Nurse Endoscopy

In June I attended the Victorian Health Care Quality Association showcase on award winning innovative practice. My previous report is on the HCCA blog.

The innovation showcase was an event put on by the Victorian Healthcare Quality Association, the Centre of Research Excellence in Patient Safety, the Victorian Department of Health and the Australasian Association for Quality in Health Care. It was held in St Kilda over two days, and show cased quality improvement initiatives which have won major awards across Australia over the previous 12 months

Sylvia Constantinou, a Nurse Endoscopy at the Austin Hospital, gave an overview of the nurse endoscopy services in Victoria. This is related to the Health Workforce Australia work on Extended Scope of Practice for health professionals.

In the state of Victoria endoscopy nurses are advance practice nurses and have been credentialed to deliver this service. They scope independently and with access to gastroenterologists. They are not nurse practitioners. This is a new pathway for nurses in Australia but has been happening overseas for some time (the UK has been doing this for 20 years.)

Why nurse endoscopists?

Bowel cancer is a preventable disease. Early detection results in cure. There has been a bowel cancer screening program put in place but there I an increasing number of requiring screening with a colonoscopy. There is a growing awareness in the community of familial links. Yet with this awareness it is the second most common cancer in men and women in Australia.

Austin Health was part of the National Bowel Cancer Screening Program since 2002, when the pilot. In Victoria there were 188,000 screened. 6000 were faecal occult blood positive. Of these one third will show cancerous cells.

This year there will be 4.8 million people eligible for screening.

Austin, Alfred, Monash and Western have all been implementation sites as part of Health Workforce Australia program. The Victorian Government funded the State Endoscopy Training Centre (SETC) and the goal is to train 15 nurse endoscopists to work at ten public hospitals.

The Austin Hospital has a large gastro hospital and perform almost 3000 colonoscopies per year with more than 2000 people waiting. At the Austin 12% of colonoscopies are completed by the There are 29 doctors and colorectal surgeons and they perform 79% of the colonoscopies

There are two nurse endoscopists in Victoria and independently practices and there are three trainees as part of the HWA project. The theoretical training is provided by University of Hull in the UK.

Austin Health have a useful FAQ on nurse endoscopy online.

It seems clear that there is a role for nurses working in this area with extended scope. We need them to be safe and procedurally efficient. We also need a career path as well as need for education, support and supervision.  With the demise of HWA I hope this program of work is not shelved as the functions are absorbed into the Department of Health

Darlene Cox

Managing and Enhancing Care Co-ordination in Chronic Disease Management

Speaker: Jan Ironside

June 20 2014

On Friday 20 June, HCCA in collaboration with the Chronic Care Program at the Canberra Hospital hosted a health issues group on how to better manage your chronic conditions and what services the Chronic Care Program provide to the community in order to achieve this.

The growing ageing population has led to an increase in the number of people developing and living with chronic conditions. This has brought up global concerns as there are limited resources to accommodate for the increase in patients. In response to this growing health issue, the Clinical Care Program has trialled a successful project that focuses on better self-management and person centred care.

The project works to maintain patient safety, ensuring that people are informed decision makers and more in control of their health. The Chronic Care Program categorises people using their level of need; category 1 for high needs and category 2 for low needs. This enables staff to prioritise and appoint the appropriate amount of time to each of their patients, improving efficiency but not decreasing the quality of care received.

All people referred to the program by nurses or general practitioners are contacted immediately by an assigned care co-ordinator and are categorised as category 1. The care co-ordinator assesses the living environment of the person through a home visit and helps them to create a care plan that is specific to their needs. They can also make any appointments the person may need and can accompany them for extra support. Phone calls are made regularly to the person to ensure they are on track with their plan and self-managing their condition.

Once the person has become familiar with their care plan and have gotten into a regular routine, the person graduates from category 1 to category 2. Category 2 allows people to have more independence with managing their condition. Phone calls become less regular and the care co-ordinator slowly becomes less involved in their care routine.  Once the person feels in control of managing their condition without much assistance from their care co-ordinator, either the co-ordinator or the person can recommend to be taken off the program.  

Alongside this project, the Chronic Care Program have collaborated with the CSIRO in a nationwide trial of the Tele-health home monitoring devices that further educates and supports people with chronic conditions to manage their health and improve their quality of life. The devices allow people to self-monitor and measure their blood pressure, blood sugars, lung capacity, body weight and temperature and perform a basic Electrocardiogram (ECG). This information can then be transmitted securely through a high-speed internet connection (provided by the CSIRO) to health professionals who can assist the person with any concerns they may have via a telephone call. This helps to reduce the number of unnecessary hospital and doctor visits and the costs that are associated.

With the success of their trial, the Chronic Care Team hope to increase their capacity to expand this promising program. For more information, contact the Chronic Care Program on 02 6244 2222.

By Khalia Lee

HCCA Administration Assistant

Job Vacancy

Project Officer

Health Infrastructure Program

(SCHADS Community Worker Level 5)

Do you care about the quality and safety of health services? Are you interested in planning and project management? Can you work independently and use your initiative? Are you resourceful and like a challenge?

We are looking for someone to  join our staff team working on the Health Infrastructure Program (HIP).

The Project Officer will work under limited supervision by the HIP Coordinator to

• Support Consumer Representatives on a range of committees involved in decision making for the HIP;
• Represent HCCA on a range of committees involved in decision making for the HIP;
• Network with consumer and community groups to further consumer involvement in informing decisions regarding the HIP.  This will include outreach to marginalised and vulnerable communities (including but not limited to: people living with chronic conditions, who have low socio economic status or are disadvantaged, are from culturally and linguistically diverse backgrounds, have a disability, young people and children);
• Liaise with ACT Government about opportunities for consumer involvement in HIP activities; and
• Work closely with consumer and community organisations to ensure opportunities for engagement of health consumer representatives in HIP activities.
• Help ensure the work of HCCA on the HIP is effective and meets the requirements of the Service Funding Agreement with the ACT Government.

This is a full time position but there is potential to negotiate on hours. This is a contract position until 30 June 2016, in line with our Service Funding Agreement with the ACT Government. Other conditions of employment will be based on the Social, Community, Home Care and Disability Services Industry Award 2010 (SCHADS).

HCCA promotes a healthy work-life balance and is committed to offering employees a supportive family friendly working environment.

Selection Criteria

1. Excellent communication and interpersonal skills to effectively communicate information and ideas, work cooperatively with others, and negotiate and advocate on behalf of consumers. 
2. Demonstrated ability to manage complex projects effectively including experience in project management
3. Excellent time management skills and demonstrated ability to manage competing priorities and achieve work outcomes
4. Understanding of governance principles and committee processes
5. Strong understanding of community development and experience in community engagement, including the capacity to represent the organisation in public forums and facilitate meetings, information sessions and workshops
6. Demonstrated ability to plan, organise and facilitate workshops, information sessions, discussion groups and public meetings.
7. Proven ability to develop and maintain strong networks and partnerships with key stakeholders including people from diverse language and cultural backgrounds.
8. Demonstrated understanding of the barriers and opportunities which exist in achieving systemic change
9. Computer literacy including experience with MS Office and Internet research skills

DESIRABLE QUALIFICATIONS:

10. Relevant tertiary or other recognised qualifications
11. Current drivers licence.

All applications must include:

1. A covering letter stating your intention to apply for the position and addressing the selection criteria listed below.

2. A current CV.

3. Information for two Referees. (Name, Title and Organisation, Relationship to applicant, contact telephone, contact email address)

Applications close on Monday 21 July 2014 and should be addressed to:

Darlene Cox

Executive Director, HCCA

100 Maitland St Hackett ACT 2602

Full details are on the HCCA website:

http://www.hcca.org.au/about-hcca/staff