NBMLHD 2025 Innovate Together Quality Awards

Innovation

Recipient of Chief Executive's Safety & Quality Award

Tele-PrEPP To You

Prehabilitation significantly improves surgical recovery, but remote location and cost often create barriers. At Nepean Hospital, the prehabilitation program already reduces length of stay and ICU admissions. To boost access, a virtual prehabilitation service was launched.

This innovative virtual model enabled 76 of 234 patients to complete the program, reaching those previously disadvantaged. It reduced hospital stays (8.2 vs. 10.2 days), readmissions (4.6% vs. 12.43%), and complications. As the first NSW site recognised by ACI for virtual prehabilitation, Nepean is pioneering accessible, high-quality care, ensuring more patients are optimally prepared for surgery and experience better outcomes.

Research and Innovation

Recipient of Board Chair's Health Research & Innovation Award

Tabletop Role-Playing Therapeutic Group

Facing a surge in referrals for children and young people experiencing neurodivergence, trauma, and the effects of violence, the Community Counselling Service and Child Protection and Counselling Service sought a new approach. They developed an eight-week therapeutic group program using a Tabletop Role-playing Game, integrating Narrative-Play and Adventure Therapy, encouraging participation from those reluctant to engage in traditional therapy.

This innovative program, developed and facilitated by Allied Health Clinicians, yielded remarkable results. Pre- and post-intervention surveys showed significantly improved prosocial behaviour and reduced emotional, conduct, hyperactivity, and peer problems. Participants overwhelmingly agreed the program was successful, demonstrating positive outcomes for problem-solving, decision-making, identity, and social skills. This engaging, evidence-based approach offers crucial early intervention, reducing reliance on future health services for vulnerable youth.

Excellence in Aboriginal Healthcare  

‘On your turf’: Supporting the engagement of Aboriginal patients through home-based assessments

Many Aboriginal community members face barriers accessing vital support services like the NDIS. Recognising low engagement with traditional hospital clinics, a new Occupational Therapy Clinic was launched designed specifically to foster trust and participation.

The Clinic embraces a ‘no wrong door’ approach to referrals and conducts assessments in familiar, culturally safe spaces like homes and community centres. By partnering with local Aboriginal-led services, they've achieved remarkable results: 13% of referrals come from Aboriginal services, 25% engagement from Aboriginal consumers, and a low rate of cancellations. Crucially, 100% of Aboriginal NDIS applications were approved, even for those previously declined. This success highlights the power of culturally safe, client-focused care in empowering Aboriginal community members to access the support they deserve.

Excellence in the Provision of Mental Health Services

Safeguards – Child & Adolescent Assertive Response Mental Health

The NBMLHD Safeguards team, launched in August 2023, provides vital, short-term, assertive crisis mental health support to children and adolescents (0-17) and their families. This outreach service addresses the critical need for immediate, age-appropriate care for young people previously ineligible for tertiary services.

Since late 2023, 265 consumers have been supported. The team has expanded to reach remote Blue Mountains and Lithgow communities, ensuring priority populations, including Aboriginal and Torres Strait Islander youth and those under 12, receive timely care. Safeguards delivers recovery-focused, trauma-informed assessments and interventions, working in pairs to enhance safety, capacity, and combat staff burnout, ensuring positive mental health outcomes for young people and their families.

Excellence in Multicultural Health Care  

Breaking Barriers to Mental Health Access for CALD

A rise in culturally and linguistically diverse (CALD) communities facing complex social and mental health challenges has initiated a partnership between our Mental Health service partnered with Multicultural Health. Refugees and asylum seekers, often traumatised by exposure to conflict, persecution and displacement, experience mental health issues including PTSD, depression, and anxiety.  

To bridge gaps in health literacy and awareness about good mental health, they developed a 'Mental Health Implementation Plan for CALD Communities,' based on six pillars for culturally competent care. This involves partnering with CALD consumers, upskilling staff in 'teach-back' methods, and using interpreter services. Over 90% of the plan is now active, improving staff cultural responsiveness, reducing stigma around mental health, and strengthening outreach. This sustainable model significantly enhances health literacy and access to mental health care for all CALD communities.

Keeping People Healthy  

Rehab Revival

Faced with increased patient volumes, rehabilitation bed delays, and reduced therapy intensity, the ‘Rehab Revival’ project initiated a major overhaul. Through stakeholder workshops and surveys, 70 improvement opportunities were identified. Five working groups, involving all clinical staff, developed 12 solutions.

Changes implemented include new discharge processes, cultural changes, NDIS streamlining, and new models of care including a ‘Fast Track’ and a new ‘Stroke Pathway’. Results showed decreased rehabilitation bed delays, reduced length of stay, and improved functional outcomes. Patient surveys show a 34.7% improvement in care aligned with best practice and a surge in personalised discharge planning.  

Keeping People Healthy Highly Commended

Target 500: Creating a Sustainable Community OT Service

Facing a surge in referrals and wait times that far exceeded targets, the Community Health Care Occupational Therapy service recognised an urgent need for change. Increased demand, largely driven by My Aged Care funding, had blown out recommended timeframes and created significant clinical risks.

In response, the service implemented a multi-faceted strategy. This included a 'Rapid Access' service for immediate, short-term interventions and proactive screening of existing waitlists to promote self-management or redirect clients. This decisive action paid off; within just seven months, they slashed the waitlist by 500 clients.

Now, new referrals are seen within recommended timeframes, ensuring better care, improved client outcomes, and boosted staff satisfaction. This innovative approach means the Occupational Therapy service can more effectively keep people safe and supported at home.

Health Equity Award (New Category)  

Sexual Assault Counselling for Women in Custodial Settings

Sexual Assault Services (SAS) face significant challenges providing trauma care in custodial settings. A 2023-2024 pilot program offered four weekly telehealth sessions with a counsellor to sexual assault survivors, focusing on foundational safety and stability to lead into trauma processing work.  

The pilot demonstrated improved psychological distress for participants (mean K10 scores pre 33.5 to 26.2 post), with participants reporting positive benefits from strategies and counsellor connection. This pilot demonstrates a positive impact despite inherent risks, providing a vital, formerly inaccessible service to vulnerable individuals. It challenges conventional views on feasible healthcare in custodial settings, empowering clients and establishing a sustainable model for other SAS services.

Patient Safety First Award

Sepsis Escape Room: Engaging Paediatric Sepsis Education Through Simulation

Traditional medical training often falls short in high-stakes environments. A recent project addressed this by engaging healthcare professionals in active learning on the updated NSW Paediatric Sepsis Pathway through an innovative simulated escape room.  

Teams solved sepsis-related clues, mirroring real-world urgency and teamwork. This significantly enhanced staff knowledge retention, improved protocol application, and increased team collaboration. Pre/post-surveys showed a 60% rise in confidence. Conducted over four weeks across paediatric shifts, the project was adapted for Emergency Department mixed adult/paediatric sepsis education.  

Patient Safety First Highly Commended

Blue Mountain's Travellers – Effective Preemie transfers to BMDAMH - SCN

Blue Mountains District ANZAC Memorial Hospital's (BMDAMH) Special Care Nursery (SCN Level 2) expanded services for premature infants, but some developed respiratory issues post-transfer, causing distress and prolonged stays. This situation added significant stress for families and disrupted the continuity of care, affecting both patient safety and the overall patient experience.

A retrospective audit identified key risk factors. In response, new admission criteria and pre-transfer screening protocols were implemented. This has significantly reduced post-transfer complications, ensuring infants receive the right care in the right setting. The changes mean better feeding progression, shorter stays, and earlier family bonding. This project enhances patient safety, reduces unplanned transfers, and transforms the patient experience, providing seamless care for vulnerable premature infants and their families.

People Culture Award

Homeward Bound: Supporting allied health with complex discharges

Navigating complex hospital discharges, especially with the NDIS, was causing significant patient length of stay (LOS) issues, with clinicians seeking a collaborative approach for improved patient care. To streamline this, the Nepean Hospital Occupational Therapy and Social Work departments launched Enhancing the NDIS Pathway for Inpatients (ENPIP) in January 2025.

Taking the form of a Consultation Clinic, ENPIP provides a collaborative forum for clinicians to discuss complex cases with the LHD Disability and NDIS Manager, improving communication and discharge planning. In just nine weeks, ENPIP reviewed 82 cases, leaving clinicians feeling supported and more confident in managing complex patients. It's also reduced the time from admission to NDIS/NCAT application submission.  

Transforming Patient Experience Award  

Hour of Power: Physio Led Plaster Clinic

Born from the need for timely, accessible fracture care, our physiotherapy-led plaster clinic offers a patient-centered alternative to traditional hospital clinics. Developed during COVID-19, it streamlines simple fracture and musculoskeletal injury management.

Led by expert physiotherapists with advanced training in immobilisation techniques and orthopaedic triage, the clinic accepts direct referrals from EDs, GPs, and urgent care centers, and orthopaedic surgeons offering fixed appointments. Early data shows high patient satisfaction, reduced staff overtime, and improved efficiency. This innovative model enhances patient access and experience, decongests surgical outpatients, and optimizes resource use by diverting simple cases. It's a testament to the effectiveness and sustainability of physiotherapy-led care, ensuring faster recovery and better outcomes.

Consumer Choice Award (shared)

Transforming Patient Experience Highly Commended

The Tree of Life

Older patients with cognitive impairment face drastically higher risks in hospitals, including increased hospitalisations, longer stays, and more falls. At Lithgow Hospital from January to October 2024, this group, despite being only 12% of inpatients 65+, accounted for 75% of all falls, with an average of 83% of all major falls linked to cognitive impairment. Existing person-centered care and communication aids proved insufficient in busy acute settings.

To address this, Lithgow Hospital designed the Tree of Life (ToL). This person-centered tool, relying on care-partner involvement, aims to improve communication and reduce hospital-acquired complications. Tried with 37 inpatients, ToL significantly reduced falls and eliminated major harm falls, transforming the 'dementia patient' into an empowered individual with unique history, receiving overwhelmingly positive feedback from staff and families.

Consumer Choice Award (shared)

Oral Health Patient Reported Experience Measures (PREMs)

Past patient experience surveys in Oral Health lacked depth, hindering service improvement. To address this, the Oral Health service, collaborated with local consumers to develop and launch comprehensive patient-reported experience measures (PREMs) surveys. These surveys capture detailed demographics and inquire about communication, informed care, hygiene, and overall satisfaction.

Since April 2023, over 10,600 surveys reveal significant success: 98% of respondents trust staff, and 97% recommend our services. This data provides actionable insights, driving continuous improvement and empowering patients in their care journey. This culture of shared decision-making, helps to prioritise patient safety, and enhances the overall quality of oral healthcare.

Environmental Sustainability

Environmental Sustainability Highly Commended

Safe and Save – Keeping Documents Secure and Sustainable

Cancer Services previously mailed 700 dictated clinic letters weekly, consuming vast amounts of paper and staples. Now, after medico-legal review, they've implemented double-sided printing and secure emailing via Kofax encryption.

This eco-friendly shift reduces our carbon footprint, administrative costs, and staff time, even eliminating stapling-related RSI. This project empowers staff, streamlines processes, and enables instant, secure communication with GPs. They've saved 50% on multi-page letters, 100% on staples, and gained significant time by embracing digital solutions for a more sustainable and efficient healthcare future.

Additional entries:

‘Games Group’ – Increasing patient therapy and engagement

Nepean Hospital's rehabilitation ward faced a challenge: patients were disengaged with traditional upper limb therapy, and previous group sessions flopped. Recognising the need for a fresh approach, staff created ‘Games Group’, a twice-weekly session where patients participate in various board, card, and electronic games.

This innovative group isn't just fun; it's smart therapy. Patients with upper limb deficits, perhaps from stroke or brain injury, naturally engage their arms while playing, transforming essential physical therapy into an enjoyable, motivating experience.  

Since its launch, Games Group has led to a 30% increase in weekly upper limb therapy, with patients reporting high satisfaction from the social aspects, fun, and comfort it provides.  

Building the clinical confidence of New Graduate Occupational Therapists

Our Occupational Therapy New Graduate program has transformed and moves beyond traditional lectures, now offering dynamic, hands-on monthly education sessions led by 'near-peer' facilitators. This redesigned approach significantly boosts early career professionals' skills and confidence.

Pre- and post-session surveys show a remarkable 28.5% increase in confidence, with participants rating session value at an average of 9.23 out of 10. This success highlights the program's effectiveness in enhancing skills across diverse clinical topics. By providing crucial support and training, we're building a highly skilled workforce, empowering new graduates, and fostering a culture of lifelong learning aligned with NSW Health's workforce plan and our retention strategy.

Community Health Care Virtual Library

The Community Health Care virtual library, powered by Microsoft 365, significantly boosts educational access for Community Health Care nurses. It offers on-demand access to a wealth of past online educational content like in-services and podcasts, crucially recording completion for reportable staff attainment via My Health Learning. The library's success is evident in high staff engagement and its ability to accurately track participation. This robust system ensures a reliable learning record, allowing the District to monitor training impact, ensuring compliance, accountability, and continuous professional development.

Elevating Cultural Voices: Multicultural Consumer Reference Group

Culturally & Linguistically Diverse (CALD) consumers have historically been underrepresented in healthcare planning. To change this, the Multicultural Consumer Reference Group was formed. Developed collaboratively with consumers and community leaders, the group is a great example of our commitment to creating a healthcare system that is inclusive and accessible to everyone. Since inception in 2023, the Group has grown to 11 active members, meeting bi-monthly with endorsed work plans and ongoing partnerships. This model has established a scalable and sustainable platform for inclusive consumer input in healthcare design and delivery.

Empowering GPs to Manage ADHD in the Community

Limited access to ADHD diagnosis and treatment in Australia, due to high costs and specialist shortages, is being tackled by a pilot program. It trains General Practitioners (GPs) to independently diagnose and manage ADHD in primary care.

GPs undergo a three-month program with supervised clinical exposure and education. Since June 2023, five GPs completed training, with three now operating ADHD clinics, seeing up to six new patients weekly. The program enrolled 200 participants, reducing wait times to four weeks and expanding referrals across NSW. This sustainable model significantly enhances access, improves patient outcomes, and alleviates specialist demand.

Enhancing women's birth experiences and strengthening woman-centred care

Midwives at Nepean Hospital's birth unit identified a gap in support and guidance for women when choosing a birth support person. To address this, they developed an informational brochure, empowering women and enhancing support people's confidence.

The collaborative project, spanning several months, involved creating and then surveying the brochure's impact. Results were overwhelmingly positive: 83% of women would recommend it, and 83% of support people stayed throughout labour, indicating increased confidence. Midwives (55%) also felt it positively influenced women's decisions. This low-cost, evidence-based resource strengthens woman-centered care, improves communication, and is easily replicable across health services, fostering more positive, supported birth experiences.

Improving NICU to Post-Natal Ward Handover: A Structured Approach

This project aims to address communication gaps during the handover process between the Neonatal Intensive Care Unit (NICU) and the Paediatric team working in the postnatal ward at Nepean Hospital. To address this, a structured handover tool was introduced. This simple checklist ensured essential information was consistently shared during patient transfers. The results showed improved staff satisfaction, higher confidence in handovers and a decrease in errors in patient management.  

Introducing the Allied Health Rapid Response Team in ED

Facing increased Emergency Department (ED) admissions, especially complex social and NDIS cases, Nepean Hospital trialled a dedicated Winter Strategy whereby a multidisciplinary Allied Health Rapid Response team was embedded in the ED for three months.

This team, including Social Work, Occupational Therapy, Speech Pathology, Physiotherapy, and Dietetics, provided immediate, comprehensive care. This approach to care led to an increase in community referrals, reduced re-presentation rates, more direct ED discharges for NDIS patients, and a significant decrease in wait times for allied health intervention. By integrating allied health at the patient's journey's outset, this project streamlines discharge planning, ensures holistic care, and helps patients receive crucial follow-up, ultimately enhancing patient experience and reducing re-admissions.

Maximising Potential: Integrating AHAs into NPACC

Physiotherapy Allied Health Assistants (AHAs) are vital, yet their skills were underutilised in acute orthopaedics due to a lack of formal training. This, coupled with rising healthcare burnout, highlighted a critical need for change and improved career pathways.

A Quality Improvement initiative launched to upskill AHAs in acute orthopaedics and boost job satisfaction. Collaborating with ETS, a comprehensive training program and competency assessment were developed. Now, 100% of AHAs are confident delivering acute orthopaedic services, supported by ongoing mentorship. This project not only improved service delivery amidst growing waitlists but also fostered a culture of wellbeing, ensuring AHAs feel supported, respected, and empowered to provide high-quality care.  

Paediatric Documentation and Clinical Coding Improvement Initiative

Accurate patient information is vital, especially for children. The Paediatric Documentation and Clinical Coding Improvement Initiative is tackling inconsistencies in discharge summaries and clinical coding. This project aims to validate documentation and coding accuracy, ensuring proper patient diagnosis grouping and identifying education needs. Through audits and training, it's already improving coding accuracy, documentation skills, and revenue. This initiative will positively impact paediatric patients, junior medical officers (JMOs), and the coding team. Measured by revenue analysis and JMO comfort levels, it will reduce post-discharge complications and boost staff engagement through continuous feedback and learning.

Parkinson’s Disease Motor On Service Redesign

The Parkinson's Disease (PD) Motor On Service was redesigned to elevate physiotherapy and client experience. After mapping patient needs and upskilling staff with PD Warrior training, a comprehensive, evidence-based program was developed.

Key changes include four dedicated 1:1 sessions before group classes with tailored exercises, skill development which boosted confidence, engagement, and self-management while reducing falls. The service also implemented a 6-month monitoring process to track progress and adjust care. The goal was to empower clients to live well with PD, ensuring they are an expert in their health journey. Clients receive a comprehensive booklet for seamless information sharing with all healthcare providers, ensuring consistent, high-quality care throughout their journey.

Rehab Hour

The ‘Rehab Hour’ initiative aimed to boost active therapy minutes for patients on A11D by providing supervised, physiotherapy-led exercise in the Level 11 Gym. In just eight weeks, 37 intervention patients showed remarkable improvements compared to a control group.

Participants gained a 16% increase in average active minutes per week, a 7.7-day reduction in acute physiotherapy length of stay, and an 11% improvement in mobility. Eighty-three percent of patients rated Rehab Hour as good/very good. This collaborative project, vital for fall prevention and mental wellbeing, demonstrates how targeted therapy improves patient outcomes and overall quality of care.

TAP On or TAP Off

Nepean ICU challenged traditional pillow use for pressure injury prevention, implementing the Stryker Turn And Position (TAP) system to improve sacral offloading and patient turning frequency.

Over a 12-month trial with 254 patients, the TAP system reduced ICU-acquired sacral pressure injuries. Staff reported high satisfaction, and a refined decision-tree now targets at-risk patients, ensuring cost-effectiveness and sustained improvements in patient safety and quality of care.