Quality Account 2021-2022

Previous quality stories

• Consumer Representatives at the Eye and Ear

  Vision impaired Consumer Representative Sandra Knight, discusses her role as a Consumer Representative and the newly appointed Chair of the CAC Consumer Working Group. Watch as Sandra explains the importance of this role in the overall patient experience and emphasises that the patient voice matters.

• Creating cultural change: Interview with Equity and Inclusion Coordinator, Barb West

  

  At The Royal Victorian Eye and Ear Hospital we are committed to providing an inclusive and respectful environment, free from discrimination.

  Barb West joined the Eye and Ear in March 2022 to support our action plans and work to further build a culture of equity and inclusion. Barb comes from a professional background in academia, landing what would have been her dream job at 33— tenured professor at a university. It was at this time she realised she wanted more from life and decided to move from her then-home in California to Melbourne. From here, Barb wrote a number of books, including a book on the history of Australia and a book about Australian culture and the workplace. Barb and her partner started their own intercultural consulting business to help organisations incorporate equity and inclusion into their workplace in an impactful way.

  Importance of difference, equity and inclusion

  Through her experience as an intercultural consultant, Barb has worked with a range of clients on supporting a variety of intercultural projects. These projects included working with universities to support them in appropriately welcoming their international student cohorts and working with healthcare institutions on improving their informed consent practices.

  “What we found was that many patients were saying ‘yes’ but didn’t always know what they were saying ‘yes’ to. I worked a lot in upskilling this form of communication,” said Barb.

  Barb later moved back into the academic world and accepted a lecturer position in Hungary, moving there just before the pandemic hit. In late 2021, Barb moved back to Melbourne where she applied for the Equity and Inclusion Coordinator role at the Eye and Ear.

  “I was so impressed and delighted with the Eye and Ear in choosing me as the candidate for this role as I haven’t necessarily followed a standard career trajectory,” explained Barb.

  Key areas of focus for this role include:

  • Supporting further development of our Aboriginal Employment Plan, working closely with our Mirring Ba Wirring team
  • Developing diversity and visibility within the LGBTQIA+ community
  • Disability employment
  • Implementing our Gender Equality Action Plan
  • Upskilling and empowering staff with intercultural knowledge

  “I hope to create a culture of celebration and adaption. I want all staff to be comfortable at work and be able to be 100% authentically themselves. Work environments with this kind of ethos create a vibrant and positive workforce,” explained Barb.

  Gender Equality Action Plan

  In 2020, the Victorian Government introduced the Gender Equality Act, which holds the hospital accountable for making meaningful changes in the workplace in order to strive for gender equality. An audit has been completed to determine the key benchmark statistics. The plan will focus on three key areas of improvement and change with constant consultation with the dedicated Eye and Ear working groups. Barb has commenced working through the actions and influencing change throughout the hospital.

  What this means for patients

  This role will highlight the importance of all forms of cultural and identity difference through increased visibility, adaptation and celebration. Enhanced cultural development training to both educate our staff and create a professional environment based on learning, adapting and the principles of intercultural communication will be undertaken.

  “The overarching goal is to create long term change internally, which will filter through to our communications and actions with patients and carers,” shared Barb.

  By empowering staff with knowledge, we can create better connections to our patients and approach each person with intercultural empathy and understanding.”

  Barb explains that creating cultural change requires building the skills of all staff and ultimately comes down to the way in which we act and communicate.

  She considers the cognitive processing differences as a good example.

  “Are you a linear or a circular communicator? Most professional situations in the English-speaking world require you to speak in a linear manner. In many other languages this is not the case,” explains Barb.

  Linear communication is a type of communication that moves in only one direction, whereas circular communication refers to more discussion-centric communication involving storytelling to develop context around the key message.

  If our staff are skilled in identifying these types of cognitive differences when treating patients, then they will be able to adapt and become better communicators and better clinicians overall.

   

  We will continue to share quality and improvement stories and data on this page throughout 2022. In the meantime, if you would like to learn more about what we are doing to support our patients, consumers, volunteers and staff, please read more in our Partnering with Consumers and Community Plan.

• Concierge process at the Eye and Ear

  The Concierge Team was introduced to the Eye and Ear as part of our COVID-19 response efforts. Watch as some of the team explain their role and the importance of the concierge process for overall patient flow at the hospital.

  

  Improving patient services and access

  “I remember the day that COVID-19 truly hit us. It was a Thursday afternoon and the news came through the press conference. It felt like the world stopped, and yet the team stepped up and staff from around the hospital banded together to create a crisis response plan.”

  Patient services, access, team work, improvement and change – these are the core elements of the Patient Services and Access Team. Manager Kathryn Day has worked for the Eye and Ear for over 15 years, but has experienced nothing quite like the past two years.

  Kathryn commenced at the Eye and Ear in her role as Outpatient Bookings Coordinator, and worked her way up to a multi-disciplinary leadership role and during this time has gone from a small team of seven staff to now managing over 80 staff across both sites.

  This team is at the heart of the Eye and Ear and is often both the first and last step of the patient journey.

  Every patient will have some interaction with at least one of Kathryn’s team before they see their treating doctor. The team has a range of responsibilities including processing referrals, sending patient letters, booking patient appointments, supporting clinical triage, managing waiting lists, assisting with patient wayfinding and patient check-in as well as providing support for patients while they are in the waiting room.

  “This team is critical. Without them, clinics wouldn’t be booked and patients wouldn’t get to where they need to go,” explains Kathryn.

  COVID-19 impacts

  When the COVID-19 pandemic hit it was all hands on deck. The team were involved in complex management and rearrangement of patient appointments in a very fast-changing environment and more than ever it became clear how integral their roles were to hospital operations.

  “I remember the day that COVID-19 truly hit us. It was a Thursday afternoon and the news came through the press conference. It felt like the world stopped, and yet the team stepped up and staff from around the hospital banded together to create a crisis response plan. We got as many people as possible on the phones cancelling appointments for the upcoming week,” explained Kathryn.

  Kathryn and her team worked with the doctors on prioritising patients and categorising them as either urgent, telehealth suitable appointments, or patients who could wait.

  “No one knew how long it would be, it was hard to predict. We normally book appointments six-weeks in advance, so we started there. We reviewed every single clinic and every single session, for every single day, for six weeks,” said Kathryn.

  As the pandemic worsened and appointments and surgeries continued to be cancelled things became more complex. While patients were understanding of the cancellations they still required specialist advice and some even began to run out of specific medication that can only be purchased at the hospital.

  “Some patients were running out of eye drops, for example, and they needed a way speak to a doctor and so medical staff joined us in the call centre to take clinical calls. This support streamlined the call flow and made call management more efficient. From this, we made a process for clinical queries that both our doctors and nurses provide support to, ” said Kathryn.

  During the height of the COVID-19 pandemic, Kathryn also onboarded a team of concierge staff to support patient flow and COVID-19 compliance.

  Digital improvement

  One thing was clear, digital support was key. The call centre became a core tool in the hospital’s COVID-19 crisis response, and while we have always operated a call centre, the scalability of our processes proved difficult.

  “There was a day where the call centre nearly blew up! Patients were scared and the volume of calls in bound and out bound was unlike anything I’ve experienced,” said Kathryn.

  The pandemic launched our call centre into an almost constant state of call surge, especially after a press conference aired. Processes were developed that can now be replicated in other scenarios to help support call flow and manage sudden increased call volumes efficiently.

  COVID-19 has provided us with a case study in improvement placing digital acceleration at the forefront of success. It revealed our digital blind spots and our COVID-19 response is helping to inform future initiatives in the Patient Services and Access Team.

  “We have always been very paper-focused, we are now working on an electronic referral system and are looking for opportunities for efficiencies in the digital health space,” explained Kathryn.

  Future challenges and opportunities

  The overall challenge for all health services across the country is making up for lost time and getting patients seen as quickly as possible.

  One way to help alleviate this pressure, is increasing opportunities for patients to be seen in different ways by reviewing and trialling alternative models of care.

  “We have been working on a Department of Health funded initiative that aims to support healthcare demand by increasing the delivery of hospital services in patients’ homes,” explained Kathryn.

  The team is also looking at different approaches to the call centre, placing the patient’s wants and needs at the centre of our communication.

  “What information do the patients want us to know? Do they want to have different ways to communicate with us? Email or live chat for example, these are the types of insights we are looking for,” explained Kathryn.

  We are currently rolling out our digital patient check-in system in the hospital to speed up the reception process and allow for staff and patients to engage in more meaningful conversation.

  “The future that I would like to see is my team having the time, thanks to digital processes like the electronic patient check-in, to engage more with our patients and give them the attention they need,” said Kathryn.

  As our redevelopment nears its final stages, the team will look at restructuring to ensure patient services and access are its primary focus.

  “My team are passionate about what they do and really want to be here. They try their very best to be kind and ensure the patient needs are at the core of their every interaction,” said Kathryn.

• Quality Performance at the Eye and Ear

  Watch Executive Director Medical Services and Chief Medical Officer, Dr Birinder Giddy, give an overview of the Eye and Ear’s quality performance over the past year.

  Measure	2018-19	2019-20	2020-21	2021-22
  Staff flu vaccination percentage rate	85%	86%	71%	92%
  Staff hand hygiene percentage rate	80%	83%	87%	87%
  Total number of incidences relating to the administration of blood and blood product wastage	0	0	0	3
  Total number of cases of staphylococcus aureus	0	0	1	0
  Total number of cases of clostridium difficile	0	0	0	0
  Total number of post-operative eye and ear infections	Change of reporting	0	7	6
  Total number of patients who fell over with no significant harm	23	28	27	25
  Total number of pressure injuries recorded during an inpatient stay	3	2	4	9*
  Total number of employees	Change of reporting	930	934	965
  Total number of interpreter appointments and number of languages	17,023 appts in 79 languages	13,636 appts in 84 languages	9911 appt. 82 languages	9977 appts in 86 languages
  Total number of registered consumers	30	27	25	22

  * Some pressure injuries might not be developed at the Eye and Ear, but were found and reported during skin assessment