|Peninsula Sleep Clinic||(02) 9451 0522|
|49 Frenchs Forest Road East, Frenchs Forest 2086
Suite 3, Level 2, Building 1, Forest Central Business Park
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Peninsula Sleep Clinic has been growing and evolving on the Northern Beaches of Sydney since its beginning in 1992. At that time Dr Keith Burgess and Dr Stanley Braude were conducting unattended home sleep studies from their consulting rooms in Dee Why. In 1993 Dr Burgess negotiated a joint venture with Health Care of Australia and established the first sleep laboratory of its kind on the Northern Beaches. This was a two-bed laboratory at Peninsula Private Hospital in Harbord (now Freshwater) where Dr Burgess & Dr Braude were joint medical directors and reporting physicians. The laboratory operated for six years until until 1999 when the private hospital closed down their sleep services.
Peninsula Health Care Pty Ltd then opened a new three bed facility called Peninsula Private Sleep Laboratory in September 1999 as a co-located private hospital on the Manly Public Hospital campus. Dr Burgess is the sole director of Peninsula Health Care Pty Ltd and was also the Executive Officer and Medical Director of that Laboratory. Dr Braude continued to be a Visiting Medical Officer (VMO) at the new facility, and in 2003 Dr Adrian Havryk was appointed as a VMO, until he left in 2012.
Between 2006-2008 Peninsula Health Care Pty Ltd also ran a satellite two bed remote laboratory at Mosman Private Hospital in Mosman.
In April 2009 Peninsula Private Sleep Laboratory moved to a new six bed purpose built facility in Frenchs Forest where it currently resides. The Laboratory had a slight name change to Peninsula Sleep Laboratory at this time. Dr Burgess remains the Chief Executive Officer and Medical Director and Dr Braude remains a VMO. In 2009 Dr Kate Barclay was appointed as a VMO and in 2017 Drs Linda Seeto and Philip Lee were also appointed as VMOs.
In 2014 was the next step in the evolution of Peninsula Sleep Laboratory with another small name change to Peninsula Sleep Clinic, to better reflect our current multidisciplinary sleep disorders facility and team.
The current laboratory operates as a six bed private hospital employing a small highly skilled and enthusiastic team including; nursing, technical staff, administrative staff and cleaning staff.
Peninsula Sleep Clinic has always strived to lead the field in Sleep Medicine with the highest standards in patient care, data collection and analysis. The Clinic has been accredited with Global Mark (originally Benchmark) since November 2001 and with the Thoracic Society of Australian and New Zealand (later the Australasian Sleep Association) since November 2004.
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Accreditation / Certification Quality and Safety:
Peninsula Sleep Clinic (PSC) is accredited by the Australasian Sleep Association (ASA) / NATA current until 2021. Re-accreditation was conducted in July 2017. The Clinic has been continually accredited since 2004. This process involved clinical peer review by an expert panel of Sleep Physicians and technical personnel nominated by the ASA / NATA independent of PSC. The panel reviewed all systems, documentation, tests (except bi-level ventilation), servicing, quality and technical records, staff recruitment and development, equipment, provision for emergencies and the quality assurance programs. As a result of this audit our electrical supply was updated in the patients bedrooms / bathrooms in accordance with AS / NZ 3003:2011 at a body protected level.
PSC is also accredited to the new National Safety and Quality in Health Service Standards (NSQHS) developed by the Australian Commission on Safety and Quality in Health Care (www.safetyandquality.gov.au). An independent assessor reviews the quality and safety of the services provided and measures the Clinic’s achievements against the industry standard. PSC will be expected to comply with the version 2 of the Standards by July 2019. Accreditation to both the ISO and the NSQHS standards can no longer be assessed at the same time. As a direct result of this PSC has decided to drop the ISO accreditation due to workload and expense.
PSC was first assessed by Global Mark in 2013 against the National Safety and Quality Service Standards version 1.
The second edition of the NSQHS Standards was released in November 2017.This edition addresses gaps identified in the first edition, including mental health and cognitive impairment, health literacy, end-of-life care, and Aboriginal and Torres Strait Islander health. Assessment to the second edition will commence from 1 January 2019.
Version 2 Standards include:
PSC also continually reviews and strives to improve the quality of the service we provide. At our last review in November 2018 the Global-Mark independent auditors in summary reported that ‘Peninsula Sleep Clinic continues to demonstrate strong leadership in Quality and Safety processes’.
In 2014 PSC was recognised by the Sleep Health Foundation as a supplier of CPAP Sleep Therapies. Current recognition is valid until 21/8/2019. This is to ensures a high standard is maintained as PSC must comply with a ‘Code of Practice’ set out by the Foundation (www.sleephealthfoundation.org.au)
Monitoring of Clinical Key Indicators
PSC routinely monitors and records key elements of our performance to facilitate continuous improvement to ensure we provide a quality service to our patients, consumers, carers and to our referring doctors. Elements monitored:
All results are analysed and presented at the Management Review Committee (MRC) and the Medical Advisory Committee (MAC) meetings.
Partnering with Consumers:
Effective communication is an essential element to providing excellent patient care. Patients and carers have the right to be involved in their care and therefore engagement and comments are actively sort.
In 2012 PSC independently sought opinions on our information provided to prospective patients, our CPAP information packs, and our CPAP charges. Since then PSC has continued to seek further feedback from consumers who have utilised our CPAP clinic services. Feedback is regularly reviewed by management and at routine meetings.
The feedback for 2018 remained at 98% satisfaction.
PSC continues to seek comments from consumers regarding our ‘Quality and Safety’ report including any recommendation for improvement. Recommendations and suggestions are discussed at the regular management meeting and where appropriate change is instigated.
Staff In-service training includes regular education by “CPAP and other users”.
In April 2019 the staff were trained by a consumer who uses a dental device.
A monthly random audit is undertaken to determine the quality of the recordings and to determine whether there are any systematic equipment issues or other issues. The results and feedback from these surveys are presented to management and discussed with staff at their regular technical meetings.
In 2018 our overall quality of all the recordings was 98.7%
The Medical Director who is a recognised Respiratory / Sleep Physician regularly monitors the quality of the reports of the other Sleep Physicians. This ensures consistency in reporting and that the key elements of the report are conveyed to the referring doctors. The results are discussed by management and the reporting Sleep Physicians.
CPAP Clinic Outcomes – Quality Assurance
Adherence to CPAP treatment is the largest factor impacting on the effectiveness of CPAP treatment. PSC routinely collects data to be able to demonstrate this effectiveness. Data is collected during the home trial period, at 6 and 12 month intervals and any time there is an issue. The data is analysed and presented at management meetings and CPAP Clinic meetings. In 2018 our CPAP compliance figures improved from 86% 2017 to 94.2%.
PSC continually monitors patients’ satisfaction regarding the care and services provided, and seeks opinions on how we can improve our services. PSC considers consumers’ opinions to be very important and encourages all patients to take the time to complete the questionnaire prior to discharge. PSC seeks feedback on:
1. Whether there was sufficient pre-procedure information
2. Whether you were happy with the care you received
3. Whether you were happy with the attitude and behaviour of the staff
4. Whether you felt your privacy and confidentiality were maintained
5. Would you return to the facility
6. Whether you were happy with the cleanliness of the facility
7. Whether you had any suggestion for improvement
8. And on a scale 1-10 how would they rate the facility
At the end of 2015 we added two further points:
9. Whether you have any suggestions for improving our paperwork
10. Whether you have read the Quality & Safety report and whether you have any recommendation or suggestions for improvement
In 2018: 81.4% of patients completed a survey with 99.95% satisfaction. In 2014, 2015, 2016, 2017 and again in 2018: Global-Mark independent auditors reported that “the actions taken to maximise patient quality care was met with merit”
Referring Doctors’ survey
Every two years our referring doctors are surveyed to determine their level of satisfaction with the services provided by PSC to their patients. The data collected is analysed and reviewed by management who may make recommendations as a result of the outcomes / suggestions. In 2017 a survey was conducted with an overall satisfaction rate of 88%. The next survey is due in 2019.
CPAP Clinic Survey and CPAP Consumers Feedback
PSC is trying hard to improve the service provided to our CPAP users and as a result have actively sought feedback from patients who have both recently used the services or have previously used the services of the Clinic. In 2018: the consumer initial feedback was 98% satisfaction. The ‘blind’ CPAP Clinic survey results showed 78.57% satisfaction which was down from previous years. These outcomes were discussed with staff and management with the aim to improve on these results. The next survey is due later in 2020.
Healthcare Associated Infections
The risk of getting an infection in hospital depends on how healthy you are, how long you have been in hospital, certain medications and whether you have had an invasive procedure such as surgery. At PSC patients stay overnight only, there are no invasive procedures performed and no medication is prescribed or altered and all accommodation is in single rooms. PSC does not accept admission from other hospitals. Anyone with a respiratory infection, colds, flu, vomiting, diarrhea or other communicable disease including shingles, other hospital acquired infections such as MRSA are re-scheduled. PSC does not have the resources to do wound dressings and therefore will not accept patients who require this intervention. Prospective patients are given information regarding minimising the risks. It is considered that the risk of contracting an infection at PSC is extremely low.
At the Global-Mark audit conducted in November 2017 as part of the NSQHS requirements PSC were required to implement a 5 year ‘Action Plan’ to ensure compliance with the infection control standard AS / NZ 4187:2014. This required additional work after the audit to ensure we met this requirement. Over the next four years we will be working to achieve the goals set out in the plan. In 2018 the plan was to purchase a printer for our thermal disinfector, this took some time to achieve (due to circumstances beyond our control), however that now done we are in the process of upgrading our protocols and staff training.
Staff In-service training includes regular education on infection control.
The single most effective strategy in preventing and or minimizing the spread of infection is hand hygiene. There are hand basins throughout the facility, there is hand rub (which is just as effective as soap & water) in every room and there is hand rub on each set-up trolley. Staff are educated in hand hygiene and participate in on-line hand hygiene modules set-up by Hand Hygiene Australia. Hand hygiene is regularly monitored and the outcomes are reported to management.
How can you help to limit the spread of infection?
1. Let the staff know prior to admission if you have an infection, particularly if you have a cough or the flu, an open wound or a contagious disease.
2. Wash your hands with soap and water or the hand rub on admission.
3. Cover your mouth and nose when you cough or sneeze and wash your hands afterwards.
4. Wash your hands after using the toilet.
5. Do not bring visitors into the Clinic if they have an infection.
Identification and Clinical Handover
While PSC only performs Polysomnography it is important that you are identified correctly. On admission and again prior to consenting to a Sleep Study your identity will be confirmed. You may be asked your date of birth, your name, your address or your Medicare card number.
There is usually only one clinical handover during your stay in the Clinic and this occurs at 11.00pm. At this time the staff stop what they are doing and confirm your identity, your type of Sleep Study, whether you have any allergies / alerts / Advanced Care directive / Enduring Guardian directive and any other relevant history.
Polysomnography is a comprehensive recording of the bio-physiological changes that occur during sleep and is a very specialised medical field. Therefore, staff require intensive training to ensure they have the necessary skills to perform their duties to the highest standard. PSC has a well-documented orientation program; new staff are provided with one-on-one training with an experienced staff member and there is regular in-service education which is compulsory and where relevant staff are provided external education. In addition, staff are given the opportunity to attend the Sydney University Sleep Course. Staff performance is reviewed and documented annually and if necessary further training is provided.
In 2014, 2015, 2016, 2017 and 2018: Global Mark independent auditors reported that “agreed and documented guidelines and pathways are available to clinical workforce and the use of agreed clinical guidelines by the clinical workforce in monitored: both were met with merit” However in 2018 PSC was required to provide evidence that staff were trained in ‘Patient Centred Care” – this was provided in December 2018.
Visit our Resources page to view various news items and research studies conducted by Peninsula Sleep Clinic.