Concurrent Streams

Concurrent Session Streams

The 2015 NSW Rural Health & Research Congress included six themed Concurrent Streams:

1. Aboriginal health – Closing the Gap / opening the connections.
This stream will showcase projects/presentations that explore current issues/successful programs in Aboriginal health in rural and remote communities. Demonstrating progress on strategies to Close the Gap in health outcomes, and cross service integration.

2. Mental health/drug and alcohol – a focus on recovery
Speakers will focus on mental health and drug and alcohol issues facing rural communities. Examples include the impact and treatment of ICE (Methamphetamine) addiction, alcohol abuse and treatment of trauma related mental health problems. Speakers will explore transition from inpatient to community care.

4. Partnerships and integrated care – connecting rural people and services
An opportunity to showcase initiatives and programs that have improved how rural services work together. This stream will emphasise how these collaborations have improved care for consumers.

3. Social determinants of health in the bush – the changing landscape
This stream will explore social and demographic related influences on the health of rural communities with a particular focus on changes that are occurring or likely to occur and their impact on health outcomes. Presenters will look at the equitable delivery of services based on need.

5. Rural health research in practice – connecting for change
Speakers will demonstrate how their research has or is likely to contribute to improved practice and potential change in rural health care settings. Examples of collaboration between researchers and clinicians and across different settings.

6. Connecting through transfer - right care, right place, right time
 This stream will include presentations that look at how we transfer information, expertise and patients between services separated by great distance. Topic areas will include Telehealth, eHealth innovations and patient transfer systems.

Below are the presentation summaries for the sessions held in each theme:
Please email for more information.

1. Aboriginal health – Closing the Gap / opening the connections.

Session Title:
An intervention for young people with multiple and complex needs: preliminary results.
Speaker: Alice Knight, National Drug and Alcohol Centre, UNSW NDARC

Presentation Summary: Young people with multiple and complex needs (YPMCN) experience substantial harms associated with multiple risk factors. Young Indigenous Australians are disproportionately represented amongst this group. Despite this, very little is known about effective interventions. This paper aims to: i) describe a community-based intervention for YPMCN that is based in Armidale; ii) describe an evaluation of the program; and iii) report preliminary results from the evaluation.

Session Title: Tamworth Hospital Closing the Gap videos, connecting patients and staff in a regional centre.
Speaker: David Willis, Chief Radiation Therapist, North West Cancer Centre, Tamworth Hospital. Hunter New England Local Health District

Presentation Summary: This project describes innovative videos that aim to give Aboriginal patients a better understanding of specific regional health services, and give staff in those services a better understanding of their Aboriginal patients. It exemplifies the collaboration of health sectors with the local Aboriginal Community to achieve shared goals.

Session Title: Sugar SNAP: Closing the Gap - Supporting the Needs of Aboriginal People (the Dubbo Aboriginal Diabetes Project)
Speaker: Anne Field, Manager, Performance and Service Development, Integrated Primary Care and Partnerships, Western NSW Local Health District

Presentation Summary: Despite a clear evidence base detailing how to prevent, manage and treat Type 2 diabetes; incidence and prevalence continues to rise - particularly amongst Aboriginal people, who are three times more likely to have diabetes and seven times more likely to die from it. This is magnified in rural and remote areas. A partnership between the Bila Muuji Aboriginal Corporation, WNSWLHD and the former WNSWML was formed, and the "Sugar SNAP: Closing the Gap" project was established. Following extensive consultation with key stakeholders, a flexible integrated care model was developed which includes a focus on completion of the diabetes Cycle of Care. Research has also been conducted which will be used to further refine the existing model to better meet patient needs. Early results include: - Formation of a Diabetes Network to upskill Aboriginal Health Workers (23.8% increase in self-reported confidence) - 46% increase in NDSS registrations - Increase in completion of Diabetes Cycle of Care from 15.5% to 20.9% in first two practices - Four Aboriginal Health Workers and one research academic presented at National Rural Health Conference in Darwin.

Session Title: Let's Talk Tucker: Nutrition Resource Manual for Aboriginal Health Education Officers
Speaker: Jodie Peace, Dietitian, Tamworth Community Health Service

Presentation Summary: Let’s Talk Tucker (LTT) Nutrition Resource Manual aims to empower Aboriginal Health Education Officers (AHEO’s) to deliver preventive nutrition information to communities. This presentation will explore the partnership between Aboriginal Health and Dietetics to develop a nutrition initiative based on the expressed needs of AHEO's within the rural sectors of the HNELHD. LTT is a 19 chapter nutrition reference manual for staff. It improves accessibility of accurate nutrition information, and supports reach of nutrition education to communities acting as an individual and workforce capacity building strategy in the rural context.

Session Title: Maranguka Bourke Community Hub: co-location as an answer to a fragmented service system in Bourke NSW
Speaker: Lorna McNamara, A/Director, Child Protection and Violence Prevention, NSW Kids and Families

Presentation Summary: Bourke's service system is fragmented with limited reach within the Aboriginal community. Through co-locating services and building local connections with the Aboriginal community and existing service providers, NSW Kids and Families, UnitingCare Burnside and the Department of Family and Community Services is working together to deliver more targeted, integrated and accountable services to Aboriginal children and families in Bourke.

Session Title: Aboriginal stories of diabetes care in Dubbo
Speaker: Emma Webster, Senior Lecturer Rural Research, University of Sydney School of Rural Health

Presentation Summary: The Dubbo Aboriginal research team is a group of five researchers working together to study Aboriginal people’s stories of diabetes care in Dubbo as part of a larger Integrated Care trial. The team bring experience and qualifications in Aboriginal health, nursing, social services, diabetes education and research. Between them they have over 60 years experience in health. They represent Dubbo Regional Aboriginal Health Service, Marathon Health, Western NSW Local Health District and the University of Sydney.


2. Mental health/drug and alcohol – a focus on recovery

Session Title: Mind the Gap: building regional trans-disciplinary teams to address the mental health treatment gap in palliative care
Speaker: Julianne Whyte, Chief Executive Officer, Amaranth Foundation

Presentation Summary: Mental illness in the terminally ill is underdiagnosed and undertreated – it’s a “Treatment Gap”. Responding to the complex mental health needs of these people requires specialist skills and knowledge. Trans-disciplinary teams, that routinely screen and treat mental illness, as opposed to traditional multi-disciplinary teams, are the answer for rural communities.

Session Title: What does a multidisciplinary approach look like to a drug and alcohol patient
Speaker: Lynette Bullen, Senior Drug and Alcohol Worker, Involuntary Drug and Alcohol Treatment Unit

Presentation Summary: The Involuntary Drug and Alcohol Treatment Unit (IDAT) deliver services throughout all of NSW. IDAT is an involuntary program for patients who are deemed to have severe drug and/ or alcohol dependency with complex health issues. The Drug and Alcohol Treatment Act of 2007 provides for a secure facility for up to 84 days as an inpatient. The IDAT model of care has been developed using a multidiscipline framework, including medical, nursing and an allied health team approach.
 This is a new service delivery model for the drug and alcohol field, in this presentation the IDAT team will demonstrate a case example of a "typical patient" and their journey of referral, assessment, treatment and follow up back into their community and the importance of using the allied health team approach in an inpatient and outpatient settings. This IDAT model of care focuses on the patient’s dependency and its impact on their health and wellbeing.

Session Title: Did it ‘Break the Cycle’? The impact of community led programs which aimed to prevent drug and alcohol harms in two remote NSW communities.
Speaker: Anthony Shakeshaft, National Drug and Alcohol Centre (NDARC)

Presentation Summary: “Bourke tops list: more dangerous than any country in the world.” This questionable 2013 headline highlighted one salient truth: the often forgotten issue of rural drug and alcohol abuse and its relationship to crime and poverty. This evaluation used routinely collected data from 2002-2014 for Bourke and Brewarrina to estimate the overall impact of a suite of programs aimed at reducing D&A harms.

Session Title: Yarning with Aboriginal pregnant women and mothers about quitting – increasing the smoking cessation skills of health professionals
Speaker: Cherie Butler, Analyst, NSW Kids and Families

Presentation Summary: In NSW in 2012, 49.9% of Aboriginal women smoked in pregnancy, compared to 9% of the non-Aboriginal population. Decreasing smoking in pregnancy will achieve short, medium and long-term health gains for Aboriginal women, their children and families. The NSW Kids and Families Yarning about Quitting blended learning package was developed to build the capacity of staff to provide effective and culturally appropriate smoking cessation support to Aboriginal pregnant women and mothers. Initial results from delivery of the training in regional and rural Local Health Districts will be presented.

Session Title: Collaborating on an integrated model of care for the treatment of co-occurring mental health and substance use disorders: an innovative approach designed by clinical services
Speaker: Catherine Foley, Psychologist, MNCLHD Drug and Alcohol Service, Coffs Harbour

Presentation Summary: This presentation will show how clinicians from separate mental health and drug and alcohol services operationalised change from parallel to integrated treatment in a rural residential mental health rehabilitation unit. It will conclude with the principles and practices that can be replicated in other services.

Session Title: Healthy Mind and Body: Headspace and Dietitians connecting to improve the health and well being of young people with disordered eating in rural NSW
Speakers: Deanne Harris, Dietitian Tamworth Rural Referral Hospital, Hunter New England Health

Presentation Summary: Nearly one million Australian's live with disordered eating in 2015. Early identification and intervention leads to improved outcomes, however young people are often reluctant to access mainstream health services.A partnership between local dietitians and headspace Tamworth has led to improved identification and access to disordered eating treatment for young people.

3. Partnerships and integrated care – connecting rural people and services

Session Title:
Help me to say NO - Residential Aged Care Facilities (RACF) Education and Quality Improvement Project
Speaker: Jenny Zirkler, Executive Care Manager, Nambucca Valley Care

Presentation Summary: This initiative provided support to aged care nurses in the use of clinical tools to improve the health care experience of residents, improve clinical communication and decrease avoidable hospital presentations. Aged care nurses were empowered to be professional advocates and assist residents in choice and decision making especially at end of life.

Session Title: A public-private partnership model for a rural physiotherapy service
Speaker: Kylie Marquart, Finely Hospital HSM, Murrumbidgee Local Health District

Presentation Summary: Description of a project commissioned to investigate the viability of a private Physiotherapy service to provide services to the communities surrounding Finley NSW, given service gaps, population demographics and the prevalence of obesity and osteoarthritis.

Session Title: Delivering an integrated system of care in Western New South Wales
Speaker: Julie Cooper, Director of Integrated Primary Care and Partnerships, Western NSW Local Health District

Presentation Summary: The Western NSW Integrated Care Partnership is transforming its rural and remote health system into an integrated system of care to improve access and health outcomes, with a particular focus on improving the Aboriginal health gap.
The Partnership is taking a whole of system approach to service integration including:
• Developing innovative models of care with a focus on risk stratification and GP-led multidisciplinary care teams
• Strengthening clinical leadership across primary and specialist care settings
• Shared service and care planning across local health organisations
• IT support to enhance clinical decision-making across care settings.

Session Title: Innovative approaches to delivering oral health services by the Royal Flying Doctor Service
Speaker: Lara Bishop, Manager of Research and Policy, Royal Flying Doctor Service

Presentation Summary: Poor oral health can negatively impact speech, sleep, productivity, self-esteem, psychological and social wellbeing, and relationships. Fly-in fly-out, mobile and outreach models are an effective way to provide oral health care to remote/rural communities. RFDS showcases two programs that delivered 266 fly-in dental clinics to 1,795 residents in 2013/14.

Session Title: Against all Odds!  A Chronic Palliative Integrated Approach – Inspiration, Integration and Collaboration.
Speaker: Michelle Baird, Chronic and Complex Care Nurse Practitioner, Western NSW LHD

Presentation Summary: A case study demonstrating “A Chronic Palliative Integrated Approach” in managing the palliative phase of patients living with COPD in rural Western NSW.  It explores horizontal and vertical integration of an interdisciplinary service delivery, spanning the continuum of care for patients with COPD, highlighting care coordination, communication, access and patient centred care.

Session Title: Mid-Western Live Smart  Healthy Communities Alliance
Speaker: Kate Egan, Manager Primary and Community Health, Mudgee and Gulgong Health Services

Presentation Summary: Mid- Western Live Smart aimed to improve the nutrition and physical activity status of the community using a capacity building approach to sustainably embed healthy lifestyle programs and behaviours within the community.  A collaborative Healthy Communities Alliance was formed using a whole of community approach to prevention and sustain the positive outcomes of the Live Smart project.

4. Social determinants of health in the bush – the changing landscape

Session Title:
Improving the management of refugee patients in Australian hospitals
Speaker: Lindsey Ross, Final Year Medical Student, University of Notre Dame Australia

Presentation Summary: Refugees often have complex health needs that challenge the Australian health care system. We sought to determine the knowledge and attitudes of nursing, midwifery and allied health staff regarding the management of refugee patients in regional and urban settings. This research provides direction for improving services for this demographic within our community.

Session Title: Healthy Kids Bus Stop: overcoming barriers to care in the bush
Speaker: Samantha Adams, Research Officer, Royal Far West

Presentation Summary: The Healthy Kids Bus Stop is a travelling comprehensive screening program for rural children. A large number of parents participating in the program have failed to recognise their child’s health and developmental issues. The program overcomes this problem by providing families with access to health professionals and referral pathways.

Session Title: Healthy Futures Network
Speaker: Anne Williams, Integrated Care Manager, HealthWiSE New England North West

Presentation Summary: A cross–sectoral and cross-departmental approach is essential to addressing the Social Determinants of Health (SDoH). A partnership of local Councils, primary health care and the local health district formed to discuss issues impacting the health of local populations and to increase community and organisational knowledge of the SDoH.

Session Title: Physical and mental health of informal caregivers in northern regional New South Wales
Speaker: Peta Ryan, Research Assistant, The University of New England

Presentation Summary: Rural carers are suffering from a lack of funding and supports. A survey of rural carers was conducted and mental and physical health is a grave concern for the population. If appropriate intervention does not take place the burden of the carers will fall back to government and society.

Session Title: Intimate partner violence and self-reported health: A comparison of women living in metropolitan, regional and rural areas.
Speaker: Gina Dillon, Researcher, University of New England, School of Rural Medicine

Presentation Summary: This study used data from the Australian Longitudinal Study on Women’s Health to investigate self-reported physical and mental health for a cohort of over 14,000 women.  The health of women with a history of intimate partner violence (IPV) was compared to women without a history of IPV.  Additionally, amongst IPV affected women, comparisons were made between the self-reported health of women living in metropolitan, regional and rural areas.

Session Title: Exploration of Social Determinants of Self Harm...preliminary findings from the ARCHER Study
Speaker: Karen Paxton, ARCHER Study Manager, School of Rural Health

Presentation Summary: Preliminary analysis of data from the ARCHER Study cohort explores the connections between social determinants of health and self harm behaviour in rural young people.  Among the ARCHER participants self-harming behaviours were shaped strongly by cultural background. Early analysis suggests community connections may provide some protective barriers to self-harm.

5. Rural health research in practice – connecting for change

Session Title: Identifying Approaches to Reduce Q Fever in NSW
Speaker: Tony Lower, Director, Australian Centre for Agricultural Health & Safety (University of Sydney)

Presentation Summary: This study has used a mix of individual interviews and focus groups across NSW to determine knowledge of the risks, experiences and preventive options available for sheep, cattle and dairy farmers. A key focus is to ascertain how to improve communication with producers to reduce Q Fever risks.

Session Title: Creating rural allied health leadership structures using district advisors
Speaker: David Schmidt, Physiotherapy District Advisor, Southern NSW Local Health District

Presentation Summary: This presentation explores the processes and outcomes of implementing a District Advisor model of Allied Health leadership into a rural local health district.  In 2013 Southern NSW LHD integrated Allied Health District Advisors into their leadership structure. Advisor positions included Dietetics, Occupational Therapy, Physiotherapy, Speech Pathology and Social Work and were instituted to provide strategic leadership across the district. This research sought the views of key stakeholders - the advisors, clinicians and managers to describe this leadership model and its outcomes.

Session Title: Antibiotic Prescribing in the Emergency Department
Speaker: Girish Swaminathan, Chief Pharmacist, Bega District Hospital

Presentation Summary: This study gave insight into prescribing practices in a rural hospital Emergency Department, which is mainly managed by locum doctors. This information will help to target interventions that could lead to practice improvement. The study site has no onsite Infectious Diseases physician or Antimicrobial stewardship pharmacist.

Session Title: Exploring Patient Safety in Rural New South Wales
Speaker: Vicki Parker, Co-joint Professor of Rural Nursing, Hunter New England Local Health District and the School of Health University of New England

Presentation Summary: This presentation reports on the results of the first two phases of a three-phase study examining patient safety in rural areas. The study is the first Australian study to identify patient safety factors specific to the rural Australian context and make recommendations to improve patient safety based upon those factors.

Session Title: Engagement as a Catalyst: Developing an Evidence-Based Toolkit for Planning Rural and Remote Maternity Services
Speaker: Margaret Rolfe, Biostatistician, University Centre for Rural Health

Presentation Summary: The Australian Rural Birth Index study developed an evidence-based Toolkit for assessing and planning rural and remote maternity services. This presentation describes the engagement strategies used to translate our research findings into a practical tool for use in maternity service planning.

Session Title: Autism  Diagnosis in a Rural Community: Are There Opportunities for Improvement?
Speaker: Catherine Bourke, Social Worker, Mudgee Health Service

Presentation Summary: Diagnosis of autism at the youngest possible age can reduce family stress, provide earlier access to intervention services and lead to better developmental outcomes for children with autism. Using parent interviews and focus groups with health and early education professionals, this research project highlights opportunities for improvement in the autism diagnostic process for young children in a rural community.

6. Connecting through transfer - right care, right place, right time

Session Title: Telepaediatrics: Bridging the gap in knowledge and service delivery in rural and remote NSW
Speaker: Piumee Bandara, Telepaediatric Program Manager, Royal For West

Presentation Summary: This presentation will discuss findings from a telepaediatric pilot program delivered to children in rural and remote NSW with developmental-behavioural problems. Findings from the pilot indicate videoconferencing is a successful medium for delivering paediatric therapy for local doctors and families and builds therapeutic relationships between paediatricians and doctors.

Session Title: Caring for Country Kids
Speaker: Helen Stevens, Paediatric Clinical Nurse Consultant, Hunter New England Health / Northern Child Health Network

Presentation Summary: This project will support implementation of the particular paediatric components of the Guide to Paediatric CERs and Beyond Facility Escalation Documentation contained within PD2013_049 Recognition and Management of Patients who are Clinically Deteriorating. Implementation will provide point of care support and timely escalation in rural hospitals which is stepped and integrated.

Session: Addressing the burden of disease: Is it possible to create and implement a structured Cardiac Rehabilitation program in a small rural village, which is effective and meets the expressed needs of clients
Speaker: Barbara Turner, Health Service Manager, Menindee Health Service, Far West Local Health District

Presentation Summary: Circulatory disease is identified as the leading cause of death for the Far West Local Health District. Access to Cardiac Rehabilitation is severely reduced for people living outside the major town of Broken Hill. This mixed methods study evaluated the implementation of a Cardiac Rehabilitation program in a small rural village in Far Western NSW.

Session Title: Rheumatology Rural Outreach Project
Speaker: Ainslie Cahill, Chief Executive Officer, Arthritis Australia & Manu Arora, Arthritis NSW Rural Outreach Education Program

Presentation Summary: Following identification of sub-optimal diagnosis and treatment of chronic rheumatological conditions, Arthritis Australia and the Australian Rheumatology Association provide clinical support and education among selected communities and health service providers in regional NSW. The project achieved significantly improved access to treatment and improvements in education and awareness.

Session Title: Connecting with rural generalist nurses through a needs-based eLearning program to support and enhance excellence in patient care
Speaker: Maureen Winn, Senior Program Officer, Health Education and Training Institute (Nursing & Midwifery Portfolio)

Presentation Summary: HETI has worked with LHDs and rural expert nurses to develop a needs-based eLearning program to support the role of the rural generalist nurse. Five areas were identified: Mental Health, Paediatrics, Aged and Palliative Care and Comprehensive Assessment. The program uses a variety of learning methodologies, including an innovative game format to address the challenges of comprehensive assessment.

Session Title: Cerebral Palsy Hip Surveillance: A Virtual Clinic Model
Speaker: Karen Height, Service Manager, Kaleidoscope Paediatric Rehabilitation Service (KPRS)

Presentation Summary: The Cerebral Palsy Hip Surveillance (CPHS) Service provides coordinated hip surveillance for children with Cerebral Palsy (CP) across Northern Child Health Network (NCHN) via a virtual clinic model which prevents un-necessary face-to-face appointments, reduces associated costs to the family and health system and results in better health outcomes