Surgical Services

Day Surgery Facility
The Day Surgery Facility conducts elective and emergency surgery on public and private patients. The majority of patients treated in the department have elective cataract surgery as day patients and are discharged back home soon after surgery. Other eye and ENT surgery is also performed in the Day Surgery theatres. The preparation of patients before a day surgery procedure involves outpatient assessments, pre-admission tests and co-ordination with several other areas within the Hospital. Day Surgery conducts approximately 6,000 surgical procedures per year.

Department of Anaesthesia
The Department of Anaesthesia provides a 24-hour anaesthesia service including peri operative care for elective and emergency patients. The Department is extensively involved with the pre-admission service and all aspects of patient care to provide optimum health outcomes for patients undergoing surgery. The Department is the largest ophthalmic and otolaryngology service provider in Australia and plays an important role in training and providing professional advice about ophthalmological anaesthesia. In 2004, the Department reviewed and updated anaesthesia policies and protocols, and continued its stringent reporting of adverse events, which led to the improved management of patients with co-morbid conditions such as diabetes and high blood pressure. 

Main Operating Theatres
The Main Operating Theatre Suite (OTS) provides a 24 hours a day, 7 days a week service to both elective and emergency ophthalmic and ENT surgery. The unit treats over 7,000 patients annually requiring a range of surgical procedures, and provides specialised nursing care to patients treated in the basement complex. The unit also provides nursing resources to the radiology department for pre-operative cochlear implant, CT scanning as well as nursing resources for the Broadmeadows spoke services. Detailed Description

Medihotel
Opened in February 2004, and officially launched by the Victorian Health Minister in June, this facility is for patients requiring supported or assisted overnight accommodation rather than acute nursing care. The primary purpose of this 10 bed facility is to reduce demand on the Hospital's acute care beds. Patients admitted to the Medihotel include those who need supervision rather than treatment after surgery, patients who do not have a carer to stay with them at home for the first night after an operation and patients from rural areas who need to be present at the Hospital the day after surgery for a follow up appointment or treatment. Patients can be admitted before and after operations. The Medihotel is open Monday to Saturday and is staffed by a registered nurse at all times. Within 5 months of opening, the facility was operating at 75% occupancy and has resulted in a reduced length of Hospital stay for some patient groups.

Pre-Admissions
The pre-admission service ensures patients coming to the Hospital are medically fit and psychologically prepared for surgery and post-operative recuperation. Patients are triaged and attend pre-admission clinics depending on the presence of other medical problems. Patients who are young and fit are pre-assessed by telephone interview 3-4 days before surgery and do not attend a clinic. The service began to pre-admit patients by phone in 2004, leading to a 39% increase in the service. Extra pre-admission clinics were provided to manage additional patients being operated on Saturdays. The department also developed a project aimed at reducing the number of patient cancellations and improving patient flow.

Surgical Bookings Unit
The Surgical Bookings Unit manages the in-patient surgical waiting list and ensures patients receive timely and fair access to urgent and routine surgical appointments. The Unit books approximately 3,500 public and private theatre lists annually, ensures Hospital theatre lists are adequately and appropriately booked and that patients are optimally prepared for surgery. For the second consecutive year, the Hospital was selected as a designated centre for participation in the Elective Surgery Access Service (ESAS) program. This involved coordinating and treating large numbers of ENT patients who have been waiting extensive periods of time for an operation at other Victorian hospitals. The department also coordinated additional operating lists on Saturdays to ensure patient surgical targets were met.

Ward 4
Ward 4 provides a Monday to Friday peri-operative service for patients requiring ophthalmology and ENT surgery. Ward 4 has 24 recliner chairs and a dedicated paediatric area with 4 beds/ cots. Predominately a day procedure ward this area co-ordinates patients on the day of surgery, ensuring they are adequately prepared before escorting them to the main operating theatre suites. After the operation, patients are transferred back to Ward 4 for the final stages of their recovery and are discharged home or to another ward if they require a stay in Hospital for observation. The department increased its throughput by 10% compared to its overall performance from last year.

Ward 8
Ward 8 is a 30 bed acute ward, providing medical and surgical care to eye and ENT patients. Ward 8 has a dedicated area for paediatric patients with an adjoining playroom. At the end of 2003, Ward 8 increased its capacity from 25 beds to 30 beds following the modification of one ward to a Medihotel. The changes to the Ward included remodelling of ensuites and paediatric area, the addition of bedside phones and a call system and the creation of a new pharmacy dispensing station.

Ambulatory Services

Broadmeadows Spoke Service
Late in 2003 the Broadmeadows spoke service entered a unique partnership that has resulted in privatisation of the outpatient service to Broadmeadows Eye and Ear Specialists (BEES). This relationship has resulted in significantly improved access to ophthalmology services for patients in western metropolitan areas. Benefits include improved outpatient access to first appointment and referral for surgery at East Melbourne or to Hospital run operating theatres at the Broadmeadows site. Hospital staff continues to provide a comprehensive pre-admission service to patients referred to surgery ensuring a seamless, high quality service for patients.

Cochlear Implant Clinic

The Cochlear Implant Clinic (CIC) assists severely hearing impaired adults and children achieve significant improvements in their daily communications through a range of surgical and non-surgical interventions. A comprehensive multi-disciplinary clinical programme involves experts in surgery, audiology and speech assessment and (re)habilitation. The Clinic offers public and private services to Australian residents as well as being able to tailor programmes to suit international patients. Staff also participate in teaching and community education activities and the CRC (Co-operative Research Centre) for Cochlear Implant and Hearing Aid Innovation research activities. The CIC is committed to teaching and research activities and has close relationships with several of the Hospital's partner organisations.

In 2004 the clinic formalised an agreement with the Royal Children's Hospital to conduct cochlear implants in children less than 2 years of age. The clinic developed further initiatives to improve patient pathways and worked to reduce surgical waiting times from 9 months to 3 months. It also commenced two off-site therapy programmes, one in the eastern suburbs and one in the western suburbs.

Emergency Department
The Emergency Department provides 24-hour emergency ophthalmic and ENT care to Victorians and assess approximately 36,000 patients per year, treating a range of conditions from conjunctivitis to severe penetrating eye injuries and post-tonsillar bleeds. The Hospital's Emergency reception desk and triage areas were relocated and refurbished, leading to improved communication between staff and more timely assessment for patients. The department also amended practices to comply with DHS guidelines for classifying patients according to 5 different triage categories.

The Medical Photographic Imaging Centre is the largest provider of medical photographic services to patients in Victoria, supplying eye or ENT specialised investigative or diagnostic imaging. Photographs, videos or images are supplied for clinical diagnosis, assessment, treatment and teaching. The variety of services offered to patients has increased by 47% in the past 2 years. The centre has played a fundamental part in expanding clinical research at the Hospital and has introduced a new retinal map analysis system, advancing diagnostic capacity in the department. 

Orthoptic Department 
The orthoptic department provides eye testing services to Hospital patients from a variety of outpatient clinics. The service provides clinical assessment before patients are seen by the specialist, which helps clinicians make decisions on treatment and monitor the progress of individual cases. The department is the largest provider of orthoptic clinical education in the state, and also provides training for ophthalmic registrars. The department assisted in the redesign of referral forms to Vision Australia, who assess patients affected by vision impairment for assistance with their daily activities.

Outpatient Services
Outpatient services provided at the East Melbourne site have grown by 3% compared to the same period last year. Ongoing changes and service modifications have continued throughout the year aimed at streamlining access to clinics and meeting demand. Of particular note has been the reallocation of some clinics to alternate floors to improve patient facilities. These changes, along with improved seating and general conditions in waiting areas, have seen benefits to patients. There has been a greater focus on the development of improved reporting mechanisms enabling more detailed analysis of waiting list trends.

Pharmacy
The Pharmacy Department acts as the central reference point for all medicine-related activities within the Hospital, and provides pharmaceutical advice and supplies to clinicians, patients and researchers. It is responsible for maintaining the integrity of the range of hospital approved drug supplies for patients. The department also provides clinical education on a needs basis to other Hospital areas as well as conducting its own research. Throughout 2004, the pharmacy department successfully implemented the Pharmaceutical Benefits Scheme (PBS) throughout the Hospital and a new system for monitoring and measuring medication errors. The department also introduced a fully equipped dispensing station in the Hospital's inpatient ward to improve drug access in the Peter Howson Wing. 

Speech Pathology
The department provides a full time service for children and adults with communication and swallowing difficulties linked to ENT problems. It has expanded and improved assessment procedures and continues to train increasing numbers of university students at undergraduate and postgraduate levels. The number of patients referred to and assessed by the department doubled over the past year. 

Taralye Oral Language Centre
The Hospital's spoke service at Taralye provides specialist ENT services for children. This joint service enables convenient access to ENT outpatient appointments, together with hearing assessments and Hospital referrals for surgery if required. Hospital administration staff work in close liaison with Taralye staff to ensure an efficient clinic referral system for families residing within the eastern metropolitan region.

Corporate Services

Building & Engineering Services
In August 2002, the Hospital's Board of Management approved an infrastructure upgrade to repair and upgrade aspects of the 40 year old building. The $6 million infrastructure upgrade started in late 2003, concluded in 2004 and was entirely self-funded. This work included repairs to the exterior of our two buildings to rectify the effects and continued problems associated with concrete cancer. The electrical supply was upgraded; piping systems were replaced; and a new generator, chiller and water plant were installed. The lifts in the Peter Howson Wing were refurbished to meet Australian standards and the security camera system was updated.

Clinical Governance
The Clinical Governance department approaches clinical governance progressively in conjunction with risk management and clinical risk management. The department uses sophisticated tools to capture information, set priorities and monitor progress. 

Contracts and procurement
The Contracts and Procurement Department (including general stores) provides and manages effective contracts and framework agreements with suppliers to obtain high quality goods and services. The department manages tender processes across the Hospital, rewriting Expression of Interest and Request for Tender documents. The department entered into the re-tendering of Hospital support services including security, cleaning services, ward support, and patient meals.

Finance Department
The Finance Department provides strategic, financial, management and policy support for all areas of the Hospital as well as statistical reporting to the Board and the Department of Human Services. The department processes financial data for the Hospital and manages the Hospital's financial resources via financial planning and internal control programs. In 2004, the department aligned its Chart of Accounts to the DHS account system, in preparation of the introduction of new Financial Management Information Systems scheduled for 2005.

Health Information Services 
Health Information Services provide and support the maintenance of complete and accurate medical records and patient information systems, which are pivotal to quality patient care, Hospital planning, the provision of appropriate funding and support of medical research. The department has continued its supportive role with the Hospital patient information system (PIMS) and has significantly increased its focus on data analysis and the provision of information for Hospital decision making and research. A certificate course for system users is planned to further promote improvements in the area of data quality. There has been continued emphasis on the content of the medical record to improve the capture of clinical information. Electronic requests for records have also been introduced to improve workflow and timely service delivery. 

Human Resources Department
Human Resources develop, review and implement policies and procedures governing the operations of payroll, occupational health and safety and human resource management. Human resources co-ordinates training and development of Hospital staff, and is responsible for staff advertising and recruitment. The department implemented many projects throughout the year including a training program for management staff in the areas of project management, recruitment, performance management and development of other staff. The department reviewed the Hospital Code of Conduct and introduced a staff Reward and Recognition program. 

Information Technology
The Information Technology Department provides reliable, up-to-date and integrated technology to enable teaching, training and research across all areas of the Hospital. The department provides strategic advice and guidance to the Hospital's Executive team on matters relating to the use, or potential use, of IT. 

Occupational Health and Safety Department

As part of the Hospital's commitment to Occupational Health and Safety, the department created an inventory and implemented training strategies related to the safe management of Dangerous Goods and Hazardous Substances. Emergency Management Procedures were reviewed across the Hospital and a National Public Health forum for Human Resources practitioners was implemented.

Support Services

Diabetes Education
Dose Adjustment for Normal Eating (DAFNE) is an intensive 5-day group education program that provides a unique method of management by matching the insulin taken to what the person with diabetes wants to eat. This differs greatly from traditional methods of managing diabetes that adapt the timing and content of the meals to a more fixed dose of insulin. Adult learning and self management principles are used throughout the program to build confidence and patient autonomy. Two DAFNE programs are run each year with a maximum of eight participants. Better diabetes control improves patient quality of life as well as reduces the risk of patients developing Diabetic Retinopathy and slows the progression of this eye condition. Read more about DAFNE.

Friends of the Eye & Ear and Volunteers
Friends of the Eye & Ear have made an invaluable contribution to the hospital in the areas of fundraising, administration and patient support. Fundraising Friends continue to provide much needed financial support to the hospital through the sale of gift items and Christmas cards, cake stalls, games days, raffles and the day to day running of the hospitals Opportunity and Gift shops. Service Friends provided thousands of volunteer hours in a variety of roles across the hospital including service provision to patents, carers, visitors and hospital staff. 

Fundraising
The key focus of the Hospital's Fundraising and Development Program during the year has been to broaden and further develop both new and existing fundraising initiatives, increase philanthropic support and create a self-funding, sustainable program. Funds raised through planned giving program, donations, volunteers and philanthropic trusts and foundations contribute to the provision of care in the Hospital. 

Infection Control
The Infection Control department monitors and ensures the provision of an effective infection control risk management program in addition to a staff health program which minimises the risk of employees contracting or spreading infections. Infection prevention audit tools have been developed and implemented and compulsory Infection Control induction sessions introduced for all new clinical staff. In 2004, the department initiated and conducted the Hospital's inaugural infection control seminar.

Interpreter Unit
This department plays a vital role in the communication process between patients and health professionals. Continued growth in demand for this service resulted in the Hospital appointing in house interpreters to service Greek, Vietnamese, Italian, Cantonese and Mandarin languages. Contracted services continue to be utilised for all other languages.

Patient Transport & Accommodation
The patient transport and accommodation department is responsible for co-ordinating, assessing and processing the transport and accommodation needs of Hospital patients. On average 150 bookings are processed each month in addition to the co-ordination of interpreter bookings. A major initiative last year was the review of transport eligibility criteria ensuring the equitable provision of services to patients. 

Public Relations
This department is responsible for raising the Hospital's profile within the community as well as enhancing staff and patient communication and information. As a means of strengthening the Hospital's public profile, the services of a communications agency were engaged to develop a strategic long-term communications plan. The expectations and needs of different stakeholders are being incorporated into this process to ensure the community is well informed about the positive work conducted at the Hospital.

The Ronald Lowe Library
The conjoint Libraries of the Eye & Ear Hospital and the Royal Australian and New Zealand College of Ophthalmologists (RANZCO) operate together as a specialist health and research library, focussing on ophthalmology and otorhinolaryngology. A greater emphasis has been placed on electronic access, with the introduction of an online catalogue and updated website for improved access to resources. During the year, the library conducted a user satisfaction survey, resulting in fourteen major outcomes to be implemented in the coming year. 

Social Work
The hospital social worker assists patients with vision and hearing problems and their families and carers. Social Work provide psycho-social assessments, consultations, liaisons with community organisations, resource information and refer patients to appropriate support services. Short term counselling is available to understand the impact of sudden and chronic sensory impairment and life changes.

Sterile Processing Service
The Sterile Processing Service functions 6 days a week and provides reprocessing and sterilisation services to all hospital departments and spokes services. It created a new process for sterilising equipment from the emergency department, permitting the tracking of specific equipment items to individual patients which improved infection control practices. Two new instrument decontaminators were installed with a higher capacity to accommodate the service's increased workload. 
Detailed Description