ServioNews
A Royal Perth Hospital publication
Summer 2014
Greetings from the Executive Director
By the end of the year we will have seen more than 82,000 patients come
through the Emergency Department, provided 440,000 outpatient
appointments and served more than 1.3million meals to our patients. We
have also celebrated more than 300 staff members reaching the milestone
of 10, 20, 30, 40 and 50 years of service, secured millions of dollars in
research grants, congratulated countless award winners, and delivered a
range of life-saving treatments to patients.
This year also marked the closure of Shenton Park Campus (SPC) after
121-years of service to the Western Australian community. On 4 October all
SPC patients were safely transferred to the new Fiona Stanley Hospital
State Rehabilitation Centre, with many staff also relocating there or moving
to our Wellington Street Campus.
By March, RPH will be a 450-bed tertiary hospital providing a range of
services including adult major trauma, emergency medicine, surgical
services and mental health. We will also say farewell to a number of
services as they transition to Fiona Stanley Hospital or other health sites,
and this edition of Servio News recognises their contributions.
All this change unfortunately brings with it great uncertainty for individuals.
The stresses associated with uncertainty around jobs have been, I believe,
a low point for the organisation and against this background it is difficult to
clearly articulate to staff how critical and valued their dedication and
professionalism are to the organisation and its future. I would like to thank
staff for their commitment and hard work throughout 2014. It has been a
year of change which will continue through 2015, and together I am
confident that the new Royal Perth Hospital will not only survive but thrive.
As the holiday season approaches, I hope you all enjoy a well-deserved
rest and return ready for the exciting challenge of 2015.
Dr Aresh Anwar
Acting Executive Director
Royal Perth Group
Closing the gap in Aboriginal kidney transplants
A new model of care for kidney transplants for Aboriginal and Torres Strait
Islander people was awarded top honours at the 2014 WA Health
Excellence Awards.
The Department of Nephrology Renal Transplant Unit took out the
Aboriginal Health category, and were also this year’s recipient of the
Director General’s Award.
Medical Renal Transplant Unit (MRTU) lead Dr Suda Swaminathan says
prior to 2012, the transplant failure rate in the WA Aboriginal population
was three to four times greater than non-Aboriginal patients.
“This poor outcome could not be ignored, so we were determined to do
something about it and two years on, we have seen huge improvements in
transplant success,” Dr Swaminathan said.
“Since 2012 there have been no transplant failures in Aboriginal patients
and those patients are leading a life free of dialysis. This is a result we are
all very proud of and it shows we are providing better care for our patients.”
By encouraging patients to make lifestyle changes before their transplant,
altering dosages of post-transplant medication and providing daily follow-up
for four weeks after the transplant, infections have reduced.
“One of the main causes of transplant failure in Aboriginal patients is
infection and the team have reduced infection rates to numbers similar to
non-Aboriginal transplant patients,” Dr Swaminathan said.
Mr Lloyd Henry, MRTU Aboriginal transplant patient, received an early
morning phone call with news that his new kidney was waiting. He travelled
from his home in Collie and
was in surgery by 3pm that afternoon.
“Receiving a kidney is very emotionally overwhelming as I have been given
a second chance at life and want to do all the right things to make it work,”
Mr Henry said.
“The entire team have been marvellous the whole way through the process.
They have provided me with all the information and advice I need to take
care of myself and are willing to answer any questions I have, day or night.”
Once Mr Henry fully recovers and heads back home he will continue to
receive high quality care.
“Through communication via tele-health and by working more closely with
health professionals in rural and remote areas, patients continue to receive
high quality care and support once they return home,” said Dr
Swaminathan.
“This is just one of the many ways Royal Perth Hospital helps patients to
continue good health once they leave the hospital.”
Securing RPH’s rich history
After eight years of negotiations, the Royal Perth Hospital Heritage Society
has achieved their goal to have the heritage buildings on Murray Street
officially handed over to the National Trust of Australia (WA).
Founding member and Heritage Society Chair, Mr Fred Ordinski said
handing the land and buildings over to the National Trust ensures the RPH
Museum will be permanently housed on the grounds of RPH and the
names of Royal Perth Hospital and Colonial Hospital remain linked to the
site.
“After many years of petitioning, meetings, countless letters, and much hard
work by the Heritage Society and friends of the society, we are now the
proud recipients of the Crown Land Title,” Mr Ordinski said.
“This is the largest medical precinct ever handed over to the National Trust,
which is an exciting recognition for the hospital and the society.”
The five buildings, which make up the Heritage Precinct are the Colonial
Hospital, the old
administration block, old kitchens, nursing quarters, and radium therapy.
“The fig tree on Murray Street and the land on which the buildings stand are
also covered by the title,” Mr Ordinski said. “Our next step is to be officially
recognised as the caretakers of the land and buildings, and we are in the
process of putting together a business plan to achieve that.”
The Heritage Society, made up mostly by RPH Museum volunteers, began
as a steering committee in 2006 and became incorporated in April 2009
with the aim of ensuring RPH stays linked to its rich history.
Hot tips for warm weather with Dr Michelle Johnston

Dr Michelle Johnston is an Emergency Medicine Consultant who has
worked in the RPH Emergency Department for 20 years, giving her a
wealth of knowledge and experience in all things emergency.
Summertime has come calling on the good citizens of Perth and we’ve
emerged from winter, blinking and enchanted by the brilliant sunshine,
ready to bask and unwind in the toasty warm weather. Or are we?
Could there be dangers lurking behind this sunny façade? Absolutely! One
must be wary of the hidden perils waiting to pounce and deposit you,
surprised and confused, in front of the triage nurse in the Emergency
Department.
Hay fever and allergies
Perth has a particularly high pollen count which erupts during the warmer
weather, leading to an epidemic of itchy noses, watery eyes, and perpetual
sneezing. Although rarely necessitating a visit to the Emergency
Department, the symptoms can still be debilitating.
Hot tip
Antihistamines can take the scratching edge off your symptoms, however a
short burst of potent nasal steroids (prescription only) will be the best relief.
Sunburn
Sunburn is more than an amusing annoyance, it is a cancerous radiation
burn that creeps up with the stealth of a ninja and can fry your skin quicker
than you can say “aloe-vera”. Sun exposure is cumulative, and can be
damaging even on mild sunny days.
Hot tip
Remember Slip, Slop, Slap and get back into the habit of applying
sunscreen before you head out, reapplying every two to four hours and
after swimming.
Food poisoning
The barbecue season is upon us and it’s not just the bird and bee type of
romances going on out there. All sorts of microbiologic beings are taking
advantage of the warmer weather to procreate in your food!
Hot tip
Refrigerate your meat and your left overs. Don’t be responsible for the
unwitting consumption of flagrantly breeding bacteria which may translate
into gastrointestinal disease- there are better places to spend summer than
the lavatory!
The pioneers of Royal Perth Hospital
RPH has a rich history spanning more than 180-years of leading the way
for Western Australia’s healthcare services and is renowned for leading the
State’s, and even some of Australia’s, best medical services. As the
pioneer in leading and developing WA healthcare services, the RPH legacy
will be handed over to the new Fiona Stanley Hospital in February 2015
which will, no doubt, build upon what we have achieved throughout the
years at RPH. We take the opportunity to recognise their outstanding
achievements and thank staff for their dedicated service over the years.
Bone Marrow Transplant Unit
WA’s first bone marrow transplant took place at RPH on 17 January 1979
and in March 1994, the purpose built Bone Marrow Transplant Unit (BMTU)
was officially opened.
The BMTU has come a long way since 1979, from patients originally
isolated in plastic bed spaces called ‘life islands’ for up to eight weeks, to
performing the world’s first ‘at-home’ transplant program in 1994.

Since 1979 RPH has performed more than 1,300 bone marrow
transplant procedures.
Sleep Disorders Service
Providing a 24-hour service, the small group of dedicated scientists and
clinicians provide around-the-clock support for the study and management
of patients with Obstructive Sleep Apnoea. Today, 24 new patients are
seen each week with 20 per cent referred for a sleep study.
The Burns Service
As one of Australia’s leading burns service the RPH Burns Service is the
source for specialist knowledge on burns injuries in WA and beyond.
With a multi-disciplined team of more than 30 staff, the Burns Service has
been providing specialist services since the 1960’s.On average 400
inpatients come through the service each year with the outpatient clinic
providing rehabilitation treatments to more than 5,000 patients each year.
One of the most significant achievements of the Burns Service was the
treatment of 32 Bali bombing victims in 2002, led by Dr Fiona Wood. The
mammoth task of treating so many seriously injured patients earned the
Burns service international recognition and contributed to Dr Wood being
awarded Australian of the Year in 2005.

The Burns Service has been providing specialist services for more
than 50-years and has helped more than 20,000 inpatients.
Cardiothoracics
The Cardiothoracic Department performs all of the States heart and lung
transplants and leads
the way in organ retrieval and usage. The service is the only one in the
country to achieve 100 per cent survival rate for the lifesaving pulmonary
thromboarterectomy procedure.
Alongside the Cardiothoracics Department we will also farewell the
Advanced Heart Failure and Cardiac Transplant Service, as well as the
Transcatheter Aortic Valve Insertion (TAVI) program. The TAVI program
greatly improves the quality of life for high-risk patients with heart
conditions, and is the second largest program in Australasia, recently
celebrating its 200th patient.

Since the year 2000 the service has performed more than 200
transplants.
Medical Oncology
The Medical Oncology Department opened in 1979 with a team of four
housed in a single room next to the chapel. With the development of
successful supportive therapies, treatment is now mainly outpatient based
and patients can return to the comfort of their home. The Department has
an active clinical trials unit and facilitates oncology outreach clinics and
treatment to country centres including Geraldton, Kalgoorlie, Northam,
Albany and Esperance.
Renal Transplant Unit
RPH performed the first renal transplant in WA on 5 January 1967. Since
then the service has grown and now performs 40 transplants each year. In
July 2012, a separate Medical Renal Transplant Unit (MRTU) was formed
as a sub-speciality of Nephrology to provide highly specialised care to
patients. The team implemented a new program in 2012 to improve
outcomes for Aboriginal patients and to-date has seen excellent results.

The Renal Transplant Unit is the State centre for performing bloodtype incompatible transplants and performs 80 per cent of the state’s
Aboriginal renal transplants.
Clinical Immunology
In the early 1990’s RPH’s Clinical Immunology Department was the first lab
in Australia, and among the first in the world to do tissue typing with DNA
sequencing, which involves using DNA to match donors for kidney, liver,
lung, heart and bone marrow transplants. By using DNA to match donors,
RPH has been able to increase the number of successful transplant
outcomes.

Established in 1976, Clinical Immunology is the sole Statewide
provider of HIV monitoring tests.
Da Vinci trial un-clots mystery treatment
Venous thromboembolism (VTE) is a significant health problem in Australia,
and accounts for more than 5,000 deaths each year.
RPH researcher and Intensive Care Clinician Dr Kwok Ho has been
awarded $340,000 to evaluate the effectiveness of a current method used
to manage blood clots which has trauma clinicians across the world
divided.
Dr Ho explains that VTE is the process where a blood clot in the deep veins
of usually the legs, known as deep vein thrombosis, travels and creates a
blockage of the main artery in the lung.
“Most patients can be givenanti-clotting medication to prevent VTE but for
patients where the risks of uncontrolled bleeding are high, such as a major
trauma patient, this medication can be dangerous,” Dr Ho said.
“An alternative to the anticlotting medication is the insertion of a device
called an Inferior Vena Cava filter, or IVCF, into a patient’s major vein
inside the abdomen.”
Although IVCFs are already used in place of medication, Dr Ho highlights
that their effectiveness in preventing VTE is still uncertain. His project,
named the Da Vinci Trial, aims to assess IVCFs impacts, benefits and
harms.
“My aim is to uncover evidence that looks at the value of early intervention
of IVCFs, within 72-hours for patients admitted to hospital with severe
injuries,” Dr Ho said.
“Providing evidence of the effectiveness of IVCFs will allow clinicians
around the world to make more informed choices.
“This research has the potential to greatly impact the lives of thousands of
patients both in Australia and around the world, so I am very glad to receive
this support,” Dr Ho says.
Dr Ho thanks both the State Health Research Advisory Council and the
RPH Medical Research Foundation who have provided the funding.
RPH leading the way in health care
Top honours at the 2014 WA Health Excellence Awards


Winner of the Primary Care category was the Improving the care of
inherited high cholesterol disease in families program.
Winner of the Director General’s Award and the Aboriginal Health
categories was the Closing the gap in Aboriginal kidney transplants
program (front page).
The Improving the care of inherited high cholesterol disease in families
program, is a joint effort by RPH, WA Health’s Health Strategy and
Networks and Office of Population Health Genomics branches, PathWest
and a number of other external organisations.
The program has developed a model of care to enable GP’s and other
primary care providers to diagnose and treat familial hypercholesterolaemia
(FH).
FH is the most common and serious form of inherited high blood
cholesterol and the Primary Care Model of Care for FH aims to integrate
primary care services with tertiary centres, laboratories, academic centres
and WA Health, so care can be provided closer to home. The program
raises awareness of the disease and its treatment, and provides GPs’ with
the training they need to care for patients with FH.
Top dollar grant!
Director of Research, Department of Anaesthesia and Pain Medicine
Professor Tomas Corcoran was recently awarded $4.6 million from the
National Health and Medical Research Council, the largest research project
grant awarded in the 2014- 2015 round.
Professor Corcoran is the Chief Investigator for the Perioperative
Administration of Dexamethasone and Infection (PADDI) trial, and along
with his colleagues will conduct a major international study investigating the
safety of dexamethasone, a commonly prescribed drug used to prevent
postoperative nausea and vomiting.
Achieving good outcomes
Congratulations to RPH Consultant Geriatric Psychiatrist Professor
Osvaldo Almeida who was recognised for his excellence in research at the
2014 Mental Health Good Outcomes Awards.
The awards recognise outstanding contributions to mental health in
Western Australia and Professor Almeida won the GESB Award for
improved outcomes in seniors
mental health.
RPH takes P.A.R.T.Y time seriously
The RPH State Major Trauma Unit treats over 6,000 patients each year and
of those patients, more than 500 are teenagers who need treatment after
accidents involving alcohol or risk-taking behaviour.
The Prevent Alcohol and Risk-related Trauma in Youth (P.A.R.T.Y.)
Program has been running at RPH since 2006 and more than 8,000 high
school students have been taken on the confronting journey of a trauma
patient.
PARTY Program Coordinator Ms Michaela Copeland explains that students
are taken through the arrival of a trauma patient in the Emergency
Department, shown the stark reality of the Intensive Care Unit and visit
patients recovering in trauma wards.
“As part of the program, a St John Ambulance paramedic and a victim of
road trauma speak with students about the gruesome reality of a crash
scene and the life-changing effects injuries can have on a victim and their
loved ones,” said Ms Copeland.
Dr Sudhakar Rao Director of Trauma Services says RPH is the first hospital
in Australia to adopt the program from Canada and is now receiving
national attention, with a number of States around Australia also
establishing the program.
“The Program’s success prompted a recent visit from Australian Medical
Association Federal
President Associate Professor Brian Owler,” said Dr Rao.
“Associate Professor Owler was highly impressed at our commitment to
trauma prevention and the impact the program has on teenagers.”
The Program has won two awards this year, an Injury Control Council of
WA Injury Prevention and Safety Excellence Award in April, and in August
the WA Government Department Award at the 2014 Constable Care Child
Safety Awards
Employee of the Month
Shenton Park Campus
August 2014
Joe Lopez, Patient Care Assistant
Ward 2
September 2014
Michelle Watts, Clinical Nurse Specialist
Ward 1
October 2014
Carlo Divito, Senior Occupational Therapist
Occupational Therapy
Wellington Street Campus
August 2014
Ellen Henden, Enrolled Nurse
Medical Oncology
September 2014
Ian Suttie, A/Clinical Nurse Specialist
Ward 9A/B
October 2014
Gillian Watt, Staff Development Nurse
Ward 9C
November 2014
Deepan Krishnasivam, Registrar
Acute Medical Unit