.

Health workforce

• Supporting and strengthening Victoria’s health and mental health workforce through the People in Health workforce development initiative.

• Supporting productive and effective health workforces through initiatives to extend health professionals' scope of practice and build multidisciplinary health teams.

• Supporting health services to respond to clinical and non-clinical violence and aggression by patients, staff and visitors.

Capital

• Investing in Ambulance Victoria’s helicopter fleet ($550 million). • Improving community health infrastructure ($14 million for new Melton Community Health Centre). • Supporting additional health capital projects and infrastructure improvements including the Latrobe

Regional Hospital redevelopment, Boort Hospital redevelopment, expansion of Healesville Hospital and expansion of the Austin Hospital short stay unit.

• Boosting community health services, with the new Barwon Health North facility and a new community health building for Moyne Community Health Service in Port Fairy.

• Supporting the replacement of critical engineering infrastructure in hospitals, such as lifts, boilers and electrical equipment.

• Continuing the replacement of medical equipment in metropolitan and rural health services.

Health Innovation and Reform Council

• Supporting the Health Innovation and Reform council (HIRC), an independent body which provides advice to the Minister and the Secretary on the effective efficient delivery and management of quality health services and the continuing reform of the public health system.

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Mental health and other initiatives

• Implementing mental health initiatives and growing mental health services including three new prevention and recovery care units.

• Continuing housing support for people with a mental illness through the Doorways project. • Boosting alcohol and drug services, including expanding drug treatment services to support more

effective education and treatment responses. • Supporting Victorians with diabetes manage their conditions with free access to insulin syringes

and pen needles through the National Diabetes Syringe Scheme (NDSS). • Increasing support for older people through the Home and Community Care (HACC) program to

assist them to remain living in their homes for longer.

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Part A: Strategic overview Mission statement Our Vision

Exceptional care, outstanding outcomes

Our Values

At Monash Health, we work together with:

Integrity (we act fairly, honestly and openly) Compassion (we interact with dignity and empathy) Accountability (we take ownership and responsibility for performance) Respect (we value difference and individual worth) Excellence (we aim for and recognise innovation, quality and professionalism)

We remain strongly committed to our iCARE values, which will continue to underpin our culture as we translate our vision into reality.

Our Purpose

To deliver quality, patient-centred health care and services that meets the needs of our diverse community.

Our Strategic Priorities

Our strategic priorities for July 2013 to June 2018 are:

• We put our patients first • We drive innovation • We partner strategically for outstanding outcomes • We lead sustainable healthcare

Service profile Monash Health provides our community with access to uniquely integrated community and hospital based services across the entire lifespan focusing on improving their health through:

• Prevention and early intervention • Hospital and community-based treatment and rehabilitation • Highly specialised surgical and medical diagnosis, treatment and monitoring services • Hospital and community based mental health services • Comprehensive aged care programs • Aged residential services • Palliative care

Monash Medical Centre is a 640 bed teaching and research hospital of international standing providing a comprehensive range of specialist surgical, medical, allied health and mental health services to our community. It is designated a national provider of renal and pancreatic transplants, and statewide provider of Thalassemia and children’s cancer services. It is also the base for MonashHEART, a centre of excellence in cardiac assessment, treatment and research; and Monash Children’s, the third largest provider of paediatric services in Australia. Offering integrated maternity and newborn services on the one site, Monash Medical Centre – Clayton provides one of Victoria’s largest women’s health services. It is also renowned for men’s health services. McCulloch House located on-site is a 16 bed facility providing palliative care for people within our catchment area with advanced progressive disease.

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Moorabbin Hospital is the home of the Monash Cancer Centre and one of Victoria’s leading cancer treatment centres, providing a range of clinical oncology services. The hospital hosts the Southern Melbourne Integrated Cancer Service and offers radiotherapy in partnership with the Peter MacCallum Cancer Centre. It is also a centre for research, being in particular a major contributor to cancer-related research. The 147 bed hospital also offers elective surgery, short-stay care and dialysis. Home to Victoria’s first Patient Simulation Centre, the hospital plays a major role in the education and training of undergraduate and postgraduate medical students, nurses and allied health professionals.

Dandenong Hospital is a 573 bed acute hospital providing a wide range of health services to the people living and working in Dandenong and surrounding areas. Services include general medical and surgical care including orthopaedic services, an intensive care unit, emergency department, rehabilitation and aged services, pathology, radiology, day oncology, maternity unit, special care nursery, Monash Children’s services, mental health services and allied health services. The hospital is also central to our role as a State leader in addressing refugee health needs.

Casey Hospital is a 273 bed hospital serving one of the fastest growing areas in Melbourne's outer east. Services include an emergency department, general medical, mental health, rehabilitation, surgical and ambulatory care services, maternity and a special care nursery. The hospital is a provider of paediatric services for Monash Children's.

Cranbourne Integrated Care Centre provides a range of same-day acute and sub-acute services including surgery, renal dialysis, specialist consulting services, regional ophthalmology services and mental health services. It also provides the local community with access to community health services and a community rehabilitation centre.

Kingston Centre is a 183 bed facility specialising in high quality rehabilitation, function restoration, aged care and aged mental health. Its highly regarded rehabilitation program focuses on restoring function after illness or injury with the full range of allied health services provided to adults of all ages. The centre provides specialist services for older people including Aged Care Assessment, cognitive dementia and memory services. It also offers a Falls and Balance Clinic, Pain Clinic, Clinical Gait Analysis, and continence service. It is at the forefront of research into movement and gait disorders, aged mental health and geriatric medicine and has a leading role in providing care for sufferers of Parkinson’s Disease.

Monash Health Community is an amalgamation of services and funding streams that provide support throughout the client’s journey. Monash Health Community proactively supports our community in order to improve and maintain health, independence and well being by coordinating and/or providing integrated, multidisciplinary care across multiple settings within the local community. Our aim is to empower and prepare clients to self-manage their health and health care.

Working with clients across the age spectrum, Monash Health Community provides a continuum of care, supporting clients through all stages of non-acute care from prevention through to rehabilitation. We provide services which support clients in their homes; community based facilities and dedicated Monash Health Community hubs. These services are offered face to face and in group settings and include clinical (e.g.: nursing, dental, medicine, physiotherapy, occupational and other therapies) and non-clinical (eg: counselling, community development, social work, case management) services.

Monash Health Community has locations across five local government areas from Kingston to Cardinia.

Mental health services are our hospital and community based facilities providing a comprehensive range of services for children and adults experiencing mental health issues. Our vision is to be a dynamic mental health service that inspires confidence in our patients and their families and supports staff to provide consistent and contemporary care. Working with clients across the age spectrum, the mental health program provides a range of services including alcohol and drug; telephone psychiatric triage; crisis assessment and treatment; consultation liaison psychiatry; primary mental health; mobile support and treatment; acute inpatient care; extended inpatient care; perinatal and infant care; eating disorders care; prevention and recovery care; community residential and rehabilitation services; agile

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psychological medicine outpatient assessments; and Police, Ambulance and Clinical Early Response (PACER) response.

Aged residential care is provided at Allambee Nursing Home and AG Eastwood Hostel at the Kingston Centre (Cheltenham); Chestnut Gardens Aged Care (Doveton); Yarraman Nursing Home (Noble Park) and Mooraleigh Hostel (East Bentleigh), providing 249 aged and aged mental health residential beds.

Strategic planning The Monash Health Strategic Plan 2013-18 can be read at: http://www.monashhealth.org/icms_docs/14257_Monash_Health_2014_Strategic_Plan.pdf

http://www.monashhealth.org/icms_docs/14257_Monash_Health_2014_Strategic_Plan.pdf

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Strategic priorities The Victorian Government’s priorities and policy directions are outlined in the Victorian Health Priorities Framework 2012–2022.

In 2014–15 Monash Health will contribute to the achievement of these priorities by:

Priority Action Deliverable

Developing a system that is responsive to people’s needs

Develop an organisational policy for the provision of safe, high quality end of life care in acute and subacute settings, with clear guidance about the role of, and access to, specialist palliative care

Continue the implementation and review of the End of Life Care Policy and End of Life Care Management Adult Procedure by evaluating the implementation of the Promoting Improved Care of the Dying (PICD) pathway and development and implementation of the Goals of Care Summary Form

Develop and implement an organisational wide framework that supports the four key priority action areas outlined in the Department of Health Advance Care Planning Service Plan 2014-18

Work collaboratively with Ambulance Victoria to achieve timely transfer of patients

Implement the new protocol recording the management of handover time, as per the outcomes of the Ambulance Transfer Taskforce final report

Implement an organisation-wide policy for responding to clinical and non-clinical violence and aggression by patients, staff and visitors (including code grey) that aligns with department guidance (2014)

Complete the roll out of Code Grey across Monash Health sites by June 2015

Progress partnerships with other services to improve outcomes for regional and rural patients

Continue to work with Bass Coast Regional Health and Orbost Regional Health to help deliver services to regional and rural patients, as per agreement with the Department of Health

Optimise timely access to specialist care through the implementation of the Access Policy for Specialist Clinics in Victorian Public Hospitals

Implement patient centred booking system to provide patients with increased choice of outpatient appointment date and time

Improve outcomes for people with heart disease by addressing the strategic directions of the Heart Health Strategy

Demonstrated improvement in the outcome of patients with Heart Failure through the implementation of the MonashHeart Early Intervention Systolic Heart Failure Program

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Improving every Victorian’s health status and experiences

Use consumer feedback to improve person and family centred care, health service practice and patient experience

Implement the 2014-15 Patient Centred Care Steering Committee work plan: • Utilise the Patient Experience

Questionnaire to identify organisational and point of care improvements

• Implement strategies to contribute to achieving consumer, carer or community participation on all organisation-wide planning and governance committees

Reduce unplanned re-admissions Commence and complete implementation of the Representation Rates to Emergency Department for Mental Health Patients Project

Identify service users who are marginalised or vulnerable to poor health, and develop interventions that improve their outcomes relative to other groups, for example, Aboriginal people, people affected by mental illness, people at risk of elder abuse, people with disability, homeless people, refugees and asylum seekers

Implement 2014-15 milestones for the Refugee Service Plan including: • Enhancing health literacy, self-

management and sustainability • Enhancing cultural competency

and responsiveness organisationally and regionally

• Improving service integration, care coordination and discharge planning at organisational and regional levels

Build on current data collection by working with the Department of Health to enhance our understanding of available data and the best use of this data to better understand aboriginal health and the impact of our interventions on clinical outcomes

Improve health literacy and support informed choice and shared decision-making by responding to the health information needs of service users

Implement the 2014-15 Patient Centred Care Steering Committee work plan action around application of health literacy principles to all forms of communication

Expanding service, workforce and system capacity

Develop and implement a workforce immunisation plan that includes pre-employment screening and immunisation assessment for existing staff that work in high risk areas in order to align with Australian infection control and immunisation guidelines

Implement the new ‘on-boarding’ software for new starters, including requirement for all clinical staff to submit evidence of immunisation status

Build workforce capability and sustainability by supporting formal and informal clinical education and training for staff and health students, in particular inter-professional learning

Evaluate the newly implemented inter professional induction program

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Increase employment of Aboriginal people in mainstream health services in line with the strategic objectives of Koolin Balit: Victorian Government strategic directions for Aboriginal Health 2012–2022 and Karreeta Yirramboi workforce participation targets

Implement the Aboriginal Employment Plan including the Trainee and Cadetship Framework

Increasing the system’s financial sustainability and productivity

Identify and implement practice change to enhance asset management

Achieve the asset sustainability milestone set out in the Monash Health Cash Strategy 2014-18

Reduce health service administrative costs

Implement the Health Purchasing Victoria Procurement Framework and Purchasing Policies

Implementing continuous improvements and innovation

Develop a focus on ‘systems thinking’ to drive improved integration and networking across health care settings

Complete a Strategic Service Plan, identifying five-year planning priorities, and complete 2014-15 milestones

Drive improved health outcomes through a strong focus on patient-centred care in the planning, delivery and evaluation of services, and the development of new models for putting patients first

Continue to work with the Department on the establishment of the Monash Children’s Hospital, including the development of new models of care

Increasing accountability & transparency

Undertake an annual board assessment to identify and develop board capability to ensure all board members are well equipped to effectively discharge their responsibilities

External evaluation incorporating 360° feedback of Board, Board Chair and Directors performance. Resultant actions determined for continuous improvement and board education and development activities

Demonstrate a strategic focus and commitment to aged care by responding to community need as well as the Commonwealth Living Longer Living Better reforms

Complete implementation of 2014-15 milestones for strategies in response to reform of ambulatory aged care services

Participate in the My Aged Care National Demonstration Project through the Kingston Centre Aged Care Assessment Service (ACAS)

Ensure that gender sensitivity and women's safety are key principles in the delivery of mental health and alcohol and drug services

Develop a plan to achieve gender sensitivity and women’s safety principles in acute psychiatric inpatient services

Improving utilisation of e-health and communications technology

Trial, implement and evaluate strategies that use e-health as an enabler of better patient care

Commence implementation of the electronic medical record strategy: • Commence implementation of an

Electronic Medical Record Strategy for Monash Children’s Hospital

Ensure local ICT strategic plans are in place

Refresh the Monash Health Information Technology Strategic Plan and commence implementation

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Part B: Performance priorities Safety and quality performance Key performance indicator Target

Patient experience and outcomes

Victorian Healthcare Experience Survey (1) Full compliance

Healthcare associated infection surveillance No outliers

ICU central line associated blood stream infections (ICU CLABSI) No outliers

SAB rate per occupied bed days (2) < 2/10,000

Maternity - Percentage of women with prearranged postnatal home care 100

Mental health - 28 day readmission rate 14

Mental health - Post-discharge follow up rate 75

Mental health - Seclusion rate per occupied bed days < 15/1,000

Governance, leadership and culture

Patient safety culture 80

Safety and quality

Health service accreditation Full compliance

Residential aged care accreditation Full compliance

Cleaning standards Full compliance

Hand hygiene (rate) – quarter 2 75



Healthcare worker immunisation - influenza 75 (1) The Victorian Healthcare Experience Survey (VHES) was formerly known as the Victorian Health Experience Measurement

Instrument (VHEMI). (2) SAB is staphylococcus aureus bacteraemia.

Financial sustainability performance Key performance indicator Target

Finance

Annual operating result ($m) 0.5

Creditors < 60 days

Debtors < 60 days

Percentage of WIES(1) (public & private) performance to target 100

Asset management

Basic asset management plan Full compliance (1) WIES is a Weighted Inlier Equivalent Separation.

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Access performance Key performance indicator Target

Emergency care

Percentage of operating time on hospital bypass 3

Percentage of ambulance transfers within 40 minutes 90

Percentage of Triage Category 1 emergency patients seen immediately 100

Percentage of Triage Category 1 to 5 emergency patients seen within clinically recommended times 80

NEAT - Percentage of emergency presentations to physically leave the emergency department for admission to hospital, be referred to another hospital for treatment, or be discharged within four hours 81

Number of patients with a length of stay in the emergency department greater than 24 hours 0

Elective surgery

NEST - Percentage of Urgency Category 1 elective patients treated within 30 days 100

NEST - Percentage of Urgency Category 2 elective surgery patients treated within 90 days 88

NEST - Percentage of Urgency Category 3 elective surgery patients treated within 365 days 97

Number of patients on the elective surgery waiting list (1) 6,810

Number of Hospital Initiated Postponements (HiPs) per 100 scheduled admissions 8

Number of patients admitted from the elective surgery waiting list – quarter 1 6,715




Number of patients admitted from the elective surgery waiting list – annual total 26,552

Critical care

ICU number of days below the agreed minimum operating capacity - Monash Medical Centre Clayton(2) 0

Adult ICU number of days below the agreed minimum operating capacity - Dandenong

(3) 0

Neonatal ICU number of days below the agreed standard and flexible operating capacity(4) 0

(1) The target shown is the number of patients on the elective surgery waiting list as at 30 June 2015. (2) The agreed minimum operating capacity is 21 ICU equivalents (ICU minimum operating capacity includes 5 PICU beds). (3) The agreed minimum operating capacity is 10 ICU equivalents. (4) The standard operating capacity and flex capacity is 26-28.

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Part C: Activity and funding Funding type Activity Budget ($'000) Acute Admitted WIES Public 142,035 $623,333 WIES Private 14,837 $49,452 WIES (Public and Private) 156,872 $672,784

WIES DVA 622 $2,788 WIES TAC 584 $2,296

WIES TOTAL 158,078 $677,868

Acute Non-Admitted Emergency Services $67,872

Specialist Clinics $82,586

Subacute & Non-Acute Admitted Rehab Public 36,479 $17,510 Rehab Private 10,016 $4,467 Rehab DVA 458 $266 GEM Public 41,536 $19,937 GEM Private 9,898 $4,415 GEM DVA 1,453 $844 Palliative Care Public 7,295 $3,502 Palliative Care Private 175 $78 Palliative Care DVA 117 $68 Transition Care - Beddays 17,520 $2,575 Transition Care - Homeday 10,950 $558 Subacute & Non-Acute Other Other specified funding $1,000

Subacute Non-Admitted Health Independence Program 163,639 $34,538

Health Independence Program - DVA $231

Subacute Non-Admitted Other $890

Aged Care Aged Care Assessment Service 4,940 $2,777 Residential Aged Care 57,856 $2,997 HACC 133,599 $11,670

Aged Care Other $296

Mental Health and Drug Services Mental Health Inpatient - Beddays 20,246 $11,491 Mental Health Inpatient - WOt 57,881 $37,154 Mental Health Ambulatory 123,100 $48,722 Mental Health Residential 45,290 $3,333 Mental Health Sub Acute 32,870 $13,938

Mental Health Service System Capacity $2,432

Drug Services 925 $4,718

Other specified funding $934

Primary Health Community Health / Primary Care Programs 69,358 $7,982

Community Health Other $3,318

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Other Transplants Pancreas $2,552

Other specified funding $27,749

Total Funding $1,101,269

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Part D The Victorian health system has faced a number of changes to Commonwealth funding since 2012–13. The 2014–15 Commonwealth Budget also presented significant changes to funding arrangements. The new funding arrangements will continue to be linked to actual activity levels between 1 July 2014 and 30 June 2017.

The Commonwealth funding contribution outlined the 2014-15 Commonwealth Budget was based on estimates and has since been updated by the Administrator of the National Health Funding Pool, based on latest activity estimates from States and Territories. However, given that final funding amounts are based on actual activity, there may be adjustments to funding throughout the year as a result of reconciliations and other factors outlined below.

Period: 1 July 2014 – 30 June 2015

Estimated National Weighted

Activity Units Total Funding ($)

Provisional Commonwealth Percentage (%)

Activity Based Funding 246,497.11 960,484,688 35.91

Other Funding 95,023,374

Total 1,055,508,062

Note:

• Estimated National Weighted Activity Unit may be amended by the Department following the finalisation of the 2013-14 reconciliation by the Administrator of the National Health Funding Pool.

• Provisional Commonwealth Contribution Percentage is subject to change following state-wide adjustments (i.e. cross border patient flows), the 2013-14 reconciliation and Commonwealth announcements (i.e. Mid-Year Economic and Fiscal Outlook 2014-15).

• Activity loadings are included in the Estimated National Weighted Activity Units (i.e. Paediatric, Indigenous, Remoteness, Intensive Care Unit, Private Patient Service Adjustment, and Private Patient Accommodation Adjustment).

• In situations where a change is required to the Part D, changes to the agreement will be actioned through an exchange of letters between the Department and the Health Service Chief Executive Officer.

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