The Ryde Hospital Fracture Clinic sees 80 patients each Friday afternoon. It requires significant hospital resources, including 15 staff from multiple disciplines for around 5 hours per week. An audit found average patient waiting times were 81 minutes in 2015. Only 47% of patients surveyed were very satisfied with the service due to long waits, a poor environment, and lack of information. The #FixIt project aims to improve the clinic efficiency and patient experience by 25% within 12 months by enhancing the environment, reducing waits, and improving patient flow and information.

1. The Ryde Hospital Fracture Clinic is an
outpatient orthopaedic service that
typically sees 80 patients each Friday
afternoon. Demand has continued to
increase over time, with a 150%
increase in patient numbers since
2012.
The Fracture Clinic requires a signifi-
cant use of hospital resources, includ-
ing 15 staff members across multiple
disciplines for approximately five hours
per week. Many of these staff need to
manage Fracture Clinic patients in
addition to their regular workload,
such as radiologists who are required
to perform x-rays and scans for clinic
patients in addition to inpatients and
those in the Emergency Department.
An audit conducted in October 2015
found the average waiting time in the
Fracture Clinic was 81 minutes. A
satisfaction survey of 99 patients and
carers at this time found only 47% of
patients were ‘very satisfied’ with the
service provided, with several
complaints received by clinic staff. The
key reasons for this dissatisfaction were
long waiting times, a poor clinic
environment and no explanation of
what was involved in a visit to the
Fracture Clinic. The ineffective booking
process and lack of clinic governance
also caused dissatisfaction and
reduced morale among staff in the
Fracture Clinic.
To address these challenges, the #FixIt
project was established to improve the
clinic environment, reduce waiting
times and improve patient flow. It was
anticipated that improving the
efficiency of the clinic would also
reduce its impact on other areas of the
hospital during clinic times, such as
radiology services.
The ultimate aim of the project is
to improve the satisfaction of patients
and carers attending the Fracture Clinic
at Ryde Hospital by 25% within 12 months.
A full evaluation will be conducted in
December 2016, with measurement of
the following outcomes compared with
baseline results obtained in October
2015:
 patient waiting times
 patient and carer satisfaction levels
 completion and use of patient
streaming system
 number of patients who receive the
information sheet prior to their
appointment
 workplace attendance rate of the
Clinic Concierge.
More info at https://
www.aci.health.nsw.gov.au/ie/projects/
fixit
Ryde Fracture
Clinic Redesign
Metro South Health QLD
Innovation Culture
#FixIt: The Ryde Hospital Fracture Clinic
Redesign Project (featured on the NSW Agency for Clinical Innovation website)
Newsletter October 2016
Change Champions & Associates
Change Champions & Associates
Innovation Round Up
Summaries and links to
some of the interesting
innovations projects we
have gathered from
Australia and overseas
in 2016.
Inside this issue:
1
Hip Fracture Care
Clinical Standard
NSW Cancer Innova-
tions Conference
Presentations
2
Seminar Registrations
A Healthy Hospital is a
Happier, Safer and
More Productive Place
for Care
Call for Abstracts,
Consumer Carer
Engagement and Health
Literacy
3
Book Review—How to
Thrive in a Challenging
Job
New book by Kathryn
McEwen, Building Team
Resilience
4
Worth a Read (thought
leadership from
abroad)
5
Resilience at Work
Assessments + Sustain
Success On Line
Resilience Course
6
Seminar Presentations
available for download
Emotional Intelligence
7
Metro South Health Queensland
Innovation Culture
Keen to inspire a culture of innovation,
Metro South Health in Queensland has
established a Transformation and
Innovation Collaborative.
Its all about staff coming up with great
ideas for consideration by Executive
Planning and Innovation Committee
(EPIC.
Summaries of approved innovations
projects together with tools to help with
planning, implementation and evalua-
tion can be found at
https://metrosouth.health.qld.gov.au/
innovation/epic-approved-projects

2. The Australian Commission on Safety and Quality in Health Care, in collabora-
tion with consumers, clinicians, researchers and health organisations, has devel-
oped the Hip Fracture Care Clinical Care Standard and resources to guide and
support its implementation.
The Hip Fracture Care Clinical Care Standard aims to improve the assessment
and management of patients with a hip fracture to optimise outcomes and
reduce their risk of another fracture. It covers the care that patients with a sus-
pected hip fracture should be offered from presentation to hospital through to
completion of treatment in hospital, and also includes patients who sustain a
hip fracture while in hospital.
Additional resources include an Indicator Specification (a set of suggested indi-
cators to assist with local implementation of the Hip Fracture Care Clinical Care
Standard. Clinicians and health services can use the indicators to monitor the
implementation of quality statements, and support improvement as needed)
and fact sheets for clinicians and consumers.
Find out more at https://www.safetyandquality.gov.au/our-work/clinical-care-
standards/hip-fracture-care-clinical-care-standard/
If you missed the NSW Cancer Institutes, 2016 Innovations Conference, you can
download the presentations and posters at
https://www.cancerinstitute.org.au/about-us/events/innovations-in-cancer-
treatment-and-care/2016-innovations-conference
Hip Fracture Care Clinical Care
Standard (reproduced from On The Radar)
Page 2
Change Champions & Associates
On The Radar is an excellent
weekly summary of
research, publications,
reports, news and views
sourced and collated for
distribution by the Australian
Commission on Safety and
Quality in Healthcare
Subscribe at https://
www.safetyandquality.gov.a
u/subscribe/
NSW Cancer Institute—
Innovations Conference

3. Last Days for Early Bird Registration
Page 3
Change Champions & Associates
A Healthy Hospital is…. a Happier, Safer and More Productive Place for Care
12-13 October 2016, MCG, Melbourne, Victoria
This seminar showcases successful initiatives that have positively impacted on
quality, safety and performance by improving workforce and organisational
culture.
Become part of a positive future
Join our keynote presenters:
Bernie Harrison, Director, Improvement Academy, Australian Council on
Healthcare Standards
Prof David Watters OBE, University Hospital Geelong and Deakin University, VIC
Dr Victoria Atkinson, Group General Manager, Clinical Governance and Chief
Medical Officer, St Vincents Health Australia, VIC
Janelle Hearn, Principal Project Manager - Occupational Violence and Bullying
and Harassment Projects, Worker Health and Wellbeing, Health Service Programs
Branch, Department of Health and Human Services, VIC
Dr Mark O'Brien, Medical Director, Cognitive Institute
Kathryn McEwen, Managing Director, Working with Resilience
Ashleigh Smith, Human Synergistics Australia
Adj Prof Kylie Ward, CEO, Australian College of Nursing
HURRY—EARLY BIRD ONLY OPEN UNTIL MIDNIGHT 5 OCTOBER 2016
http://www.changechampions.com.au/program/
Preliminary_Program_26_9_2016.pdf
Improving Consumer and Carer Engagement in Health Care
2-3 March 2017, Gold Coast, QLD
Join us in a practical seminar to share the achievements of initiatives designed
to improve patient, consumer and carer engagement in healthcare.
The seminar will focus on two main themes, partnering with consumers and
health literacy.
DOWNLOAD THE CALL FOR ABSTRACTS AT http://www.changechampions.com.au

4. Catherine Lothian’s Book Review
How to Thrive in a Challenging Job
Page 4
Change Champions & Associates
People will always say I am too busy at work: but what does busy mean? How
urgent is the next task? I have always been a glass half empty person, this
concept I now believe is what will bring me down if I do not choose to see things
differently.
Before reading this book I was partly involved in investigating some complaints
at my workplace. The staff members involved were not engaged in their role in
these complaints and I was struggling with how I could get them to accept how
their words and actions impact our patients and families. What I was really doing
was questioning my own values.
This book has led me on my own journey of reflection and self-engagement,
change and sustainability. The author recommends progressing through the first
chapters and completing an initial assessment of your own resilience before
moving through the seven chapters dedicated to each component.
You can chose to work on as many aspects as you need or all of them and you
can revisit and review as your circumstances change. There are seven chapters
exploring the components of resilience: authenticity, purpose, adaptability, self-
care, support, energy and networks. Each chapter has exercises to prompt self-
reflection, case studies showing how others have felt and managed in circum-
stances and interesting ‘top tips’ and ‘quick quips’ that show how the author
and others have used these strategies in their work. This leads you into seeing
how the component will work for you in your own circumstance.
Resilience needs to be worked on and revisited from time to time as you grow
and change, as your work and home lives change. I will continue this journey,
looking at my own beliefs and value system as I move forward in my life and
work. I can now say that instead of the glass being either half empty or half full, I
can now see that the glass is refillable, I am in charge of the glass, I have the
power to change.
Catherine Lothian, Clinical Nurse Educator
Wyong Hospital NSW
Order your copy on line at http://workingwithresilience.com.au/product/building
-your-resilience-how-to-thrive-in-a-challenging-job
Kathryn McEwen
And Just Released by Kathryn McEwen
http://workingwithresilience.com.au/product/building-
team-resilience-how-to-sustain-optimal-performance-
in-challenging-work

5. What I learnt about disruptive co-production of the health and care system at
Stanford Medicine X.
https://www.linkedin.com/pulse/what-i-learnt-disruptive-co-production-health-
care-system-helen-bevan
NHS England Chief Improvement Officer, Helen Bevan’s blog, is a fascinating
consideration of the opportunities and realities of co-design and co-
production. Yes, we might all be working to break down the barriers between
patients, carers, clinicians, researchers and The System to co-design more
efficient care with better outcomes. But what is it all really about. Is it about
“what matters to you, (the patient) that matters to us (The System et al).
Should it not be about what matters to patients and their families? Helen
generously shares her epiphany about mobilizing patient leaders based on
Hahrie Han’s work on community organizing and social movement. She
outlines the types of activists that can deliver change.
Lean in Healthcare: Engagement in development, job satisfaction or
exhaustion
http://sciedu.ca/journal/index.php/jha/article/view/9970
This Swedish research team sought to identify to what extent lean tools (visual
follow-up boards, standardised work, 5S [housekeeping], and value stream
mapping [VSM]) promote working conditions for employees and managers in
healthcare organisations (outcomes: engagement in development, job satis-
faction and exhaustion), while considering the context (i.e., job resources and
job demands) and aspects of the implementation process.
Patient Activation Measure
https://www.england.nhs.uk/ourwork/patient-participation/self-care/patient-
activation/pa-faqs/
Patient activation enables people with the skills, knowledge and
confidence to choose to self manage to the extent that they are able and/or
wish to do so. It has been reported that patients who are involved in self
management achieve better health outcomes.
The Patient Activation Measure, currently being rolled out in NHS England is
reliable and validated. It can be used as a tailoring tool for measuring activa-
tion and as outcome measure.
Worth a Read….
Inviting Stories for our January 2017 Edition
Our readers are interested in
 Quality and safety
 Patient flow and
redesign
 Productivity
improvement
 Care of older people
 Leadership
 Integrated care
 Green hospitals
 Patient experience
 Health literacy
 Mobile technologies
Submit your story and
pictures to
info@changechampions.com.au
Are you excited about the
achievements of your
innovation project?
We are now inviting
submissions of stories of
around 150-300 words for our
January 17 newsletter.
Picture, links to other websites
etc are welcomed.Page 5
Change Champions & Associates

6. Looking for strategies to improve productivity in a high pressure, turbulent
environment? Working where there is just no end to change and you are
exhausted at the thought of more?
Here is an opportunity for individuals, leaders and teams to take a good look at
their resilience through the Resilience at Work, R@W, assessments. You will also
receive feedback or facilitation to make the changes necessary to not only
survive, but being to thrive in the workplace.
Four highly flexible assessment offerings based on the 7 validated R@W
competencies that can be adapted to your circumstances or environment, re-
gardless of where you work.
 Individual R@W assessment + report with a 40 minute coaching session
 Leader R@W self assessment + report with a 40 minute coaching session
 Leader R@W 180 degree assessment (choose team members to give their
feedback) + report with a 40 minute coaching session
 R@W Team Assessment (up to 15 members) + report with up to 3.5 hr facili-
tated action planning session - email info@changechampions.com.au for
a surprisingly affordable quote for the R@W Team Assessment
For more info about, R@W, Download the Flier and check out the pricing at
http://www.changechampions.com.au/program/R_WToolkitBrochure.pdf
Also available for Corporate Events, Open Days, Induction and Orientation Events
etc
New Resilience at Work Assessments
Page 6
Change Champions & Associates
Sustain Success Online Resilience Program
Leap into 2017 on the front foot
If you are under the pump and not sure that you are
managing as well as you could, this online program, Sustain Success, will help you
to build your resilience at work and
beyond.
Best of all its easy! There is no need to ask your manager for permission for time off
to attend a course. No need to feel embarrassed about your capacity to cope. No
need to consider withdrawing or watering down decision making because you feel
that your ability and your confidence are living on different planets.
Developed by acclaimed, organisational psychologist, Kathryn McEwen, here's an
opportunity to reflect on the way work pressure impacts on the way you function
at work and beyond. You can complete the program, in your own time and at
your own pace.
Better, you will be supported by a Resilience at Work Accredited coach. This is not
a one size fits all program. One 75 minute coaching session is included in the
program. Coaching sessions are confidential, individualized and conducted by
telephone. Book online at http://www.changechampions.com.au

7. Presentations from Change Champions seminars available for
download at http://www.changechampions.com.au
Page 7
Change Champions & Associates
Preventing Unnecessary Hospital Emergency Department
Transfers for Older People
5-6 May 2016
The Park Event Space, Lakeside Dr, Albert Park,
Melbourne, Victoria
Over 115 delegates from emergency departments, aged care
inc RACFs, primary care networks, general practice, academics
and community care attended. Everyone was in the room.
Most presentations available for download.
The Hospital After Hours
23 May 2016
Sir Stamford Hotel
93 Macquarie St Sydney, NSW
An excellent seminar with high quality practical presentations.
Most presentations available for download.
Emotional Intelligence Assessments
with Coaching
Wondering about your effectiveness as leader. Keen to know how
your emotional intelligence at work stacks up in comparison with
other leaders. Perhaps you'd like to know how important your emo-
tional intelligence is to your team.
Well, here's your chance to discover your potential. Emotional intelli-
gence assessments now available. These are completed on line at
the results are strictly confidential. Order yours now
Individual, 180˚, 360˚ or Team
Book yours now at http://www.changechampions.com.au

8. About Change Champions & Associates
Change Champions & Associates
PO Box 302
Kew VIC 3101
M: 0467635150
E: info@changechampions.com.au
W: www.changechampions.com.au
Innovate with us on our Facebook page
or on Linked In
Change Champions & Associates designs and produces
seminars for health professionals. We also showcase
leadership development, practice development, service
and quality improvement initiatives across the spectrum of
health and interrelated facilities and the across the
continuum of care.
We are a small coalition of the committed working with our
partners to deliver a great seminar experience. We work for
cost recovery, rather than for profit.
In collaboration with our consultants, we aim to provide
valuable and practical learning experiences for a broader
range of professionals from all sectors. These opportunities
will include workshops, in houses at your facility no matter
where (we are strong supporters of those in rural and remote
areas), group and individual coaching sessions delivered by
accredited professionals.
By the end of 2016, our website will be redeveloped to en-
able a more interactive relationship with our supporters,
streamline our seminar registration process and provide
better functionality to enable networking and the sharing of
innovation projects in Australia and New Zealand
and beyond.
CALL FOR ABSTRACTS
Topics of interest include, but are not limited to:
 Initiatives that are whole of system, whole of hospital, whole of divi-
sion/ department/ward etc and/or streamline discharge and/or flow
across transitions of care
 Improving operational management (especially where changes
have resulted from partnering with consumers) - Redesign - Co design
and patient journey improvements - Lean
 Decision support
 Contingency planning, protocols including scalability of escalation/
surge responses
 Forecasting and modeling to predict variations in flow
Submit your abstract at http://changechampions.com.au
Improving Patient Flows: Towards Sustainability
16-17 March 2017, Gold Coast, Queensland