Author: Grace DeGrazia
Late in 2020, AWH identified a need to implement a team of staff at the main entrances to our facilities, to screen members of the community who needed to enter the hospital for scheduled appointments (for example radiology, Breastscreen) and to visit patients. The ever changing rules regarding access to the hospitals under the COVID-19 restrictions provided significant challenges for the ward areas and this group of staff would significantly relieve the pressure in those areas.
A small team of concierge staff were initially employed to attend the front reception and emergency entrances at both Albury and Wodonga Campus. This team of staff has tripled in size in the last 12 months, and they now work across multiple other areas, for example, the Vaccination Hub, Maternity and Day Procedure Unit in Wodonga. The staffing requirements and location needs are, like the environments we currently work in, constantly expanding.
The primary role of the concierge staff is to ensure high quality customer service is provided to hospital visitors, patients and staff by offering assistance with access queries, QR coding, directions and general hospital information as required.
The staff who work in this team have widely varying backgrounds – many are school leavers looking for work during their gap years, others are at university and due to the transition to online learning, had availability to work. Some are business owners and employees who were suddenly unable to work due to forced lockdowns and business closures. Despite the varied backgrounds and levels of experience, this team works together seamlessly.
The managers of these staff are incredibly proud of the development this team has shown, and continue to show, every day. They have become an invaluable service that Albury Wodonga Health provides to the local community, ensuring we have measures in place to keep our staff and the community, as safe as possible in these ever changing times and we are very grateful for their persistence and professionalism.
COVID-19 Care for the Culturally and Linguistically Diverse Community Project
Authors and contributors: Emma Horsfield, Clinical Education Manager, AWH; Danny Baxter, MHLD; Leanne Smedley, Gateway Health,
Clement Birori & Sarah Mutela, Bi-cultural workers;
Jodie Farrugia & Roberta Baker, AWECC.
This project was focussed on identifying and addressing the COVID-19 care needs of the Albury Wodonga CALD community through culturally appropriate engagement and collaboration. Project Overview
- Improve service delivery to CALD community (particularly those who speak Swahili/Kinyarwanda) by understanding the enablers and barriers to COVID-19 care
- Build sustainable trust relationships between health and community services and Congolese community
COVID-19 testing clinic visits
- Employ bi-cultural project workers from Congolese community
- Increase organisational knowledge of specific needs of Congolese community in relation to COVID-19
- Culturally appropriate engagement with CALD community to improve community understanding and access to COVID-19 information, testing and vaccination
- One on one bi-cultural worker home visits / visits to English classes at local TAFE
- Informal small group community/ health service meetings
- Increase knowledge of testing processes and sites
- Bi cultural worker and AWH staff visits to AWH -Wodonga, Lavington, Albury and Central medical group clinic sites
Bi-cultural project workers visits to community members homes (culturally appropriate engagement)
- over 500 masks distributed to community members during the first month of the project, further mask distribution during project.
Topics discussed include:
Bi-lingual COVID-19 Information VideosTWELVE Bi-lingual "COVID-19 common questions and answers"
- Information about COVID-19
- How, when and why to get tested
- Correct use of masks
- When, where and how to isolate
- Assistance available during isolation
- COVID-19 Vaccination
videos were developed during the project. Videos utilise English, Swahili, Nepali and Kinyarwanda language Videos shared via WhatsApp, AWH, Gateway health and AWECC Social Media sites.
Community gatherings with project teamSIX Face to face meetings:
Culturally appropriate gatherings where Congolese leaders, elders and youth met with project team members to share food and discuss COVID-19 and ask/ answer questionsCALD Community Knowledge Gap SurveySurvey 1: November 1 - 14, 2020.50 one on one interviews
Findings; 85% not worried about COVID, Most not worried because they do not believe COVID exists, 90% would get COVID test - from that 90%, 50% said they will get tested but only because of work requirements, no one knew the different types of masks or how to use masks correctly.Survey 2: April 1 - 21, 2021.60 one on one interviews
Findings; all interviewees verbalised sound understanding of COVID-19, knew how to access COVID test and were willing to do so if required, 20% prepared to have vaccine now, 80 % vaccine hesitancy.Other Project Activity
Key Project Outcomes
- Project team presentations to AWH Person Centred Care Committee, Consumer Advisor Committee.
- Project team attended Albury Wodonga Multicultural Interagency Network Meeting to share key AWH COVID-19 messages
- Attendance at AWH COVID-19 Vaccination Communication Strategy meeting
- Bi-cultural worker site visit and tour of AWH Albury campus
- Engagement with AWH Disability Liaison Officer
- Ongoing engagement with AWH Vaccine Clinic - eg. tours of clinic organised by AWH Planning and Liaison team
- Establishment of sustainable trust relationships between AWH, Gateway Health and Congolese Community Members
- CALD community able to access credible COVID-19 information
- Public Health directives being followed by CALD community eg. wearing masks correctly, attending testing clinic when required
- CALD community uptake of COVID-19 vaccine program - as of August 4, 2021, 191 COVID-19 vaccines have been administered to CALD community members.
Respiratory Protection Program
Author: Sarah White, Respiratory Protection Program Project Manager
In response to the COVID-19 pandemic, in late 2020 the Department of Health required that health services implement a Respiratory Protection Program to minimise the risk of respiratory hazards to health care workers, such as infectious agents and diseases.
A key feature of the Respiratory Protection Program is the “fit testing” of specific respiratory protective equipment such as N95 or P2 respirators to ensure each health care worker knows which styles offer the most appropriate levels of protection against airborne infectious diseases. In line with Department of Health guidelines recommending quantitative fit testing as the preferred methodology, AWH obtained 6 AccuFit 9000 machines for the purpose of fit testing.
Due to the specialised equipment and knowledge required to implement a Respiratory Protection Program, AWH took on a regional leadership role, assisting 5 surrounding health services to implement their programs. AWH hosted a series of training days presented by occupational hygienists to train staff from both AWH and surrounding health services in the use of the AccuFIt equipment and the protocols of fit testing N95 and P2 masks. Staff from Beechworth Health, Northeast Health Wangaratta, Alpine Health, Corryong Health and Tallangatta Health attended alongside Albury Wodonga Health staff.
Fit testing of health care workers commenced in January 2021 at AWH with those working in high-risk areas such as COVID swabbing, Emergency, Intensive Care and Theatre targeted in the initial roll out. To date over 900 fit tests have been done at AWH. During this time key staff from the AWH Respiratory Protection Program have also travelled to our affiliated cluster health services to provide training, equipment and mentoring to allow these health services to successfully launch their fit testing programs.
Moving forward, AWH is participating in planning activities with the Department of Health to determine how fit testing should be implemented as an annual requirement for health care workers, including additional education and training for those who are required to use respiratory protection devices in their workplaces.
Virtual Visitor Program
Author: Dr Chi Li, Consultative Palliative Care Physician
Mr A knew that he only had a short time left to live. His prostate cancer had spread to his bones, causing significant pain and bone marrow failure. The palliative care team was able to treat his pain, but there was nothing they could do about the hospital visiting restrictions and the hard border closures brought on by the latest COVID-19 pandemic. As he lay dying in Wodonga Hospital, all Mr A wanted was to see his two daughters again before he died, but they were not going to make it in time – one lived on the other side of the country in Perth, while the other lived on the other side of the world in London.
The Virtual Visiting Program (VVP) was established in the early stages of the COVID-19 pandemic in response to the suffering experienced by patients like Mr A.
Unfortunately, even as #SocialDistancing and #StayHome #StaySafe campaigns helped to flatten the curve of daily case numbers, it also flattened the spirits of our patients and their loved ones.
While the dedicated staff at Albury Wodonga Health are able to treat physical symptoms, they are often unable to relieve the distress and loneliness associated with not receiving visits from family and friends.
Recognising the crucial role that visitors play in promoting the health and wellbeing of our patients during their hospital admission, palliative care physician Dr Chi Li and nurse unit manager Leanne Wegener developed the VVP so that our inpatients could still spend time with their loved ones, while at the same time minimise the risk of spreading the virus.
Leanne reflected: “The current visitor policy under COVID protocols has drastically changed the way many patients are able to interact with their supports. This may manifest as a cause for concern in a number of ways: one being social isolation and its negative impact on mental health; another is the reduced opportunity to discuss issues and decisions regarding the patient’s care.”
Each “virtual visit” involves using telehealth technology to connect patients with one or more family member and friends. Most of the “virtual visits” take place on the same secure online platform (Health Direct) that our patients use to attend telehealth outpatient clinic appointments.
Feedback from patients and families who have participated in VVP have been overwhelmingly positive. After participating in the VVP, one of our patients stated: “It reassures my family at home that I’m OK and at the same time fills in some time for me when visitors are a no go.”
Some patients have received multiple “virtual visits” during their admission through the VVP. Others have asked to participate in the program again when they are readmitted to hospital. The VVP even helped one patient host a group “virtual visit” with his many grandchildren living in different countries and across various time zones! Another patient was able to participate in the wedding of a family member with the help of the VVP – an important family event that they would otherwise not have been able to attend as a result of their hospitalisation.
The participation of local medical student volunteers from UNSW Medicine Rural Clinical School Albury Campus has been vital to the success of VVP. The student doctors facilitate each “virtual visit” by working with ward staff to identify appropriate patients for the program, coordinating with family and friends to set up the visit, as well as providing technical support during the video call – this is especially important for patients with cognitive or sensory impairments. Some patients have had no one to call – but nevertheless asked to participate in the program, as they enjoyed the visits from the students.
UNSW Rural Clinical School medical student Yi Yin Tan reflects on her experiences as a VVP facilitator over the last two years: “To help patients stay socially connected in hospital, we strive to find solutions around various challenges presented by illness, communication difficulties and everchanging levels of COVID restrictions. VVP is all about providing that human connection where we need it most… In building connections with patients over multiple hospital admissions, I’ve found great meaning in my involvement with the program over the months.”
Sincere thanks to our patients and families who have participated in the VVP over the last two years; to the medical student facilitators who have been the key to the program’s success; to Sally Squire (Director of Pandemic Response at Albury Wodonga Health) and Dr Mark Norden (Director of Medical Education at UNSW Medicine Rural Clinical School Albury Wodonga Campus) for their leadership and support; and to members of the VVP steering committee (Beth Sainty-Gale, Brett Pressnell, Jacinta Ducat, Shaun Thurling, Victoria Bryant and Corinne Antonoff) for your hard work and guidance.
The VVP is currently being piloted at Wodonga Hospital. It is hoped that the program will be expanded to other parts of AWH and extended beyond the pandemic to help promote the psychosocial wellbeing of our hospitalised patients and their family and friends.