Projects | St Vincent's Health Australia

People who experience homelessness have higher rates of morbidity and mortality than the rest of the population, and often face multiple barriers to accessing health care. St Vincent's Mobile Health Clinic is a full-service clinic that takes our hospital out into the community, where people experiencing homelessness or are at risk of homelessness can access the care they need in a safe and respectful environment.

The Inclusive Health Program assisted the vision for the Mobile Clinic to become a reality through provision of funds for the vehicle purchase, clinical fit out and technical fit out.

Run by our team of nurses, peer support workers and Aboriginal Health professionals, people can receive general health and wellbeing support, specialist care including diabetes, podiatry and wound care. The Clinic is also equipped with telehealth facilities meaning clients can have private appointments with chronic disease specialists, and receive alcohol & drug, and mental health support, without having to come to hospital. Read more about the clinic here.

The Stayin’ In, Stayin’ Deadly project aimed to improve the quality of care for Aboriginal and Torres Strait Islander patients presenting to Sydney ED department.

Inclusive Health funds were allocated as seed funding for a Doctor, Aboriginal Health Worker and other associated costs to develop new, innovative and inclusive model of care. This innovative approach reduced wait times, left-not seen rates and has subsequently been adopted as normal practice. We are proud that this project was recognised in the NSW Health’s Excellence in Aboriginal Health Care Award in 2022.

People utilising the North Richmond Medically Supervised Injecting Room (MSIR) are likely to experience disproportionate levels of other vulnerabilities and health issues (such as mental illness and homelessness). An Inclusive Health funded project commenced in 2019 to pilot and evaluate a new model of integrated care; providing care coordination to meet the significant unmet health and psychosocial needs of people who inject drugs. An infectious disease nurse and mental health clinician provided dual care co-ordination and clinical roles. A part time wound care nurse was also employed for 12 months to provide a service to clients and build capacity within the MSIR team.

In addition to providing clinical services on site, project staff were also able to develop relationships and referral pathways to other service providers (such as housing and mental health services), as well as building on the capacity of other MSIR staff, for example via the provision of education sessions. The critical role of St Vincent’s Hospital Melbourne (SVHM) staff was recognised in the Hamilton Review, an independent review of the MSIR, with the success of the pilot leading to the MSIR employing 2 staff in dual Mental Health Nurse and care co-ordinator positions.

Read the VIC Health review of the MSIR (https://apo.org.au).

Supported with funding from the Inclusive Health Program, Associate Professor David Goodman and Amy Atkinson working in the Department of Nephrology, St Vincent’s Health Melbourne led a campaign to encourage Indigenous Australians living with chronic kidney disease to ask their doctor if they are on the kidney transplant waiting list. The campaign was built around a concerning inequity where 13% of patients receiving dialysis treatment in Australia are Indigenous, yet only 2.3% of people who receive a kidney transplant are Indigenous.

This campaign built on work over eight years to identify barriers to Indigenous Australians gaining access to the National deceased donor kidney transplant waiting list, involving patient interviews, multidisciplinary team discussions and significant media coverage. We hope that this will ultimately lead to more Indigenous Australian’s gaining the health and social benefits of kidney transplantation rather than staying on dialysis.

Mental health conditions like anxiety and depression are estimated to affect approximately 50% of Australians during their lifetime. While common and treatable, many people who experience mental health difficulties cannot access effective treatment and often experience stigma, shame and isolation.

THIS WAY UP (www.thiswayup.org.au) is a not-for-profit, clinical service that delivers evidence-based treatment programs for mental health conditions via the internet. These digital programs are effective for improving mental health and make it easier for people to access treatment wherever they are, whenever they need it. Since 2012, THIS WAY UP have provided treatment to more than 150,000 people across Australia (and counting).

THIS WAY UP are now working to improve their reach and help more people access the care they need. With the help of funding from the Inclusive Health Program, THIS WAY UP were able to provide free access to resources to support people struggling with mental health challenges during the COVID-19 pandemic.

They are also conducting new research via an Inclusive Health Research grant to explore treatment equity for people who experience social disadvantage.

This research will be used to help improve access to digital mental health treatment for people who need it most, including those who are geographically isolated, live in remote communities, experience socioeconomic hardship and/or live with disabilities.

THIS WAY UP is a joint initiative of St Vincent's Hospital Sydney, and the University of New South Wales, Sydney. THIS WAY UP is funded by the Australia Government Department of Health and Aged Care under the Telephone Counselling, Self Help and Web-based Support Programs.

With the support of the Inclusive Health Program, SVHA Private Hospital Division is embarking on a significant project to improve capability and opportunities to improve the Aboriginal and Torres Strait Islander patient experience, ensuring all feel welcome, valued and safe when in our care. Working alongside Menzies School of Health Research, the project will involve the use of Yarning Circles for previous and current patients of our private hospitals. Through the research, we hope to understand both patient and cultural care experiences from the participants which will enhance our care into the future. The two-year project is due to be completed by February 2024.

The two large circles in the artwork represent both St Vincent’s Health Australia and Menzies School of Health Research. The other smaller circles are all of the communities and services that are part of this project. The background shows hand prints, this is an acknowledgement of our history, our journey, and our issues with healing and coping with trauma. The communities are connected by journey lines. These lines are like the rivers and waterways that bring life and maintain our cultural connection to place.

Artwork by Sydney based First Nations artist, Jasmine Sarin

It is common for people with our target population groups to have experienced trauma in their lives. With the support of the Inclusive Health Program, St Vincent’s Health Melbourne is leading a number of projects to improve ‘Trauma Informed Care’ (TIC), including the practices, procedures and policies across the organisation. Among this includes a Trauma Informed Simulation training program that began initially for graduate nurses but has been so popular we are expanding it further this year.

The evaluation of this program has shown an increase in knowledge of TIC and associated qualitative improvements in practice. The outcomes were subsequently published in Nursing Education Today and shared in various forums in Australia and internationally as part of our commitment to education and advocacy in the sector.

The overall project is bringing together lived experience of patients and staff in relation to trauma, the role of TIC in supervision, research methods, hospital spaces, cultural care, review of hospital complaints and examples of how powerful TIC practices can be for both staff and patients alike. The key will be to translate these outcomes into specific and achievable actions at the end of this project.

The LGBTIQA+ Safety and Responsiveness Project at St Vincent’s Health Melbourne has been underway since 2020, with the goal of improving and enhancing safety and responsiveness towards those who identify as lesbian, gay, bisexual, trans and gender diverse, intersex, queer, questioning, asexual and beyond (LGBTIQA+).

The project has focused on staff learning and development, visibility and awareness raising campaigns and coalition building among other activities to make SVHM a place where staff, patients and visitors of gender and sexual diversity are welcomed, included and celebrated. Highlights include the creation and rollout of LGBTIQ+ literacy training for staff across a range of departments, improved signage making bathrooms safe and inclusive for trans and gender diverse community members, the establishment of a Peer Navigator role to enhance the care and available expertise for rainbow communities, the development of a number of internal policies, continuation of the SVHM Pride Network, a range of external partnerships and a significant research project to understand the experience LGBTIQA+ staff and patients and how we can continue to improve.

Genetic factors play an important role in contributing to how patients metabolise and respond to medications. Pharmacogenomics testing, using DNA obtained through a simple cheek swab, can guide prescribers to the right medication at the right dose for their patients, optimising therapeutic efficacy and minimising side effects.

The ENACT study is a genomic research project developing, implementing and evaluating an innovative model of care to incorporate pharmacogenomics guided therapy for patients with mental illness with an aim to improve clinical care and outcomes for this vulnerable population.

Early outcomes of the study show patients are generally positive and willing to use pharmacogenomics. Psychiatrists and general practitioners say their patients feel more confident in taking medication guided by pharmacogenomics testing and therefore more likely to adhere to their medications. IHP funding over two years has helped to underpin this project, which has also secured $2.95m in Commonwealth Government funding to further this critical work.

With funding support from the Inclusive Health Program, the transformative project has been a catalyst that we aim to build further on over coming years, as part of SVHM’s commitment to diversity, inclusion, equity and social justice.

Health Equity Projects

Mobile Health Clinic

Stayin’ In, Stayin’ Deadly

Integrating care coordination into a medically supervised injecting facility

Am I on the list? Indigenous Australians living with chronic kidney disease.

Exploring health equity and the role of digital mental health

Improving patient experience of Aboriginal and Torres Strait Islander Patients in our Private Hospitals

Trauma Informed Care

LGBTIQA+ Safety and Responsiveness

Precision medicine for people living with mental illness