Inpatient Services

Phone: (03) 5722 5250

Northeast Health Wangaratta (NHW)  has an eight bed Critical Care Unit (CCU) located on the first floor of the acute block. The CCU is currently level II ICU status and specialises in providing care for patients who need care and intervention that is highly specialised and intensive.

The clinical staff working in CCU include consultant specialists, training doctors, critical care nurses and a range of allied health and the care provided by these staff is coordinated by a Nursing Unit Manager and consultant specialist doctors. Nursing staff working in CCU are required to have post graduate qualifications and skill levels to care for intensive care patients. At NHW all nursing staff working in CCU have formal post graduate qualifications or are currently studying through the Rural Critical Care Course.

NHW collect clinical indicators for CCU, such as length of stay for specific conditions and patients having to transfer to another hospital because of lack of CCU beds. When data is compared with other CCU’s in Victoria, results show the care NHW provides is equal to or better than any other Victorian CCU.

CCU is a very well equipped unit and considerable resources are invested each year to ensure state of the art monitoring, diagnostic and core equipment is maintained by our biomedical engineers.

Phone: (03) 5722 5171

The Day Procedure Unit at NHW operates as part of the operating theatre complex. Its hours of operation are 7am until 5.30pm and there are a total of 2 clerical and 6 nursing staff employed within the unit. The main three operations performed as day stay procedures last year were:

1. Colonoscopy
2. Gastroscopy
3. Knee arthroscopy

With advances in medical technology and increasing pressure on healthcare resources, a larger percentage of patients are now booked as day stay patients. Procedures that once required several days spent in hospital are now being performed as same day surgery. When patients are booked into hospital for a day procedure, they do not expect to stay overnight. Following a patients return to the recovery room, they will be transferred from a trolley to a recliner chair where nurses will monitor recovery unit the patient is fit and well enough to go home.

Phone: (03) 5722 1784

In 2006 NHW announced its participation in the ‘Dementia Care in Hospital’ Project. In 2003, carers of clients with Dementia nationally, identified that hospitals were not well equipped to meet the needs of clients with cognitive impairment and their carers. Ballarat Health Service had identified that clients with cognitive impairment were common in the acute wards settings. Clients with cognitive impairment were often not identified and this often resulted in ineffective support of these clients and their carers.

 NHW commenced the program in January 2006 with a dedicated team utilising existing hospital personnel, community groups and dementia support groups. Specific education programs were developed and have been delivered to direct and non-direct care staff throughout the organisation. A discrete visual identifier designed to trigger an appropriate response from staff to the patient with dementia and also to engage their carers is now used at NHW.

NHW began implementing the third stage of the ‘Dementia Care in Hospital’ Project in May 2006. All clients who are admitted to the hospital, who are over the age of seventy years and clients receiving orthopaedic surgery, who are sixty five and over, will be screened with a short questionnaire by nursing staff to ensure staff have a base level of the client’s cognitive state.

If at any time during a client’s admission, staff suspect that their clients have become confused, for whatever reason, a further assessment will be attended. If clients and their families consent, the Cognitive Impairment Identifier will be displayed above the client’s bed. Clients and their families are encouraged to be part of their care, talk to the staff about the questions asked and what outcomes are expected.

Phone: (03) 5722 5261

The Emergency Department (ED) at NHW sees approximately 16,000 patients annually. The Department is the designated rural trauma service for the central section of the Hume health region. The department’s medical staffing profile consists of a Director who is an Emergency Medicine Specialist (FACEM), several part time senior clinicians who are General Practitioners with special interests in Emergency Medicine and a range of Resident Medical Staff on rotation from metropolitan teaching hospitals. The department is supported by Consultants and Registrars from the major medical specialities. The nursing workforce consists of approximately 24 full time equivalent nurses, most of whom have specialist training in Emergency Nursing or Critical Care Nursing.

The department is staffed and equipped to deal with most medical and surgical emergencies, and fills the role as the major referral centre for the Hume region. The department is staffed and operates on a 24 hour a day seven day a week basis.

Patients are seen in the ED according to their medical urgency. This is determined utilising the Australian Triage Scale, which allocates patients to a triage category and allocates an expected waiting time to be seen by a doctor for each triage category. The waiting times are estimates only, we strive to ensure that patient waiting times are kept to a minimum at all times. The ED at NHW currently meets all health department guidelines for waiting times in each triage category.

NHW ED is continuously striving to keep waiting times to a minimum and has introduced several innovative programs to shorten time taken to deliver treatment to our patients. Nurses at the triage desk can order x-rays and some blood tests for certain patient groups. Some of the ED nurses are also trained in the application of plaster to broken bones.

The ED also plays a role in the regional medical Displan (disaster plan) and has the capability to send Medical/Nursing teams to disaster sites if required. The ED enjoys good relationships with general practitioners in the referral area and works to ensure a coordinated approach to patient care wherever possible.

Triage in the Emergency Department

Triage is a process that originated during military conflicts and has been refined for use in a civilian setting. It literally means ‘to sort by quality’. At NHW we currently use what is known as the Australasian Triage Scale to allocate a number rating based on urgency. There are 5 urgency categories under this system, each has its own recommended waiting time allocated and our aim is to see patients within the recommended waiting time. We measure our performance against these recommended times each month and we also compare our figures to other emergency departments.

Triage assessment is performed by a senior Registered Nurse who has completed appropriate education and assessment before being allowed to work in triage unsupervised. Patients are seen in order of triage category, and then by waiting time. This is done as there are only ever a maximum of two doctors in the Emergency Department at any given time. Unfortunately, at times there may be unavoidable delays as more urgent cases are seen first.

Phone: (03) 5722 5264

MAPS is a Medical Admissions and Planning Sub-unit. MAPS is part of the Ground West (GW) Medical Ward, where most patients with medical conditions are admitted and initial tests and care needs assessed.

The aim of this unit is to coordinate and plan your care, involving medical, nursing and allied health staff. Clinical staff will work together with you and if relevant, with your carer to plan your treatment, care and commence preparing for your transition from hospital to home.

Your stay in this unit will be up to 48 hours during which time assessments, tests and referrals to other health care professionals will be made. At the end of your stay in MAPS you will either be ready to go home or be transferred to the most appropriate unit in the hospital.

Aims

• To keep your time in the Emergency Department to a minimum.
• To reduce your time in hospital and plan for your transition to home, recognising that being home is the best place to recover.
• To commence planning for your discharge early in your hospital stay.
• To ensure appropriate referrals to inpatient services and external care providers are organised early in order to ensure a well planned and supported discharge.
• To coordinate and expedite all medical investigations and, in conjunction with the medical team, to assist with diagnosis and care plan. To involve you and/or your carer in the assessment and planning process, recognise that you need information and knowledge to enable you to make decisions about your health care.

Staffing

MAPS is managed by the Nurse Unit Manager of Ground West, your direct care will be provided and coordinated by a Clinical Nurse Consultant and Division 1 Registered Nurses.

Location

MAPS is located in rooms 26-28 in Ground West, which is located on the ground floor of the hospital. Access is via the main entrance until 8.30pm and then via the Emergency Department.

Discharge Checklist

Please ensure when you are discharged from MAPS you have the following:

• All your belongings that you brought into hospital.
• Appointments for followup care.
• Any medication that you brought with you and any new medications you may need to collect from Pharmacy.
• Any X-rays that were brought to hospital.

(03) 5722 5194

8.30am to 5pm Monday to Friday

The Oncology Day Unit provides chemotherapy and supportive treatments to people affected by cancer. It also provides a range of treatments for people with other chronic illnesses.

The unit was redeveloped in 2009 using funds raised by the local community. There are eleven chemotherapy chairs and one bed in a spacious, well lit environment in which family and friends of patients are welcome. The Oncology Day Unit embraces a patient focused model of care.

Location

The Oncology Day Unit is located on the ground floor of Northeast Health Wangaratta (NHW) between the Cafe and the Medical Imaging Department. You can access the unit by coming in the front entrance of the hospital on Green Street, turning left into the main corridor and walking past the cafe to the unit on the left. Alternatively you can come in through a dedicated driveway entrance that is situated between the Emergency Department and the main entrance where you are welcome to drive in to be dropped off or picked up.

Parking is available on the streets around the hospital. Cusack Street and Green Street in the block towards the overpass have all day parking. The area directly in front of the hospital is two hour parking.

Medical Services

Patients receiving chemotherapy in the unit are under the care of Medical Oncologists at Border Medical Oncology in Wodonga. Medical staff from NHW provide support to patients and staff in the unit.

What is chemotherapy?

Chemotherapy is the use of drugs to treat cancer. It works by destroying or slowing the growth of cancer cells. Chemotherapy mainly affects fast-growing cells, like cancer cells. Other fast-growing cells can also be affected, like the cells that cause hair to grow. There are many different types of chemotherapy drugs. Usually, people have several at the same time but sometimes only one is used.

The aim of chemotherapy may be to cure cancer, to relieve symptoms, to help other treatments work better or to improve survival.

Who works in the unit?

The unit is staffed by enthusiastic and dedicate cancer nurses. Other support services are available and can be arranged for you when you are receiving treatment in the unit. These include:

• social work
• dietetics
• psychology
• pastoral care
• breast care nurses
• lymphoedema therapy
• palliative care
• district nursing
• stomal therapy
• physiotherapy

What to expect

When you arrive at the unit you should check in at the front counter and you will be shown into a chair in the ward area.  On your first visit you will have a discussion about your treatment and side effects with one of the nurse and you will have plenty of opportunity to ask questions.

It is a good idea to arrange for someone to drive you home after your first appointment for treatment. You might be able to drive yourself for subsequent treatments depending on how you feel.

What to bring

Some chemotherapy treatments can take several hours so you are welcome to bring a friend or family member for company, something to read or music to listen to.  There is a portable DVD player that you can borrow for use while you are in the unit.

Morning tea, a light lunch and afternoon tea are provided. There is also a well stocked lolly jar should you need some sugar during the day.

Bring a list of current medications you take including over the counter preparations such as vitamins, herbal or natural medicines. Take your usual medications unless your doctor has told you not to. Eat your usual breakfast before you come.

What to wear

You should wear comfortable clothes with loose sleeves as most chemotherapy drugs are given through an IV drip that will be inserted into your arm.

Where can you get more information?

Please call the unit if you have any questions or concerns before your appointment.

There is an enormous amount of information about cancer on the internet. Hume Regional Integrated Cancer Services have a number of links to reputable websites that can be accessed by clicking on this link. www.humerics.org.au/

Phone: (03) 5722 5242

The demands of providing perioperative patient services can cause many difficult challenges for practitioners. However, with our caring, dedicated and professional team, NHW’s three Operating Theatres provide quality elective surgery (conducted between 08.00-18.00 weekdays) and 24 hour emergency services to all surrounding districts. NHW endeavours to provide the highest standard of holistic patient care, customer service and professional competency through continuing education and introduction of the latest technologically advanced equipment.

Services provided include orthopaedics, general surgery, obstetrics and gynaecology, urology, ear nose and throat, endnoscopy procedures and anaesthesia which includes a dedicated Pain Management team.

Orthopaedics can be defined as the branch of medicine devoted to the treatment of the skeletal system. This includes joints, muscles and associated structures. Orthopaedic surgery is one of the major types of surgery performed at NHW with around 1,300 cases performed annually.

At NHW we currently have four Orthopaedic surgeons who are supported by two orthopaedic registrars, an orthopaedic resident and intern.

Phone: (03) 5722 5314

The Paediatric Unit at Northeast Health Wangaratta looks after most child and adolescent health issues covering the ages 0-18 (whilst still at school). Caring for medical, surgical and mental health needs using holistic family centred care and partnerships with other local health service providers.

The unit currently provides Paediatric Hospital in the Home (HITH) in partnership with external HITH services.

Following referral from local paediatricians there is the ability for parents and/or children/adolescents to receive education relation to specific care needs whilst in the community, ie CPR, medication administration via injections.

Research in recent years has demonstrated the importance of effective management of post operative pain. Effective pain relief is associated with reduced incidents of post operative complications and decreased hospital stays.

The Acute Pain Service (APS) was established at NHW in 2001 with the introduction of a Clinical Nurse Consultant in Acute Pain Services. The aim of this service is to provide a high quality pain management service to inpatients of NHW. In providing this service, skills and knowledge of both the Wangaratta Anaesthetic Group and specialised nursing staff members are utlised.

The APS provide:

• A resource for all clinical staff
• A Monday to Friday ‘pain’ round reviewing all patients with Patient Controlled Analgesia (PCA), Epidural, Spinal analgesia and patient referrals. A Consultant Anaesthetist attends once a week, providing the opportunity to incorporate clinical experience into an education forum.
• Implementation and monitoring of new protocols e.g. Antiemetic Protocol and Acute Adult Medication Protocol.
• Education, training and compulsory competency in the Pain Education Package. This contains all aspects of acute pain management.
• Ongoing development, evaluation and implementation of Protocols and Policies in Pain Management.
• Representation on clinical committees to evaluate patient outcomes.
• Patient follow up on discharge via phone and collation of data via spot and continuous audits.

The APS at NHW has also initiated the formation of a Regional ‘Pain Group’. This group meets bi-monthly and has representatives from Goulburn Valley Health, Albury Base Hospital, Albury Private Hospital and Wagga Wagga Base Hospital.

Phone: (03) 5722 5217

Pastoral Care is available to provide emotional and spiritual support to residents, patients, their families, staff and volunteers.

Through offering companionship and support, care is centered around listening in such a way that allows each person to explore and express their hopes and concerns, while drawing on their own spiritual and personal resources.

Pastoral Care is available for all people, those with a faith tradition and those with no religious affiliation or belief.

Pastoral Care can assist with:

• Listening to your story in a supported environment which may help you to express feelings of confusion, sadness, grief or loneliness and help clarify thoughts about your experience and the way forward.
• Exploring issues of meaning, faith and doubt.
• Emotional and cultural needs.
• Prayer, meditation, celebration or specific ceremonies and rituals of saying goodbye and memorial services.

Trained Pastoral Care Volunteers support the Pastoral Care Coordinator to provide these services.

Religious leaders from your own faith tradition are welcome to provide you with Pastoral Care and can be contacted by nursing staff or the Pastoral Care Coordinator.

Northeast Health Wangaratta has a Spiritual Sanctuary which is a quiet place, open for reflection, contemplation and prayer.  It is a universal space for people of all faith traditions and beliefs.

The Pastoral Care Coordinator can be contacted by calling (03) 5722 5217 or page 217.

Phone: (03) 5722 5160

NHW Pharmacy provides the following services:

• Clinical ward pharmacy – clinical pharmacists visit the wards on a daily basis. They review and dispense patients’ medications and teach them about the medications being taken.
• Supply of medication to wards for inpatient use
• Regional hospital supply service
• PBS dispensing for hospital patients
• Outpatient service – Section 100 and Special Access Scheme
• Non-sterile manufacture
• Parenteral nutrition/other IV additive services
• Cytotoxic/oncology services
• Therapeutic drug monitoring
• Psychiatry services – including clozapine program
• Methadone program
• Ongoing quality assurance program
• Provide educational services to pharmacy students, pharmacist pre-registrants and medical students
• Comprehensive drug information service to patients and hospital staff

Pharmacy opening hours are:

Weekdays: 8.30am – 5.15pm

Public holidays: 10am-12noon

Pharmaceutical Benefits Scheme (PBS)

Previously, patients discharged from this hospital were given five days of medication. They then had to visit their local doctor to obtain a PBS prescription for further medications.

NHW Pharmacy Department now dispenses PBS prescriptions for hospital patients. Patients will receive up to a month’s supply of medication when they are discharged and when attending this hospital as an outpatient. Patients are also required to pay the co-payment set by the Commonwealth Government, the same as at thier local pharmacy. The Safety Net Scheme also applies when receiving dispensed PBS medication from this hospital. In addition, this scheme allows non-PBS items dispensed in this hospital to be added to the Safety Net card up to the co-payment amount.

Also, as part of the this PBS system:

• Patients will leave hospital with a better understanding of the medicines they are taking.
• Upon patients discharge, a list of medications will also be sent by the hospital to a patient’s usual doctor before their next visit.

This means your doctor will have up-to-date information about your hospital treatment and medications, improving your overall care.

Three things you need to know about the PBS system:

1. Remember to bring your Medicare Card, Pensioner Concession Card, Health Card, Safety Net Card and your DVA Gold, White and Orange Card if you have one.
2. You will now get up to a month’s supply of medication on discharge from hospital or when you attend as an outpatient.
3. The medicine you receive will cost about the same as it would at your local chemist.

This PBS system will improve your level of care as you move from the hospital, back into the community. Getting the medicine you need, will now be safer, easier and more convenient.

For more information on PBS and the Safety Net, please contact:

Northeast Health Wangaratta Pharmacy Department (03) 5722 5160

Department of Human Services/Health Insurance Commission

1800 020 613 (freecall)

1800 552 152 (hearing impaired)

131 450 (Translating and Interpreting Service)

pbs.enq@hic.gov.au

www.hic.gov.au

Phone: (03) 5722 5292

Physiotherapists are health care professionals who focus on prevention, assessment and treatment of physical disorders; and the promotion of movement and health.

Physiotherapists enable patients with a variety of conditions to restore their physical function and improve quality of life.  This can be achieved in a variety of ways including manual therapy, exercise therapy, movement retraining electrotherapy agents and client education.

Physiotherapists provide care and treatment for a range of conditions, including orthopaedic, surgical, musculoskeletal, neurological and cardio-respiratory conditions.

Inpatient services:

• Critical Care Unit
• Surgical/Orthopaedics
• Medical
• Obstetrics and Gynaecology
• Paediatrics
• Emergency Department
• Thomas Hogan Rehabilitation Centre
• Geriatric Evaluation and Management

Outpatient services:

• Community Rehabilitation- Home based and centre based
• Cardiac Rehabilitation
• Pulmonary rehabilitation
• Falls and Balance Clinic
• Orthopaedic Group
• Community Outpatients
• Aquatic Physiotherapy

Phone: (03) 5722 5251

All patients who have a planned admission to hospital complete a request for admission form after seeing their doctor. This is then assessed by the theatre liaison nurse who can organise appropriate care pre-operatively, depending on the need of each individual patient. On admission, the clerks in the admissions office confirm that the information they already have about you is correct as well as gathering any additional information that is required. The admitting nurse will ask you about your medical history and take your temperature, pulse and blood pressure.

Some patients who are admitted to hospital for more complex procedures or those who have relevant past medical histories are requested to attend pre-admission clinic. This ensures that all relevant tests etc. have been carried out prior to admission and assists patients in understanding what to expect from their hospital stay.

For more information about attending NHW as a patient, please see Patient Information.

Phone: (03) 5722 5284

Social Workers provide a service to patients, their families and significant others according to the needs of the patient being served and accepted standards of social work practice in accordance with AASW guidelines.  This involves assessment of the need for social work contact, planning the type of intervention required and any follow-up or referral to community based agencies for ongoing support when the patient has been discharged.  Some of the interventions used include counselling, advocacy, discharge planning and support for the patient and family using a person centred framework.

Inpatient Social Workers provide social work services to inpatients, their families and significant others to enable them to deal with the impact of changes in health on individual and family functioning and to achieve optimum assistance from health care services.  Services provided may include complex discharge planning, provision of information for patients with a new diagnosis, initial grief counselling, antenatal and postnatal contact support, liaison with community agencies, support access to residential care and general support.

Social workers can also be accessed by participants in Community Care Centre Programs.

Some useful Community Service Contacts:

Aged Care Assessment Service: (03) 5723 2007

Rural City of Wangaratta: (03) 5722 0888

Ovens and King Community Health Centre: (03) 5723 2000

Phone: (03) 5722 5249

The Thomas Hogan Centre (THC) was officially opened by the Department of Human Services, Hume Regional Director Dr Tom Keating, in June 2005. The THC was created through joining our Coordinating Care Unit (Medical) and the Thomas Hogan Rehabilitation Unit. The THC comprises of 26 beds specifically dedicated to the needs of people who require active assessment and therapeutic intervention, but whose acute health needs have reduced.

Rights, Responsibilities, Expectations and Goals

Frequently Asked Questions

Thomas Hogan Rehabilitation Centre Team