The agency's performance (RMCLHN. Annual Report 2020-21)
Performance at a glance
- Meeting targets for all ED ‘seen on time’ triage categories.
- Meeting targets in ED ‘left at own risk’ for Aboriginal and Torres Strait Islander consumers for three of four quarters.
- Meeting targets in ED ‘length of stay greater than 24 hours’.
- Meeting targets for ‘percentage ED patients re-presenting within 48 hours for two of four quarters.
- Meeting targets in elective surgery ‘admitted on time’ for last three quarters 2020-21. The first quarter data for category 2 (95%) does not meet the target of 97%, due to theatre closure attributable to the COVID-19 pandemic and illness of a surgeon.
- Meeting targets for Mental Health services including post discharge community follow up rate, seclusion and restraint episode rates.
- Meeting all targets for Safety Assessment Code (SAC) 1 and 2 incidents that are openly disclosed (unless declined or deferred).
- Meeting target of 80 per cent of complaints acknowledged within two working days.
- Successful accreditation against the NSQHSS achieved by RMCLHN. The next accreditation date is February 2024. A one-year extension has been granted by the ACHS due to COVID-19.
- Successful NDIS Practice Standards Accreditation achieved by RMCLHN Network in 2020-21.
- Current accreditation status of Residential Aged Care Facilities (RACF) in RMCLHN
|Name of Service||Current Status||Rating|
|Bonney Lodge 6149||Improvements needed||●●●○|
|Hawdon House 6005||Improvements needed||●●●○|
|Hills Mallee Southern Aged Care Facility 6178||Meets requirements||●●●●|
|Loxton District Nursing Home 6405||Meets requirements||●●●●|
|Loxton Hostel for the Aged 6064||Meets requirements||●●●●|
|Renmark & Paringa District Hospital Hostel 6075||Meets requirements||●●●●|
|Renmark Nursing Home 6936||Meets requirements||●●●●|
- Successful full facility accreditation with SAMET for intern and PGY2 medical trainees
- Delivering investment on capital upgrades and equipment in RMCLHN.
- Delivering services tailored specifically to the needs of local Aboriginal and Torres Strait Islander communities, such as the Tumake Yande Elders Program, Aboriginal Family Birthing Program, Aboriginal Health Team in the Riverland and Aboriginal Liaison Officer positions for the Riverland.
- Delivering community, in-home and residential services through RMCLHN Country Health Connect.
Agency response to COVID-19
RMCLHN COVID-19 Incident Management Team
Following the declaration of a major emergency under the State Emergency Management Act (2004) on 22 March 2020, the COVID-19 Incident Management Team (IMT) was established to respond to the COVID-19 situation and support health units across the region to access resources and systems as the pandemic situation evolved. The IMT is led by the CEO and the Executive Director of Nursing and Midwifery and includes key multidisciplinary members with a focus on operations, communications, logistics, human resources, planning and intelligence, and documentation. The IMT has oversight for all aspects of the regional response including education of medical and nursing staff, regional planning, infection control, use of Personal Protective Equipment (PPE), establishment of negative pressure rooms in the RGH and Murray Bridge Soldiers’ Memorial Hospital, COVID-19 screening sites and the COVID-19 vaccination program.
The following plans were developed and endorsed by the IMT to manage the risks associated with the COVID-19 pandemic and the health sector response within the RMCLHN:
- RMCLHN Regional COVID-19 Plan
- RMCLHN COVID-19 Vaccination Program Clinic Operations Plan
- COVID-19 Safe Plans for all facilities
- RMCLHN Residential Aged Care Facilities COVID-19 Viral Respiratory Outbreak Plans for all sites
- COVID-19 Residential Aged Care Facilities Workforce Management Plans for all sites
- COVID-19 Infection Control Plans for all Residential Aged Care Facilities sites
- RMCLHN Aged Care Outbreak Plans for all Residential Aged Care Facilities sites.
The CEO is also a member of the Statewide COVID-19 Acute Operations Group and the Executive Director Clinical Innovation is a member of the Statewide COVID-19 Clinical Advisory Group.
Due to the COVID-19 pandemic, the Barmera, Karoonda and Tailem Bend Hospital EDs collocated with RACFs were temporarily closed to protect aged care residents from the risk of cross contamination of COVID-19. Karoonda reopened in July 2020 while Tailem Bend and Barmera remain closed and the status of EDs within the region is continually reviewed in line with the Communicable Diseases Network Australian National Guidelines.
COVID-19 Testing Clinics
RMCLHN established a number of COVID-19 testing clinics in conjunction with SA Pathology across the region to assist with the identification and treatment of any outbreak within the community. Operating hours are continually reviewed and amended based on community trends and demand. The RGH located at Berri has been the main site involved in the majority of COVID-19 screening in the region, which has to 30 June 2021 undertaken more than 10,200 COVID-19 screening swabs.
COVID-19 Vaccination Clinics
The RMCLHN vaccination program has involved the use of both the AstraZeneca and Pfizer vaccines. The first phase of the vaccination roll-out commenced on 5 March 2021 with Australia’s first AstraZeneca COVID-19 vaccine administered at Murray Bridge Soldiers’ Memorial Hospital. This initial phase prioritised those most vulnerable to the effects of COVID-19, or who have the highest risk of being exposed, including aged care residents and key frontline health care and aged workers.
The vaccination program then rolled out to other healthcare workers and the wider community within the region with community clinics commencing in June 2021 at Murray Bridge, Berri, Waikerie and Meningie, with approximately 10,700 vaccinations in total administered from 5 March to 30 June 2021.
Agency contribution to whole of Government objectives
RMCLHN contributed towards achieving more jobs within the region through a number of strategies and initiatives which included:
- Continuing to offer the Nursing and Midwifery Transition to Professional Practice program (TPPP) that provides entry level supported roles for Nursing and Midwifery graduates.
- Commencing an Aboriginal and Torres Strait Islander Administrative Traineeship program that provides the opportunity for employment whilst attaining a Certificate III in Business.
- Contributing to the development of the Rural Health Workforce Strategy with the Rural Support Service (RSS).
- Contributing to the development of the Rural Allied Health Workforce Plan.
- Contributing to the development of the Rural Nursing Workforce Plan.
- Providing further specialised training for allied health professionals.
- Providing career opportunities for Aboriginal and Torres Strait Islander health practitioners including Aboriginal Liaison Officers.
- Expanding training opportunities for community support workers.
- Supporting the community nursing workforce to manage more complex clients in rural areas.
- Recruiting new doctors to the region to work in the RGH at Berri.
- Creating a new position of Executive Director of Clinical Innovation.
- Gaining accreditation for the first time to recruit junior doctors to the region in 2022.
- Partnering with the Rural and Remote Mental Health Service to create a General Practitioner Psychiatry specialist training position in Riverland General Hospital.
Lower costs Costs for consumers were reduced through delivering programs such as:
- The Patient Assistance Transport Scheme and the Riverland Transport Service.
- Timely elective surgery in the Network.
- Country Home Link.
- Provision of telehealth services.
- Home-based chronic disease monitoring including cardiac, respiratory, diabetes, musculoskeletal, paediatric and aged related chronic diseases and comorbidities.
- Facilitated culturally appropriate access to bulk-billed GP and nursing consultations for the Riverland Aboriginal Primary Health service through a service agreement with the Barmera General Practice.
Significant service outcomes achieved included:
- Increasing access to the Digital Telehealth Network (DTN) and teleconference consultation, particularly during the COVID-19 pandemic.
- Increasing access to cancer services at RGH enabling patients to receive more complex chemotherapy treatment closer to home.
- Improving remote prescribing access for GPs who provide care to residents in RMCLHN RACFs.
- Improving access to specialist palliative care support via the Regional Local Health Network Palliative Care Innovation Grant Project – Telehealth.
- Implementing a Consult Liaison Mental Health Registered Nurse position, providing enhanced support to EDs and hospitals and reducing unwarranted admissions. This assists consumers to receive timely and appropriate Specialist Mental Health Care.
- Implementing the Borderline Personality Disorder Collaborative (BDP-Co) initiative, a co-stepped model of care that includes Gold card and 11-week road map programs. The latter targets young consumers, providing evidenced based interventions for people living with BPD or complex Post Traumatic Stress Disorder.
- Implementing a 26-week Dialectic Behavioural Therapy skills group for those consumers that have more complex BPD.
- Partnering with the Rural and Remote Mental Health Service to increase Psychiatrist input for consumers of the Community Mental Health Team.
- Providing mental health education for suicide prevention and consumer care.
- Implementing COVID-19 testing and vaccination clinics across the region.
- Recommencing social and wellbeing groups that were suspended during the initial COVID-19 outbreak.
- Increasing the provision of Home Care Packages.
- Completing redevelopment works for the upgrade to the ED and Central Sterile Supply Department at Murray Bridge Soldiers’ Memorial Hospital.
- Completing redevelopment works for the installation of a MRI Unit at RGH.
- Completing redevelopment works for the Waikerie Health Services carpark, aged care rooms and hospital entrance.
Agency specific objectives and performance
|Clinical Services Reform||Chemotherapy and cancer care activity.||1072 chemotherapy treatments in 2020-21, a 32%increase from 2019-20 and 583 cancer specialist consultations were delivered at the RGH chemotherapy unit.|
|Improving access to health services in our community||Community nursing and allied health activity service activity.||Approximately 53,366 non-admitted community nursing and allied health services were delivered to 5,760 individual clients.
Country Health Connect provided 7,420 occasions of service for 574 consumers related to transport of patients to appointments and other essential services. 942 of these occasions support consumers who identified as Aboriginal or Torres Strait Islander.
420 consumers were provided 25,180 meals to support them at home.
|Allied Health hospital activity.||10,633 Allied Health occasions of service were provided to 1,689 inpatients.|
|Potentially preventable admissions.||The average potentially preventable admissions for 2020-21 was 8.0 % (target 8.5%).|
|NDIS program activity.||There were 272 active clients in the NDIS program including 129 children and 143 adults. A total of 16,474.8 hours of billable services were provided to these consumers.|
|Hospital services||ED presentations seen on time.||Targets met across all triage levels.|
|ED length of stay less than or equal to 4 hours.||Target > 90 % met in seven of 12 months in 2020-21. Results for other months range from 87 – 89%.|
|Elective surgery timely admissions – all categories.||All category 1 targets met in 2020-21. Three of 12 months not met for category 2 targets due to cancellation of theatre due to COVID-19 and illness of a surgeon.|
|Rehabilitation.||There were 82 inpatient admissions to the RGH Rehabilitation ward. 1,281 occupied beds days of care were provided. A further 1,743 non admitted service events were completed.
110 consumers received a transition care program (TCP) and a total of 8,589 hours of service were provided through this program.
|Acute inpatient activity.||10,270 same-day patients and 8,628 overnight patients were admitted (40,956 occupied bed days).
485 babies were delivered.
|Continuous improvement of quality and safety||SAC 1 and 2 incidents.||There were 14 SAC 1 and 25 SAC 2 incidents reported on SLS for 2020-21.
Overall, SAC 1 and 2 incidents accounted for 1.09% of all incidents reported.
100% of SAC 1 and 2 incidents were openly disclosed in 2020-21.
|Hospital acquired complications.||There were 51 hospital acquired complications in RMCLHN in 2020-21. This compares to 45 in 2019-20. The funding impact was
|Aboriginal Health||Aboriginal Health – left ED at own risk. Aboriginal Health – left against medical advice (inpatient).||3.0% (target less than 3%) left the ED at their own risk in 2020-21.
5% (target less than 4.5%), left against medical advice.
|Aboriginal Family Birthing Program.||There were 33 women in the Family Birthing Program in 2020-21, exceeding the target of 20 per year and an increase of 6 from 2019-20. Of these, 21 women birthed at Murray Bridge Soldiers’ Memorial Hospital and 12 at other sites.|
|Aboriginal percentage of workforce.||2.084% of the workforce identified as Aboriginal and Torres Strait Islander as at 30 June 2021.|
|Increased visibility to the community.||Annual community fourms held in three locations in October 2020 (Riverland, Coorong and Murraylands).
Creation of RMCLHN Aboriginal Health webpage as a platform for information on service provision and document sharing.
|Partnerships.||Aboriginal Interagency Forum created within the Murraylands, to ensure service providers are fully informed about local services so the local Aboriginal community have access to all the services available to them.|
|Improving Mental Health outcomes||28-day readmission rate.||The readmission rate was 8.44% in 2020-21 (Target < 12%).|
|Restraint incidents per 1,000 bed days.||There were 0 restraint incidents per 1,000 bed days.|
|Seclusion incidents per 1,000 bed days.||There were 0 seclusion incidents per 1,000 bed days.|
|Percentage of Mental Health clients seen by a community health service within 7 days of discharge.||92% of clients seen within 7 days (Target 80%).|
|Average length of stay (ALOS).||The ALOS for 2020-21 was 11 (Target <14).|
|Average ED waiting time.||The average ED visit time for 2020-21 was 2.2 hours (Target < 6 hours).|
|Aged Care||Residential aged care (RAC) occupancy.||85% occupancy across RAC sites.|
|Aged Care Assessment Program (ACAP) assessments.||656 ACAP assessments in 2020-21.|
|Home Care Package occupancy rates.||Occupancy rates increased from 226 to 318 from 1 July 2020 to 30 June 2021, a 40.7% increase.|
|Commonwealth Home Support Program (CHSP) client numbers.||2,427 CHSP clients received 83,602 occasions of service, enabling older people to remain independent in their own home for longer.|
|Consumer and Community Engagement||Launch of RMCLHN Consumer and Community Engagement Strategy.
Community report developed from the 2020 annual Aboriginal community consultations. The Meningie Aboriginal Self-Help Group (MASH) was re-established as a result of the consultation in Meningie in partnership with Moorundi Aboriginal Community Controlled Health Service.
Consultations and engagement have begun with First Nations groups in the Riverland.
Corporate performance summary
RMCLHN achieved key performance outcomes including:
- Accreditation against the Aged Care Quality Standards, Food Safety Programs and NDIS Practice Standards.
- Supporting a large number of staff with professional development opportunities.
- Meeting the target for staff having an annual performance review and development discussion.
- Meeting the target for all staff having the required Criminal History and relevant screening.
- Reducing the number of staff with excess annual leave.
- Meeting the target for the rate of new workplace injury claims.
- Attendance of 144 staff at the face to face Orientation program.
- Participation in the Office for the Commissioner for Public Sector Employment IWorkforSA Staff Survey.
- The RMCLHN Reflect Reconciliation Action Plan completed in June 2021 with a launch planned for late 2021.
- The inaugural RMCLHN NAIDOC Week Awards implemented during NAIDOC Week in November 2020 and winners announced in December 2020.
- Commitment to address racism including the introduction of a function on the Safety Learning System for staff to report any level of racism within the workplace. Processes also implemented to ensure any reports of racism are handled appropriately.
- Completion of significant capital investments including:
- The Murray Bridge Soldiers’ Memorial Hospital ED and Central Sterile Supply Department upgrade. This $12.35 million project was funded through the State Government Capital Funding ($7 million election commitment) and Asset Sustainment Fund ($5.35 million).
- The Waikerie Health Services redevelopment work on the carpark, aged care rooms and hospital entrance with the $2.14 million project funded by the Waikerie and Districts Health Advisory Council Gift Fund Trust.
- The MRI Unit within the RGH at Berri. This project was funded through the Asset Sustainment Fund ($2.3 million) and the Biomedical Equipment/ General Equipment Fund ($1.5 million).
- Completion of the Murray Bridge Soldiers’ Memorial Hospital Aboriginal Artwork project in March 2021.
- Investing in existing assets to address important repairs/maintenance including $0.62 million on minor works compliance such as equipment replacement, minor building refurbishment and communication equipment, and $6.3 million on further asset sustainment projects.
- Investing in $0.250 million in biomedical equipment.
- Finalised and launched the RMCLHN brand featuring a unique colour palette and the flora and fauna icons for our Network — the Pelican the Pelican, Murray Cod and Mallee Tree>
- Worked on the development of a RMCLHN Aboriginal Health sub brand using a local Ngarrindjeri artist to re-design our Pelican and Murray Cod icons using distinctive Aboriginal artwork.
- RMCLHN is active on social media through its Facebook page, Instagram account, YouTube channel and LinkedIn account. The Facebook page continues to be the top performing regional LHN page and RMCLHN were the first regional LHN to launch an Instagram account. For the 2020-2021 financial year, the monthly Facebook post reach averaged 12,500 and peaked at 70,148, and the monthly post engagement averaged 10,000 and peaked at 13,988. The increased social media presence includes specific showcasing of Aboriginal Health.
Employment opportunity programs
|Skilling SA||Under the Skilling SA Program, RMCLHN has supported four staff to undertake training relevant to their discipline undertaking a Certificate IV in Leadership and Management.|
|Aboriginal and Torres Strait Islander Administrative Traineeship||RMCLHN participated in a traineeship program with one new staff employed within administration and undertaking a Certificate III in Business.|
|Growing Leaders||RMCLHN continued to support five staff to undertake the Growing Leaders program.|
|OCPSE Manager Essentials||RMCLHN has continued to support five staff to undertake the Office of the Commissioner for Public Sector Employment (OCPSE) Manager Essentials program.|
|MAPA Program||RMCLHN has supported a number of staff to undertake the Management of Actual or Potential Aggression (MAPA) program.|
|OCPSE Aboriginal Frontline Leadership Programme||RMCLHN has continued to support two staff to undertake the Office of the Commissioner for Public Sector Employment (OCPSE) Aboriginal Frontline Leadership program.|
|OCPSE Executive Excellence||RMCLHN has supported one staff member to undertake the Office of the Commissioner for Public Sector Employment Executive Excellence program.|
|OCPSE The Next Executives||RMCLHN has continued to support two staff to undertake the Office of the Commissioner for Public Sector Employment ‘The Next Executives’ program.|
|Enrolled Nurse Cadets||During 2020-21, five Enrolled Nurse Cadets commenced employment with RMCLHN.|
|Transition to Professional Practice Program (TPPP)||Seven Registered Nurses, one Registered Nurse/Midwife and one Registered Midwife commenced employment as TPPPs within RMCLHN in 2020-21. Sites included Barmera Health Service, Murray Bridge Soldier’s Memorial Hospital and RGH.|
|Aged Care Scholarship Program||Loxton Districts HAC provided $6,175 scholarship funding to support 14 students undertaking Certificate III in Individual Support (Aging and Home and Community Care across 2019-20 and 2020-21.|
|Aboriginal Employee Network||Establishment of a RMCLHN Aboriginal Employee Network, which meets monthly across the region, including face to face meetings, to ensure a supported Aboriginal workforce.|
|Aboriginal Cultural Respect and Safety||Aboriginal Cultural Respect and Safety Training program implemented with all management level positions completing the training.|
Agency performance management and development systems
|Performance management and development system||Performance|
|Performance review and development supports continuous improvement of the work performance of staff to assist them to meet the organisation’s values and objectives||As at 30 June 2021, 78.6% of staff had an annual performance review and development discussion.
As at 30 June 2021, 51.16% of staff had a siz-monthly performance review and development discussion.
|Mandatory Training Compliance.||As at 30 June 2021, RMCLHN recorded 76% compliance.|
|Criminal History and Relevant Screening Compliance.||As at 30 June 2021, RMCLHN recorded 100% compliance.|
|Influenza vaccination compliance||As at 30 June 2021, RMCLHN recorded 63.5% overall compliance
From 1 June 2021, in accordance with COVID-19 Emergency Management legislation, all persons entering a RACF have been required to provide evidence of the 2021 influenza vaccination. For the period 1 July 2020 to 31 May 2021, evidence of the 2020
vaccination was required.
|COVID-19 vaccination compliance.||As at 30 June 2021, 53% of staff across RMCLHN had received a first dose of a COVID-19 vaccine and 33% of staff had received their first and second dose.|
|RMCLHN continues to foster a strong commitment to the recruitment and retention of Aboriginal and Torres Strait Islander staff.||As at 30 June 2021, 2.084% of staff within RMCLHN identified as Aboriginal or Torres Strait Islander.|
Work health, safety and return to work programs
|Prevention and management of musculoskeletal injury.||RMCLHN recorded 42 new musculoskeletal injury (MSI) claims in 2020-21. This was an increase of 26 claims (163% increase) on the previous year. New MSI injury claims accounted for 45.65% of new claims submitted (8.44% increase on last year).|
|Prevention and management of psychological injury.||RMCLHN recorded nine new psychological injury (PSY) claims in 2020-21. This was an increase of six claims (200% increase) on the previous year. New PSY claims accounted for 9.78% of new claims submitted.|
|Prevention and management of slips, trips and falls.||RMCLHN recorded 19 new slips, trips and falls (STF) claims in 2020-21. This was an increase of 10 claims (111.1% increase) on the previous year. New STF claims accounted for 20.65% of new claims submitted.|
|Workplace injury claims||Current year
(+ / -)
|Total new workplace injury claims||92||43||+114.0%|
|Seriously injured workers*||1||0||+100%|
|Significant injuries (where lost time exceeds a working week, expressed as frequency rate per 1000 FTE)||24.46||14.27||+71.4%|
*number of claimants assessed during the reporting period as having a whole person impairment of 30% or more under the Return to Work Act 2014 (Part 2 Division 5)
|Work health and safety regulations||Current year
(+ / -)
|Number of notifiable incidents (Work Health and Safety Act 2012, Part 3).||6||5||+20%|
|Number of provisional improvement, improvement and prohibition notices (Work Health and Safety Act 2012 Sections 90, 191 and 195).||5||0||+500%|
|Return to work costs**||Current year
(+ / -)
|Total gross workers compensation expenditure ($)||$1,206,390.00||$1,239,243.00||-2.7%|
|Income support payments – gross ($)||$538,950.00||$238,943.00||+125.6%|
**before third party recovery Data for the previous year is available at DataSA website - RMCLHN Data for years prior to 2019-20 related to the former Country Health SA is available at DataSA website - CHSA.
Executive employment in the agency
|Executive classification||Number of executives|
Data for the previous year is available at DataSA website - RMCLHN. Data for years prior to 2019-20 related to the former Country Health SA is available at DataSA website - CHSA.
The Office of the Commissioner for Public Sector Employment page that provides further information on the breakdown of executive gender, salary and tenure by agency.