Chief Executive COVID-19 Update: 16 September

Message from the Chief Executive

As of today, we have:

• Four COVID-19 positive inpatients, none of whom are in ICU.
• Six employees with COVID-19.
• 27 employees in precautionary quarantine.

Melbourne has moved from Stage Four to the ‘First Step’ of the roadmap for reopening, with modest changes to allow more social interaction and more time outside.

The reduction in the number of COVID-19 positive cases across Victoria is encouraging. However, we are seeing increased case numbers in some areas around Dandenong. We are taking a conservative position and have made some immediate changes within our Emergency Departments and to emergency admissions.

Additional precautions in Emergency Departments
Additional precautions now apply to patients presenting to our Emergency Departments from the following postcodes:

• Hallam: 3803
• Clyde North: 3978
• Narre Warren South: 3805

Patients presenting to our Emergency Departments from these postcodes will be streamed into high-risk zones.

Emergency inpatient admissions from these postcodes will be swabbed on admission and managed as suspected COVID-19 (droplet and contact precautions). Patients will then be managed in relevant stream/wards based on the outcome of their test result.

There are no changes to planned admissions and outpatient visits for patients from these postcodes. Outpatients will continue to be screened before arrival, and planned admissions will continue to undertake a pre-admission COVID-19 test.

Change to PPE requirements when performing Aerosol-Generating Procedures on patients who are COVID-19 negative/not exhibiting COVID-19 risk factors

On 14 August, a DHHS brief to health service CEOs advised that Tier 3 PPE should be worn by those directly involved in the intubation of a patient with no COVID-19 risk factors. We adopted this advice and updated our Conventional Use of PPE guidance on 18 August.

The DHHS amended this advice on 8 September.

The new guidance recommends the use of Tier 3 PPE for aerosol-generating procedures in patients with suspected or known COVID-19 infection. In patients who are tested negative for COVID-19 and/or have no risk factors and thus screen negative, Tier 2 PPE can be utilised when performing AGPs.

In relation to intubation and extubation: Health services are required to undertake their own risk assessment to determine whether the use of N95/P2 respirators is required for HCWs directly involved in the intubation/extubation of patients who are COVID-19 negative/not exhibiting COVID-19 risk factors. Patients who are tested negative for COVID-19 and/or have no risk factors and thus screen negative, Tier 2 PPE can be utilised when performing AGPs.

The PPE Expert Advisory Committee has considered this advice and determined that, in the current environment, the likelihood of COVID-19 in patients who are tested negative for COVID-19 and/or have no risk factors and thus screen negative, is low. The Committee has recommended to the Health Service Incident Command Team to allow Tier 2 PPE when performing AGPs on these patients. The HSICT has approved the recommendation. A briefing was provided to our Health and Safety Representatives on 14 September about the planned change.

A planned implementation will be undertaken over a period of two weeks commencing 15 September.

The updated Conventional Use of PPE poster can be accessed here.

Outbreak Management Teams

When we identify a COVID-19 exposure, whether it be through a patient or an employee, we quickly stand up a local Outbreak Management Team (OMT) which becomes responsible for managing the exposure.

Each OMT comprises representatives from the executive, the area involved, and Infection prevention, supported by People and Culture, Support Services, Communications and any other specialists needed.

I would like to acknowledge the hard work and dedication of these local teams, who have responded quickly to manage and contain 41 exposures to date. It’s a challenging task that requires quick decision making, immediate action and sensitivity. Our local teams have consistently risen to meet this challenge and have my thanks.

Thank you for your ongoing dedication and care.

Andrew Stripp

Chief Executive

 

Key Messages

Change to Code Blue response for VF arrests in MMC CCU
The PPE Expert Advisory Committee is of the view that the current guidance for PPE requirements in Code Blue and MET response is appropriate for the level of risk of potential undiagnosed infection in a deteriorating patient. This advice can be accessed here.

Over the next two weeks, the Deteriorating Patient Committee and the PPE Expert Advisory Group will continue to monitor the risk and advise of relaxation of these requirements when appropriate.

Following clinical advice, an exception has been made for a specific group of inpatients in Monash Medical Centre in CCU or Ward 32 who are known NOT to be COVID-19 or SCOVID-19 and are on telemetry or fixed ECG monitoring. This patient group are at higher risk of developing a malignant arrhythmia and, as such, prompt defibrillation is warranted. In these patients it is recommended that the skilled healthcare workers in these areas can respond and undertake defibrillation and commence cardiac compressions in standard precautions. Airway management will still require Tier 3 PPE.

Due to the level of community transmission in Dandenong and Casey, this exception does not apply in Casey and Dandenong Hospitals.

Managers: Workplace inspections are now due

If you have not yet completed workplace inspections – please do so today and take any required action swiftly. You don’t need to log in to access the Workplace Inspections Summary. The OHS tab can be found at the bottom of the BI Reports page.

Monash Health in the media: our smallest baby ever, a rare case of PIMS-TS and more

The hard work and expertise of the team at Monash Health has again caught the attention of the media. Read and watch some of our recent media coverage below.

• Smallest baby ever delivered at Monash Health goes home!
  Professor Arvind Sehgal, Head of Neonatal Cardiovascular Research at Monash Children’s Hospital, spoke to Nine News about delivering Monash Medical Centre’s smallest ever baby, which was also covered by the Daily Mail.
• Only one in five coronavirus-positive Victorians has fever
  Associate Professor Rhonda Stuart, Medical Director, Infection Prevention and Epidemiology, spoke to The Age about the different symptoms she’s seeing in COVID-19 patients.
• ‘We’ve got this’: our brave healthcare workers on the frontline
  A smiling, resilient crew from Dandenong Hospital featured in their local Star Newspaper as a reminder to our community that while cases are dropping, it’s more important than ever for us not to let our guards down.
• ‘Excellent recovery’: Boy with rare COVID-related illness on the mend
  Associate Professor Jim Buttery, Head of Infection and Immunity at the Monash Children’s Hospital, spoke to The Age about our patient with a rare case of PIMS-TS.
• USTA, ESPN and Roger Federer surprise Monash Health’s Helen Richards
  Helen Richards, Director of Clinical Operations for Hospital in the Home and Residential In-Reach, spoke to Roger Federer, and then she spoke to Nine News and The Today Show about her experience as a front line worker.

You can read the full story about how this came to be, on the Monash Health website.

Keeping the R U OK? conversation going

At last Thursday’s Employee Forum, we were joined by a panel of experts who provided advice on how to connect and engage with ourselves and others during this time of uncertainty. Dr Sarah Barker from Black Dog Institute provided some helpful tips on how to start an effective conversation, including:

• having the conversation in private
• asking at an appropriate time
• using open questions
• observing abnormal or unusual behaviour
• actively listening and engaging in the conversation.

While it is important to start these conversations, it is also equally as important to keep them going. Asking the question can be hard, but sometimes knowing what to say after R U OK? is even harder. Learn more here, including the steps you can take after asking R U OK?

Monash Children’s Hospital joins children to honour frontline workers

The children at Paisley Park Early Learning Centre in Chadstone showed their support for frontline workers by inviting the local health services, police, ambulance, fire brigade and others to an online ceremony. Hearing about this heartfelt tribute, our amazing nurses from the Monash Children’s Hospital decided to jump on to the call and join the children in their ceremony, which you can watch here.

It was a great opportunity to familiarise the children with our nurses in their PPE and remind them to let their parents know if they are feeling unwell, so they can be tested. Read more here.

Volunteers express gratitude and thanks to Monash Health employees

Members of our Volunteer Services Team were overwhelmed recently when they were inundated with cards, poems, letters and drawings filled with inspiring messages from some of our more than 400 Monash Health volunteers.

The volunteers wanted to pass on their sincere gratitude for the perseverance and commitment to patients displayed by employees throughout COVID-19. Check out a selection of cards and drawings and read more here.

Mental Health Week art competition – enter now!
There is still time to enter the Mental Health Week art competition, which celebrates art by past and present consumers, families, carers and Mental Health Program employees.

The final deadline for any entries is Friday 25 September 2020. Up to two pieces of art can be submitted per entrant, across the following voting categories:

• Aboriginal/Torres Strait Islander
• Adult
• Aged
• Carer
• Child
• Culturally Diverse
• Drug and Alcohol Services
• Dual Disability
• LGBTI+
• Staff
• Youth

The winning work in each category will be purchased by the Mental Health Program and displayed across Monash Health. For further information on how to apply and prizes, contact Louise Probert on 9554 9233, email cfcs@monashhealth.org or visit the Consumer & Family/Carer web page here.

Monash Health recognised as an outstanding clinical trial site 

Monash Health has won the Outstanding Trial Site Award by the Australasian Gastro-Intestinal Trials Group (AGITG), in recognition of their commitment to clinical research.

Our clinical trial team received the award in recognition of their long-standing commitment to gastro-intestinal (GI) cancer research.

The team currently have more than 60 clinical trials recruiting, with 20 of these treating GI cancers. These include several trials sponsored by the AGITG, offering new treatments in three GI cancers: colorectal cancer, gastro-oesophageal cancer and neuroendocrine tumours. Read more here.

Social Support program continues online  

Monash Health Communities Social Support Team for Greater Dandenong has been working hard to provide the best possible service for their clients since coronavirus restrictions began in March.

The team of diversional therapists would usually provide centre-based group activities and outings for older and vulnerable people living in our community and, while these have had to cease, the team has kept clients connected and engaged.

The number of clients requesting the service has increased, but the team still contacts individual clients for weekly chats and welfare checks. They have also assisted some clients with technology, virtual group chats, and activity packs. Read more here.

Connect to the new Wi-Fi network at Monash Health

As part of our ongoing work to improve and enhance our digital infrastructure for you, a new Wi-Fi network has been rolled-out and is now available across Monash Health.

For employees working on-site, learn how to connect your device to the new Wi-Fi network.

Employees currently working from home, rest assured you can connect your personal devices to the new Wi-Fi network once you return to the workplace safely.

Complete your daily attestation

All employees are required to complete a daily Attestation that they are well prior to commencing work on-site. You can complete the attestation online using a smartphone and show the result to our screening team, or fill in a paper form and submit it on entry (forms will be available at entrances).

You can also save a shortcut to the form on your smartphone to make the process faster.

Submit your Workplace Declaration form

It is mandatory for all Victorian healthcare workers to declare their work with any organisation, including paid, unpaid and voluntary work. If you have not completed the Employee Workplace Declaration form, please take five minutes to do so now.

If you manage a team, please log in to the Business Intelligence Portal to check the status of your team members and encourage those who have not declared, to do so.

Students undertaking placements should complete a student declaration form.

Continue to take advantage of wellbeing resources

Take advantage of the health and wellbeing resources we have available for you, including the Call a Psychologist service and the employee assistance program. Don’t forget the basics of your physical health and remember we have links to resources online for you and your teams, including a helpful guide to stretching at your desk, wherever that desk might be.

Ensure you are working to the most up-to-date advice

The information about COVID-19 is changing rapidly. Ensure you are working to the most up-to-date advice by referring to the Monash Health Employee Coronavirus website. To make accessing the site quicker, you can create a shortcut on your smartphone by following these instructions.

Upcoming events

Employee Forum, 2pm Thursday 17 September

Join our Employee Forum for an opportunity to discuss Monash Health’s COVID-19 response.

Welcome and update

Andrew Stripp, Chief Executive

Andrew will provide an update on Monash Health’s COVID-19 response.

Memory and stress

Dr Brian Long, Deputy Director and Clinical Neuropsychologist

This session will outline what constitutes “normal” memory failures in response to stress, and what we can do to safeguard ourselves from them.

Stay up to date with events on our COVID-19 website for Monash Health employees:

Watch previous recordings of Employee Forums and Manager Briefings
See all upcoming events

Stay up to date with events on our COVID-19 website for Monash Health employees:

• Watch previous recordings of Employee Forums and Manager Briefings
• See all upcoming events