HOSPITAL NEWS
Supporting medication management for cancer patients
Ramsay Pharmacy is continuing to work with oncology nursing and medical teams within Ramsay hospitals to successfully deploy the CHARM™ software,
with the 19th site activated in May 2019.
A further five sites will be deployed in
the coming 12 months. This is the largest
implementation of CHARM™ in the private
hospital sector in Australia.
CHARM™ is a specialised electronic
medication management system to manage
all stages of a patient’s chemotherapy journey,
allowing hospitals to transition from traditional
paper-based records to a centralised
electronic system in day and ward
oncology units.
18 The Ramsay Way 2019 | 02
Hospital Pharmacy Area Manager, Alicia
Simpson, said: “Ramsay Pharmacy has
continue to collaborate with our partners at
Charmhealth and Baxter (our Therapeutic
Good Administration approved chemotherapy
compounder) to create an electronic interface
to enhance the way our pharmacists order
chemotherapy without transcription”.
Previously, the software produced a
PDF document which was sent via fax or
email, then manually transcribed by the
compounding facility.
“The collaboration has also seen the way in
which we order and present our chemotherapy
products become more streamlined across the
organisation,” Ms Simpson said.
The new CHARM™ system improves
efficiencies by reducing the time taken to
order and supply information, increasing the
flexibility in managing and changing orders
and providing real time information of external
manufacturing status available for all of the
oncology pharmacy and nursing staff to view.
CHARM™ System Manager, Jameson Fawns,
said: “The benefits for the patients really come
from creating efficiencies for staff who deliver
care to the patients.”
“By optimising the way we work, we have
more time at the bedside with the patient
to discuss their treatment, manage their
medications and any questions they may
have about their therapy.”
Joondalup Health Campus
tested in disaster exercise
Joondalup Health Campus (JHC) has successfully completed a state-wide
disaster training exercise, involving activation of the State Health Incident
Command Centre (SHICC).
SHICC is the arm of the WA Department
of Health responsible for coordinating the
health system’s response to any major
incident in WA – ranging from natural
disasters through to acts of terrorism.
JHC Disaster Management Coordinator
Mary McConnell said ‘Exercise Eurus’
simulated the impact of a category five
cyclone hitting the northern suburbs
of Perth, causing the evacuation of
several suburbs into the HBF Arena
in Joondalup, the designated State
Evacuation Centre.
“As a hospital, we run regular disaster
scenario training to put our people and
systems to the test, replicating the stress
and disorientation that staff naturally feel
whenever there is a major influx of seriously
injured patients arriving simultaneously,”
she said.
“Some 25 independent and qualified
instructors from across the state attended
to formally evaluate the exercise.
“As this fictional scenario unfolded, the
Arena – which has capacity to fit 4,500
people – was damaged by the cyclone,
causing major structural damage and
injuring several hundred people who were
sheltering within it,” she said.
The ‘injured’ were taken to multiple
hospitals across Perth, with JHC receiving
some 240 patients suffering from life-threatening
crush injuries where parts of
the building had collapsed, through to the
‘walking wounded’ with cuts and bruises.
The hospital’s Business Continuity Plan was
also put to the test with a simulated mains
power and generator failure.
Mary said the exercise yielded many
lessons but also revealed some impressive
improvements since the last major exercise
was conducted two years ago.
“Independent exercise evaluators noted
even further improvement in the hospital’s
already impressive level of communication,”
she said. “Anyone who works in disaster
management knows that communication
is usually the number one area of downfall
in any crisis situation – it’s the one that
typically goes wrong. So to have feedback
on our performance in this area is a big win.”
All public hospitals in WA are required,
under legislation, to run a whole-of-hospital
exercise every two years – including
hospitals like JHC, which is operated by
Ramsay Health Care under a long-standing
and successful contract with the State
Government.
Two years of Speak
Up For Patient Safety
Nearly two years have passed since Ramsay Health Care became the first
private hospital operator in Australia to introduce a program called Speak
Up for Patient Safety, and it has been a game-changer because it addresses
behaviours that undermine culture.
The evidence-based program centres on a
proven approach developed 15 years ago
by Vanderbilt University Medical Centre in
the USA.
Since going live in May 2017 some
30,000 staff have been trained, across
the company’s 72 Australian hospitals,
in a unique graded assertiveness
communication technique known as P.A.C.E
(Probe, Alert, Challenge, Emergency) which
provides standardised language to help
staff challenge potentially unsafe situations.
This language helps staff ‘speak up’ in the
moment by using specific language that is
more likely to result in being ‘heard’ when
they witness a situation that may compromise
patient safety. It gives staff a highly effective
tool for what can be a tough conversation.
If that fails and their concerns are not heard,
staff are encouraged to make an online
report via a feedback portal. This kick-starts
an internal process whereby the doctor or
staff member (anyone can be reported) is
tapped on the shoulder by a peer, whose
job is to simply let them know they’ve had
a report made about their behaviour.
The peer is another clinician, who has
been trained in the art of delivering the
message – they aren’t privy to who made
the report and they’re unable to get
involved with its resolution.
Generally, the clinician at the receiving end
of a peer messenger visit will very much
want the opportunity to explain things from
their point of view and frequently they want
to know who made the complaint so they
can address it themselves or ‘make peace’
– but none of that is allowed under the
program rules.
For many clinicians who have a report made
about them, it will be the first time that
anyone has pointed out that their behaviour
may have compromised patient safety. The
most common response is: ‘but nobody has
ever told me that before’.
The program is now so firmly embedded
in the company’s culture that clinicians are
being made aware of it from the time they
express interest in being accredited. Putting
patient safety and respect for the individual
first is a non-negotiable.
Ramsay Australia’s Chief Risk Officer
Chanelle McEnallay said feedback from
clinicians has been overwhelmingly positive
because the program is all about clinicians
helping other clinicians.
“In the past, we would have managed
people who demonstrated behaviours
that could potentially compromise patient
safety through traditional HR performance
management processes,” Ms McEnallay said.
“This approach is much gentler – it allows
clinicians the opportunity to self-reflect
and change.”
The next step will be the commencement of
a PhD scholar who will measure the success
of the implementation of SUFPS.
HOSPITAL NEWS