Quality Account 2020-2021

Infection Control has always been an important practice across the healthcare sector, possibly never more so than in the current environment. The goal of infection control management is to reduce the risk of patients contracting preventable infections which in turn improves the overall quality of care.

Helen describes her early roles in infection control within hospital environments:

“Infection control functions were very much education focused, and being the central point of contact for all departments across the hospital, which included providing advice during construction work projects. Surveillance and responding to small infection outbreaks in the hospital was also a big part my role. I would conduct ward rounds to ensure patients were safe and the preventative measures were being correctly implemented.”

In March 2020 the role of infection control in a hospital setting developed significantly to support the fight against the spread of COVID-19. The focus for Helen was implementing the DH guidelines in clinical settings to support a COVIDSafe environment. This included advising on PPE protocols, physical distancing in waiting rooms and staff tea rooms, enhanced cleaning, and the introduction of QR codes and visitor screening at entrances.

“We did everything we could to protect our staff and patients, but there was no vaccination to roll out or mask fit testing requirements which changed the course of 2021 for the entire sector,” explained Helen.

Comparatively, the direct impact of COVID-19 at the Eye and Ear in 2020 was low with very few COVID-positive patient or staff cases. However, there was a lot of hard work happening behind the scenes. A group of expert staff from around the hospital, including Helen, joined forces to form a COVID-19 working group. Those involved planned and implemented COVIDSafe processes, many of which you can still see in our hospital today. The processes are regularly reviewed as a way of adapting to the changing COVID-19 environment.

“Some of the DH guidance applied more to larger hospitals conducting a broad range of treatments. Many of our treatments involve close patient contact and sometimes patients can’t wear PPE appropriately. This means we needed to adapt. Staff compliance was key,” Helen explains.

While 2020 was unprecedented and believed at the time to be the COVID-19 peak, it was 2021 that has proved most challenging.

“I think no one could have predicted the year that was 2021. It was very hard to prepare for. Last year, as a specialist hospital we were somewhat protected, there weren’t many exposure sites and our theatre activity was reduced,” explained Helen.

The biggest challenges this year for Helen, and the Eye and Ear more broadly, has been the unpredictable nature of the lockdowns and the flow on effect. Add to this the management of the vaccination rollout and the implementation of the hospital’s Respiratory Protection Program (RPP) made for a difficult year for all Victorian health care providers.  The RPP implements respiratory protection processes to minimise the risk to respiratory hazards, such as infectious agents. Due to COVID -19, there has been a significant uptake in usage of Respiratory Protection Equipment (RPE), and with it the need for health care workers to be trained and supported to wear and use RPE effectively.

“When I started, the infection control team was just me, and now we have our Respiratory Protection Program Coordinator, as well as a number of casual staff members that have helped with administering the vaccination and administration support,” Helen said.

We are proud of our staff for continuing to provide expert care to our patients while navigating the changes to the sector.

“It has been really tough for our staff to have to reduce visitor numbers and have patients unable to see their loved ones. However, we can all see the bigger picture and that it is essential protocol for keeping staff and patients safe. This understanding has then allowed staff to approach patients with compassion and empathy,” explains Helen.

Maureen Plain, Manager of Social Services, explains that it has been a challenging yet rewarding time for the team as they adjust to the impacts of COVID-19.

“The resilience of the team and the entire healthcare sector has been outstanding to witness and be a part of. Supporting our patients is our number one priority and each team member has adjusted their practice to ensure patients receive the best care possible,” says Maureen.

In some cases, transport and telehealth services came together to reinforce quality care for patients.

“We utilise the Red Cross for our patient transport services. In a normal year, this service is fairly self-sufficient, however it has been in and out of operation due to lockdown restrictions, which has meant our team need to think outside the box and explore options for our patients on a case-by-case basis,” Maureen explained.

Currently requests for patient transport are accessed via telephone and Telehealth is used where appropriate. Telehealth is especially useful when patients aren’t able to use public transport or catch a taxi to the hospital.

“COVID-19 resulted in the suspension of external onsite interpreters during peak stages, with these bookings being transferred to telephone. At first, this was disruptive, with bookings difficult to change, however the process has adapted to accommodate sudden lockdowns and we can now quickly change bookings to telephone when needed.

We have also seen the development of an online portal offering an alternative to these requests which will reform our translating services and reduce the time taken to process them,” Maureen explains.

Strengthening our hospital’s response to family violence (SHRFV) has been operating in public hospitals since 2018 in response to recommendations from the Royal Commission into Family Violence. SHRFV has been supported at the Eye and Ear via the introduction of family violence procedures and staff training. These enhancements have helped our staff develop the knowledge and skills to identify family violence, assessment and referral processes.

In line with the recommendations, the Eye and Ear also implemented the Multi Agency Risk Assessment Management (MARAM) framework. This ensures services are effectively identified and assessed in order to manage family violence risk. MARAM also highlights issues around family violence, not just for patients but also for staff.

Maureen noted that the Eye and Ear saw a decline in referrals during lockdown periods, but an increase once lockdown ceased, which was reflective of what was occurring in the community. The opportunity for survivors of family violence to leave the home is reduced during a lockdown and therefore the opportunity to seek assistance is also lessened. COVID-19 has provided many pressures for everyone, and this has only further exacerbated family violence within homes.

The Eye and Ear takes a holistic approach to patient care. Treatment is provided with consideration of a patient’s mental health and social wellbeing to solicit the best health outcomes.

These issues need to be addressed in order to support discharge planning, continued engagement with the hospital as well as future treatments. It is vital that all patients are provided with the opportunity to be referred to a social worker for more comprehensive support.

Throughout the pandemic, new programs have been implemented and several improvements have been made.  The hospital has seen a high degree of collaboration and leadership on many fronts. Interestingly even though patient numbers have reduced, social work has continued to have a consistent number of referrals.

During this period, the social workers, family violence and disability liaison officer have addressed some complex issues that patients have experienced including but not limited to: family support networks; home care; disability; family violence; children at risk and mental health.

The Eye and Ear’s new Disability Liaison Program, a great initiative by the Victorian Government, will provide support for individuals with a disability to access vaccinations and receive support within the clinical setting. This service is also noted in the Hospital’s Disability Action Plan.

People with disability were not coming to their appointments as much due to COVID and so now the focus is on vaccinations. However, the service extends further. It is about making sure that people with a disability have access to the right advice, guidance ensuring they have equal treatment. In addition, the ability to link with other Disability Liaison Officer’s across the state will help streamline information to further assist patients with a disability.

The Eye and Ear takes a holistic approach to patient care. Treatment is provided with consideration of a patient’s mental health and social wellbeing to solicit the best health outcomes.

These issues need to be addressed in order to support discharge planning, continued engagement with the hospital as well as future treatments. It is vital that all patients are provided with the opportunity to be referred to a social worker for more comprehensive support.

Throughout the pandemic, new programs have been implemented and several improvements have been made.  The hospital has seen a high degree of collaboration and leadership on many fronts. Interestingly even though patient numbers have reduced, social work has continued to have a consistent number of referrals.

During this period, the social workers, family violence and disability liaison officer have addressed some complex issues that patients have experienced including but not limited to: family support networks; home care; disability; family violence; children at risk and mental health.

The Eye and Ear’s new Disability Liaison Program, a great initiative by the Victorian Government, will provide support for individuals with a disability to access vaccinations and receive support within the clinical setting. This service is also noted in the Hospital’s Disability Action Plan.

People with disability were not coming to their appointments as much due to COVID and so now the focus is on vaccinations. However, the service extends further. It is about making sure that people with a disability have access to the right advice, guidance ensuring they have equal treatment. In addition, the ability to link with other Disability Liaison Officer’s across the state will help streamline information to further assist patients with a disability.