Building Capacity through Collaboration

In the lead up to the Institute of Hospitality in HealthCare conference, 17-19 October, John Kirwan reflects on almost 40 years’ experience in the healthcare industry. He urges us to look closely at the potential of working with the broader health community and organisations outside health to ensure food security and address the rise in co-morbidity.
I describe health as a unique industry because it is a labour, capital and transactional, 24 hour service. We are a complex, inter-relational industry that is constantly aiming to run more efficiently, minimise costs, maintain and improve quality and fulfil social responsibilities.
The areas of catering, cleaning and supply are often seen as costs of doing business in healthcare and an easy target when savings need to be found. Trying to maintain cost efficiency by cutting staff hours, however and reducing catering down to the bare bones, in my experience, does not translate to real, long term savings. It also restricts our capacity to meet the individual nutritional needs of patients which is an important factor in healing and preventing readmission.
Beyond Hospital
Figures from the Dieticians Association of Australia indicate that up to one third of elderly patients admitted to hospital in Australia are malnourished and we now have the disturbing paradox of obesity and malnourishment. Acutely ill patients with comorbidities who are also malnourished John Kirwan was appointed CEO of the Royal Flying Doctor Service Tasmania in Jan, 2015. He was formerly the CEO of the Launceston General Hospital (LGH), CEO of the Northern Area Health Service (NAHS) and from 2012 – 2014 the CEO of the Tasmanian Health Organisation – North (THO-N). John has almost 40 years of IR, HR and operational health experience. He has been the Commissioner for Public Employment in the Northern Territory, the Executive General Manager responsible for the Acute, Community, Public and Aboriginal Health areas of the Health Department of Western Australia (HDWA), and the General Manager responsible for Health Workforce Reform in HDWA. He was a full time union Official in Western Australia for 14 years. CEO, Royal Flying Doctor Service Tasmania present an extra problem in terms of their John Kirwan response to treatment.
Our success in short stay surgery, new drugs that allow us to get patients out of hospital quicker and pressure to clear beds are all reducing the average length of stay. A patient who would have been in a bed for 7 to 10 days where they would see the dietician, the podiatrist and the physio and OT is now in and out in a much shorter time and this brings with it a range of other issues.
We have a responsibility to our patient’s beyond hospital. On discharge, a patient’s ability to feed themselves adequately should be considered. In Tasmania we are seeing a growth in the demographic of single people living at home in small communities. The local clubs that used to provide a hot meal during the day have closed and we need to be clear about how to provide services to these people.
I’m thinking of the 80 year old bloke, discharged from hospital, living on acreage at the back of Lilydale that’s a 40 minute drive from Launceston with limited public transport options. For this man to know that he has a week’s or month’s supply of pre-cooked, nutritious meals on hand has got to be a positive in terms of recovery and prevention.

Collaboration
Moving forward, it seems to me that we need to be thinking outside the box. With health often being the largest employer and consumer, particularly in rural areas, we should look to building our capacity through collaboration and reach out to form partnerships with other organisations like agri-business and those with similar aims like defence and emergency services.
When I look at my time as the CEO of Launceston General Hospital, we supplied patient meals plus we did Meals on Wheels and products for smaller regional hospitals. If there was an emergency like bush fires, with the physical capacity of a big production area, our kitchens would be making sandwiches etc.
If health is already a large supplier of food to patients and staff, surely there is a critical mass there we can leverage from to ensure food security to a wider portion of our community by working with other organisations. Finding innovative ways to managing costs, efficiency and quality are the same solutions being sought by defence and emergency relief services.
In Tasmania, our defence technology site at Scottsdale is invested in developing food ration products for the army. They are bringing in new innovations like their Microwave Assisted Thermal Sterilisation MATS technology. MATS is a significant advancement in food processing that could revolutionise ready-to-eat meal production for the defence force and other sectors such as healthcare.
MATS enables pasteurisation and sterilisation of food produces ready-to-eat packaged meals that are shelf stable for over 12 months without freezing or refrigeration. MATS can be used for fish, meat, vegetables, fruit and grain/pasta. Using this technology, food retains more nutritional value than canning or retort processing.
So the questions I can see that we need to answer are; where are the opportunities to build partnerships with allied organisations and the broader health community? How are we addressing the new developments enabling ageing in place that is seeing more people living independently for longer? And how do we meet our responsibility for the nutritional needs of our patients with increasing comorbidities in hospital and on discharge?
don’t have the answers to these questions but it is vital that we start to have the conversation.

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John Kirwan - CEO, Royal Flying Doctor Service Tasmania
John Kirwan was appointed CEO of the Royal Flying Doctor Service Tasmania in Jan, 2015. He was formerly the CEO of the Launceston General Hospital (LGH), CEO of the Northern Area Health Service (NAHS) and from 2012 – 2014 the CEO of the Tasmanian Health Organisation – North (THO-N). John has almost 40 years of IR, HR and operational health experience. He has been the Commissioner for Public Employment in the Northern Territory, the Executive General Manager responsible for the Acute, Community, Public and Aboriginal Health areas of the Health Department of Western Australia (HDWA), and the General Manager responsible for Health Workforce Reform in HDWA. He was a full time union Official in Western Australia for 14 years.