NSW Kids & FamiliesNSW Kids & Families...healthy, safe and well.

Joanna HoltJoanna HoltChief Executive

Les WhiteChief Paediatrician

OVERVIEWOVERVIEW

1. About NSW Kids & Families

2. Current activities – Maternal, Child & Family; Violence Prevention & Child Protection; Youth o e ce e e t o & C d otect o ; outHealth & Wellbeing

3 Current activities Paediatric Healthcare Team3. Current activities – Paediatric Healthcare Team

Establishment of NSW Kids & FamiliesEstablishment of NSW Kids & Families

NSW Kids & Families is a new Board governed statutory health corporation established under the Health Services Acthealth corporation, established under the Health Services Act 1997 Sect. 41 Schedule 2.

We are a public health organisation and the fifth Pillar! We are a public health organisation and the fifth Pillar!

NSW Kids & Families ‘Opened for Business’ on 19 November 2012 when Chief Executive commenced.

Why Kids and Families?Why Kids and Families?NSW Kids & Families will aim to rebalance focus on the health, wellness and healthcare of mother’s and babies children youngwellness and healthcare of mother s and babies, children, young people and families.

Experiences and exposures before birth and in early Experiences and exposures before birth and in early childhood can influence the course of a person’s life with links to a range of chronic diseases in adulthood including diabetes cancer cardiovascular disease hypertensiondiabetes, cancer, cardiovascular disease, hypertension, obesity and mental illness.

Nearly two-thirds of premature deaths and one-third of y pthe total disease burden in adults are associated with conditions or behaviours that began in their youth, including: tobacco use, a lack of physical activity, unprotected sex or exposure to violence.

NSW Kids & Families - Organisational StructureStructure

Vision and PurposeVision and Purpose

Our VisionOur Vision

Kids and families in NSW will be healthy, safe and well.

O r P rposeOur PurposeNSW Kids & Families will provide leadership to

the NSW health system and partner with our y pstakeholders to deliver outstanding health,

wellbeing and healthcare services and to protect those most vulnerable within our community.y

Our scope?Our scope? Mothers-to-be and the growth, development, and birth of their babies to ensure the

best start to life.

The healthy growth and development of infants, children and young people and the choices they and their families make to preserve and promote good health and wellbeing.

Family and ‘whole of community’ health and wellbeing in the context of providing aFamily and whole of community health and wellbeing in the context of providing a safe and nurturing environment for healthy growth and development.

At risk mother’s, babies, children and young people, requiring additional support to achieve optimal health and wellbeing.

Women and babies, children and young people, who are unwell, injured or require other support services to restore or improve their physical or mental health.

Victims of domestic and family violence or sexual assault and the mitigation of its impact on personal health and wellbeing and family dynamics.

Some question marks – role in bed/cot planning, disability, women’s and men’s health more broadly?

Our Perspective?Our Perspective?

What we will do?What we will do? LEAD AND COORDINATE a connected and integrated system of appropriate healthcare.

EMBED EVIDENCE-BASED CARE: Research, develop and support the implementation ofEMBED EVIDENCE BASED CARE: Research, develop and support the implementation of evidence-based policy, standards, guidelines and best practice programs and models of care that reduce risk and improve the quality, continuity and consistency of healthcare delivery.

REDUCE INJURY & HARM: Develop and promote policies and practices which reduce the prevalence of injury and the health impact of violence and neglect on individuals families andprevalence of injury and the health impact of violence and neglect on individuals, families and the communities within which they live.

INSPIRE INNOVATION: Stimulate applied research and support uptake of new programs and innovative models of healthcare delivery.

IMPROVE HEALTH STATUS & OUTCOMES: Focus attention and effort on the resources and services that are proven to promote good health choices &/or improve health outcomes.

BUILD CAPACITY: Build the capacity and capability of healthcare services, communities and families to promote and protect children’s health and wellbeingfamilies to promote and protect children s health and wellbeing.

PROVIDE ADVICE & GUIDANCE: Provide expert advice to government and healthcare providers in relation to improving the health, wellbeing and healthcare of women and babies, children, young people and their families.

Building Partnerships is KEY!Building Partnerships is KEY!

T d thi t b ild t t hi ith ll i thTo do this we must build strong partnerships with our colleagues in the Ministry and fellow Pillars, hospitals, health services, Medicare Locals, General Practice, NGOs, other government agencies as well as with consumers to achieve improved health and healthcare for theconsumers to achieve improved health and healthcare for the populations we serve within the NSW.

Together we will champion:

Connected service delivery

Appropriate safe high quality careAppropriate, safe, high quality care

An environment in which children are safe and thrive

NSW Kids & FamiliesNSW Kids & Families

Current activities…

…a samplep

Maternal Child & FamilyMaternal, Child & Family

Towards Normal Birth - continuingTowards Normal Birth continuing

Next Birth after Caesarean Section Guideline – June 2013

Initiatives to improve ‘Closing the Gap’ outcomes for Aboriginal mothers, babies and children

N i f PHR d Child l t i H lth R dNew version of PHR and → Child electronic Health Record (electronic Blue Book trial)

NSW Clinical Assessment Guidelines for Children and YoungNSW Clinical Assessment Guidelines for Children and Young People in out of home care

Violence Prevention & Child ProtectionViolence Prevention & Child Protection

R i f P li D ti Vi l Id tif i d R diReview of Policy - Domestic Violence - Identifying and Responding

Working on NSW Health’s contribution to a new whole of Government Domestic and Family Violence Framework o est c a d a y o e ce a e o

Representing NSW Health - Royal Commission into Institutional Responses to Child Sexual Abuse

Child Sexual Assault in Aboriginal Communities – Senior Executive Group

Commencement of final tranche of Family Referral Services

Evaluation of Keep Them Safe initiatives

Youth Health & WellbeingYouth Health & Wellbeing

U i t h l i f l d ff ti l t t l ’Using technologies safely and effectively to promote young people’s wellbeing: a better practice guide for services – how to safely and effectively incorporate technology into practice with young people

Continuation of Youth Forums - 5 June 2013 (Wednesday)A place to call home: Meeting the needs of homeless young people

Preparation of web based resources to support parents raisingPreparation of web-based resources to support parents raising teenagers (Raising Children Network http://raisingchildren.net.au/)

General Practice and Youth Health (all health professionals) Resource ( p )Kits

NSW Youth Health Policy 2011-2016: Healthy bodies, healthy minds, vibrant futuresvibrant futures

Paediatric Healthcare Guidelines- Guidelines

Suite of 12 Clinical Practice Guidelines (ED)

Crying Baby / Infant; Community Acquired y g y ; y q

Pneumonia; Unconscious Child

Rural Paediatric Emergency Clinical GuidelinesRural Paediatric Emergency Clinical Guidelines

Development of “Death of a Child Resource

Guideline” to assist hospital staff

Other opportunities for standardisation

Paediatric Healthcare: Current Focus

CEC lead projects Children’s HealthcareCEC lead projects BTF; SPOC charts; updates /

ED

Children s Healthcare Networks Resus4Kids

DETECT Junior: mandatory education; modules

Paediatric Clinical

Allied Health Educators

Ser ice frame orks Paediatric Clinical Emergency Response System / Escalation

Service frameworks

Chronic complex care

Sepsis pathway / toolkit

QSA; CPG audit; IIMS CHN CNC’s

Paediatric Healthcare: IV Fluids in NSW

Emerging literature; unsafe practices

Children’s Healthcare Australasia (2010)

Adoption by Children’s Hospitals in NSWAdoption by Children s Hospitals in NSW

- content / bag size (1000ml v 500ml)

NSW Working Group; Implementation Taskforce

HealthShare; Baxter; costs; pumps; labels; fluid

order forms; education; monitoring

NSW IV Fluids for Children / NeonatesNSW IV Fluids for Children / Neonates Children

- 0.45% Sodium Chloride +5% Glucose +/-20mmol/Litre Potassium Chloride

- 0 9% Sodium Chloride +5% Glucose0.9% Sodium Chloride +5% Glucose +/-20mmol/Litre Potassium Chloride

Neonates- 0.22% Sodium Chloride + 10% Glucose

+/-20mmol/Litre Potassium Chloride

0 45% Sodium Chloride +10% glucose- 0.45% Sodium Chloride +10% glucose +/-20mmol/Litre Potassium Chloride

- 0.9% Sodium Chloride +10% glucose +/-20mmol/Litre Potassium Chloride

Surgery for ChildrenSurgery for Children

1 R i th i i f i l i f hild i M t1. Review the provision of surgical services for children in Metro Sydney and flows to SCHN

2. Distinguish Emergency and Planned domains2. Distinguish Emergency and Planned domains

3. Develop standards for appropriate approaches to surgical care within current resource context

4. Maintain and build local capacity/skills

5. Identify longer-term strategic planning process

LHD of Residence of Child

lS d M tGreater 

S d M t R i l R l & N S d M t

Planned Surgery: Retention, LHD providing surgery by LHD of Residence of the Child

Gran

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talSydney Metro Sydney Metro Regional, Rural & Non‐Sydney Metro

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urru

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X630 SCHN 1336 813 660 1022 1742 651 323 268 370 277 21 123 132 91 7829

Metro

X710: SWS LHD 1025 1 38 8 23 4 6 2 3 2 1 7 1120X760: NS LHD 29 596 18 5 121 11 8 120 9 16 1 2 3 4 943X700: Sydney 109 27 167 55 61 11 16 13 4 8 2 3 1 477

g LH

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Sydn

ey M X700: Sydney 109 27 167 55 61 11 16 13 4 8 2 3 1 477

X720: SES LHD 91 9 40 231 16 5 39 2 10 4 1 2 1 4 455X740: WS LHD 58 7 3 4 191 34 1 2 3 1 2 306X750: NBM LHD 9 1 95 374 1 6 6 32 1 2 527

ater

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y tro X730: IS LHD 28 2 1 1 769 1 16 818

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X770: CC LHD 1 1 638 25 1 1 667

ural

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X800: HNE LHD 1 1 1 58 1463 18 2 91 1635X850: WNSW 36 1 5 850 33 1 926X810: NNSW 1 15 1 728 1 3 749

Regi

onal,

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Sydn

ey X840: MLHD 1 1 5 468 2 1 478

X820: MNC LHD 1 18 49 338 406X830: SNSW 1 1 2 155 159X860: FW LHD 54 54Grand Total 2686 1456 927 1328 2252 1128 1164 1112 1932 1214 803 633 574 284 56 17549Grand Total 2686 1456 927 1328 2252 1128 1164 1112 1932 1214 803 633 574 284 56 17549*% Retention 38% 41% 18% 17% 8% 33% 66% 57% 76% 70% 91% 74% 59% 55% 96%*Number of surgeries undertaken at LHD of residence / Total number of surgeries X 100 = % retention

# Data covers the period: 1/1/2010 to 31/12/2010 #Includes all patient stays (ie formal admission to formal discharge) where a surgical DRG was recorded using surgical partitioning based on version 5.2 AN-DRGs # LHD of residence of the patient is based on the SLA of the patient and the December 2010 boundaries

Questions for YOU!Questions for YOU!

A few questions from NSW Kids & Families about our future qrole in the NSW health system:

Q: In your view, what do you believe NSW K&F must achieve in the next 3 – 5 years?

Q: How can NSW K&F best support children and young people’s healthcare providers moving forward?

Q: How can we establish and always maintain strong and timely connections between evidence, policy and actual practice?

NSW Kids & FamiliesNSW Kids & Families...healthy, safe and well

THANK YOU