The agency's performance (RMCLHN. Annual Report 2020-21)

Performance at a glance

• Meeting targets for all ED ‘seen on time’ triage categories.
• Meeting targets in ED ‘left at own risk’ for Aboriginal and Torres Strait Islander consumers for three of four quarters.
• Meeting targets in ED ‘length of stay greater than 24 hours’.
• Meeting targets for ‘percentage ED patients re-presenting within 48 hours for two of four quarters.
• Meeting targets in elective surgery ‘admitted on time’ for last three quarters 2020-21. The first quarter data for category 2 (95%) does not meet the target of 97%, due to theatre closure attributable to the COVID-19 pandemic and illness of a surgeon.
• Meeting targets for Mental Health services including post discharge community follow up rate, seclusion and restraint episode rates.
• Meeting all targets for Safety Assessment Code (SAC) 1 and 2 incidents that are openly disclosed (unless declined or deferred).
• Meeting target of 80 per cent of complaints acknowledged within two working days.
• Successful accreditation against the NSQHSS achieved by RMCLHN. The next accreditation date is February 2024. A one-year extension has been granted by the ACHS due to COVID-19.
• Successful NDIS Practice Standards Accreditation achieved by RMCLHN Network in 2020-21.
• Current accreditation status of Residential Aged Care Facilities (RACF) in RMCLHN

• Successful full facility accreditation with SAMET for intern and PGY2 medical trainees
• Delivering investment on capital upgrades and equipment in RMCLHN.
• Delivering services tailored specifically to the needs of local Aboriginal and Torres Strait Islander communities, such as the Tumake Yande Elders Program, Aboriginal Family Birthing Program, Aboriginal Health Team in the Riverland and Aboriginal Liaison Officer positions for the Riverland.
• Delivering community, in-home and residential services through RMCLHN Country Health Connect.

Agency response to COVID-19

RMCLHN COVID-19 Incident Management Team

Following the declaration of a major emergency under the State Emergency Management Act (2004) on 22 March 2020, the COVID-19 Incident Management Team (IMT) was established to respond to the COVID-19 situation and support health units across the region to access resources and systems as the pandemic situation evolved. The IMT is led by the CEO and the Executive Director of Nursing and Midwifery and includes key multidisciplinary members with a focus on operations, communications, logistics, human resources, planning and intelligence, and documentation. The IMT has oversight for all aspects of the regional response including education of medical and nursing staff, regional planning, infection control, use of Personal Protective Equipment (PPE), establishment of negative pressure rooms in the RGH and Murray Bridge Soldiers’ Memorial Hospital, COVID-19 screening sites and the COVID-19 vaccination program.

The following plans were developed and endorsed by the IMT to manage the risks associated with the COVID-19 pandemic and the health sector response within the RMCLHN:

• RMCLHN Regional COVID-19 Plan
• RMCLHN COVID-19 Vaccination Program Clinic Operations Plan
• COVID-19 Safe Plans for all facilities
• RMCLHN Residential Aged Care Facilities COVID-19 Viral Respiratory Outbreak Plans for all sites
• COVID-19 Residential Aged Care Facilities Workforce Management Plans for all sites
• COVID-19 Infection Control Plans for all Residential Aged Care Facilities sites
• RMCLHN Aged Care Outbreak Plans for all Residential Aged Care Facilities sites.

The CEO is also a member of the Statewide COVID-19 Acute Operations Group and the Executive Director Clinical Innovation is a member of the Statewide COVID-19 Clinical Advisory Group.

Emergency Departments

Due to the COVID-19 pandemic, the Barmera, Karoonda and Tailem Bend Hospital EDs collocated with RACFs were temporarily closed to protect aged care residents from the risk of cross contamination of COVID-19. Karoonda reopened in July 2020 while Tailem Bend and Barmera remain closed and the status of EDs within the region is continually reviewed in line with the Communicable Diseases Network Australian National Guidelines.

COVID-19 Testing Clinics

RMCLHN established a number of COVID-19 testing clinics in conjunction with SA Pathology across the region to assist with the identification and treatment of any outbreak within the community. Operating hours are continually reviewed and amended based on community trends and demand. The RGH located at Berri has been the main site involved in the majority of COVID-19 screening in the region, which has to 30 June 2021 undertaken more than 10,200 COVID-19 screening swabs.

COVID-19 Vaccination Clinics

The RMCLHN vaccination program has involved the use of both the AstraZeneca and Pfizer vaccines. The first phase of the vaccination roll-out commenced on 5 March 2021 with Australia’s first AstraZeneca COVID-19 vaccine administered at Murray Bridge Soldiers’ Memorial Hospital. This initial phase prioritised those most vulnerable to the effects of COVID-19, or who have the highest risk of being exposed, including aged care residents and key frontline health care and aged workers.

The vaccination program then rolled out to other healthcare workers and the wider community within the region with community clinics commencing in June 2021 at Murray Bridge, Berri, Waikerie and Meningie, with approximately 10,700 vaccinations in total administered from 5 March to 30 June 2021.

Agency contribution to whole of Government objectives

More jobs

RMCLHN contributed towards achieving more jobs within the region through a number of strategies and initiatives which included:

• Continuing to offer the Nursing and Midwifery Transition to Professional Practice program (TPPP) that provides entry level supported roles for Nursing and Midwifery graduates.
• Commencing an Aboriginal and Torres Strait Islander Administrative Traineeship program that provides the opportunity for employment whilst attaining a Certificate III in Business.
• Contributing to the development of the Rural Health Workforce Strategy with the Rural Support Service (RSS).
• Contributing to the development of the Rural Allied Health Workforce Plan.
• Contributing to the development of the Rural Nursing Workforce Plan.
• Providing further specialised training for allied health professionals.
• Providing career opportunities for Aboriginal and Torres Strait Islander health practitioners including Aboriginal Liaison Officers.
• Expanding training opportunities for community support workers.
• Supporting the community nursing workforce to manage more complex clients in rural areas.
• Recruiting new doctors to the region to work in the RGH at Berri.
• Creating a new position of Executive Director of Clinical Innovation.
• Gaining accreditation for the first time to recruit junior doctors to the region in 2022.
• Partnering with the Rural and Remote Mental Health Service to create a General Practitioner Psychiatry specialist training position in Riverland General Hospital.

Lower costs Costs for consumers were reduced through delivering programs such as:

• The Patient Assistance Transport Scheme and the Riverland Transport Service.
• Timely elective surgery in the Network.
• Country Home Link.
• Provision of telehealth services.
• Home-based chronic disease monitoring including cardiac, respiratory, diabetes, musculoskeletal, paediatric and aged related chronic diseases and comorbidities.
• Facilitated culturally appropriate access to bulk-billed GP and nursing consultations for the Riverland Aboriginal Primary Health service through a service agreement with the Barmera General Practice.

Better services

Significant service outcomes achieved included:

• Increasing access to the Digital Telehealth Network (DTN) and teleconference consultation, particularly during the COVID-19 pandemic.
• Increasing access to cancer services at RGH enabling patients to receive more complex chemotherapy treatment closer to home.
• Improving remote prescribing access for GPs who provide care to residents in RMCLHN RACFs.
• Improving access to specialist palliative care support via the Regional Local Health Network Palliative Care Innovation Grant Project – Telehealth.
• Implementing a Consult Liaison Mental Health Registered Nurse position, providing enhanced support to EDs and hospitals and reducing unwarranted admissions. This assists consumers to receive timely and appropriate Specialist Mental Health Care.
• Implementing the Borderline Personality Disorder Collaborative (BDP-Co) initiative, a co-stepped model of care that includes Gold card and 11-week road map programs. The latter targets young consumers, providing evidenced based interventions for people living with BPD or complex Post Traumatic Stress Disorder.
• Implementing a 26-week Dialectic Behavioural Therapy skills group for those consumers that have more complex BPD.
• Partnering with the Rural and Remote Mental Health Service to increase Psychiatrist input for consumers of the Community Mental Health Team.
• Providing mental health education for suicide prevention and consumer care.
• Implementing COVID-19 testing and vaccination clinics across the region.
• Recommencing social and wellbeing groups that were suspended during the initial COVID-19 outbreak.
• Increasing the provision of Home Care Packages.
• Completing redevelopment works for the upgrade to the ED and Central Sterile Supply Department at Murray Bridge Soldiers’ Memorial Hospital.
• Completing redevelopment works for the installation of a MRI Unit at RGH.
• Completing redevelopment works for the Waikerie Health Services carpark, aged care rooms and hospital entrance.

Agency specific objectives and performance

Corporate performance summary

RMCLHN achieved key performance outcomes including:

• Accreditation against the Aged Care Quality Standards, Food Safety Programs and NDIS Practice Standards.
• Supporting a large number of staff with professional development opportunities.
• Meeting the target for staff having an annual performance review and development discussion.
• Meeting the target for all staff having the required Criminal History and relevant screening.
• Reducing the number of staff with excess annual leave.
• Meeting the target for the rate of new workplace injury claims.
• Attendance of 144 staff at the face to face Orientation program.
• Participation in the Office for the Commissioner for Public Sector Employment IWorkforSA Staff Survey.
• The RMCLHN Reflect Reconciliation Action Plan completed in June 2021 with a launch planned for late 2021.
• The inaugural RMCLHN NAIDOC Week Awards implemented during NAIDOC Week in November 2020 and winners announced in December 2020.
• Commitment to address racism including the introduction of a function on the Safety Learning System for staff to report any level of racism within the workplace. Processes also implemented to ensure any reports of racism are handled appropriately.
• Completion of significant capital investments including:
  • The Murray Bridge Soldiers’ Memorial Hospital ED and Central Sterile Supply Department upgrade. This $12.35 million project was funded through the State Government Capital Funding ($7 million election commitment) and Asset Sustainment Fund ($5.35 million).
  • The Waikerie Health Services redevelopment work on the carpark, aged care rooms and hospital entrance with the $2.14 million project funded by the Waikerie and Districts Health Advisory Council Gift Fund Trust.
  • The MRI Unit within the RGH at Berri. This project was funded through the Asset Sustainment Fund ($2.3 million) and the Biomedical Equipment/ General Equipment Fund ($1.5 million).
• Completion of the Murray Bridge Soldiers’ Memorial Hospital Aboriginal Artwork project in March 2021.
• Investing in existing assets to address important repairs/maintenance including $0.62 million on minor works compliance such as equipment replacement, minor building refurbishment and communication equipment, and $6.3 million on further asset sustainment projects.
• Investing in $0.250 million in biomedical equipment.
• Finalised and launched the RMCLHN brand featuring a unique colour palette and the flora and fauna icons for our Network — the Pelican the Pelican, Murray Cod and Mallee Tree>
• Worked on the development of a RMCLHN Aboriginal Health sub brand using a local Ngarrindjeri artist to re-design our Pelican and Murray Cod icons using distinctive Aboriginal artwork.
• RMCLHN is active on social media through its Facebook page, Instagram account, YouTube channel and LinkedIn account. The Facebook page continues to be the top performing regional LHN page and RMCLHN were the first regional LHN to launch an Instagram account. For the 2020-2021 financial year, the monthly Facebook post reach averaged 12,500 and peaked at 70,148, and the monthly post engagement averaged 10,000 and peaked at 13,988. The increased social media presence includes specific showcasing of Aboriginal Health.

Employment opportunity programs

Agency performance management and development systems

Work health, safety and return to work programs

*number of claimants assessed during the reporting period as having a whole person impairment of 30% or more under the Return to Work Act 2014 (Part 2 Division 5)

**before third party recovery Data for the previous year is available at DataSA website - RMCLHN Data for years prior to 2019-20 related to the former Country Health SA is available at DataSA website - CHSA.

Executive employment in the agency

Data for the previous year is available at DataSA website - RMCLHN. Data for years prior to 2019-20 related to the former Country Health SA is available at DataSA website - CHSA.

The Office of the Commissioner for Public Sector Employment page that provides further information on the breakdown of executive gender, salary and tenure by agency.