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Annual Report

Our Vision: A world without limits for people with disability, illness and injury.

Contents THE YEAR AT A GLANCE

A MESSAGE FROM THE CEO AND CHAIRMAN

EDUCATION AND RESEARCH

SPINAL INJURY UNIT

BRAIN INJURY UNIT

METROREHAB HOSPITAL

ROYAL REHAB PRIVATE HOSPITAL

COMMUNITY REHABILITATION SERVICE

SPINAL OUTREACH SERVICE

BRAIN INJURY COMMUNITY REHAB TEAM 40 SARGOOD ON COLLAROY

CELEBRATING OUR PEOPLE

VOLUNTEER SERVICES

ROYAL REHAB FOUNDATION

THANK YOU

OUR LEADERS

We acknowledge the Traditional Custodians of Country throughout Australia and their connections to land, sea and community. We pay our respect to Elders past, present and future. And we extend our respects to all Aboriginal and Torres Strait Islander peoples.

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DISABILITY SERVICES

A N N U A L

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LEADING A TECH REVOLUTION IN REHAB 10

96%

97%

of patients said they would recommend RRPH*

of guests would recommend Sargood on Collaroy*

Pioneering Research + Cutting Edge Innovation

Empowered Team + Better Together + Reimagining Care & Support

Designed for Scale + Expanded Horizons

Community Rehabilitation Services

*Guest feedback results 2020/21

Volunteers

150

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*Client Exit Survey 2020/21

Accreditations

MetroRehab Hospital

volunteers engaged across our facilities

National Disability Insurance Scheme (NDIS) Practice Standards Australian Community Industry Alliance (ACIA) Standards National Safety and Quality Health Service (NSQHS) Standards.

ranking in the 2019 Stroke Foundation’s National Stroke Audit

Disability Services

178 34

people provided with specialist housing and support services

homes across 20 Sydney suburbs and growing

99% of patients had greater functional gain

*Patient Feedback Satisfaction Survey 2020/21

New Sexuality Service launched

New pain management clinic launched

Royal Rehab Foundation

$1M

We are proud to have Her Excellency the Honourable Margaret Beazley AC QC, Governor of New South Wales, and Mr Dennis Wilson as Royal Rehab’s joint patrons.

in bequest funds allocated to advanced rehabilitation technology centre

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Be bold in our ambition to grow

of guests said their stay at Sargood on Collaroy had a positive impact on their life*

of patients said the facilities were good or excellent+

Guided by our purpose and a new vision statement, we launched a six-year strategy based on three priorities and seven target outcomes.

Nurture a culture where our people and customers thrive

95%

100%

Bold New Strategy 2020/26

Be the destination for creative thinking in rehab and disability

Sargood on Collaroy

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Royal Rehab Private Hospital

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The Year at a Glance

Following several years of focus on gaining stability and strengthening our foundations — including bringing together our people, building on our reputation for clinical excellence, and increasing our financial sustainability — we are now ready to dream bigger.

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In December 2020, we committed to a new strategy of becoming an exemplar of what great care and support can look like. We will build on our leading industry reputation by investing in creative thinking that drives pioneering research and cutting-edge innovation. We will nurture a culture where our people and customers thrive. And we will be bold in our ambition to grow, to give our people and those we care for the best opportunity to thrive.

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Our new vision statement — A world without limits for people with disability, illness and injury — serves as our north star, guiding us towards a better and brighter future in rehabilitation and disability services.

Aligned Leadership

Reconciliation Action Plan During the year, we began work on a Reconciliation Action Plan (RAP). This strategic document includes practical actions that will drive Royal Rehab’s contribution to reconciliation internally and in the communities in which we operate. The RAP advances reconciliation by supporting respectful relationships with and creating meaningful opportunities for Aboriginal and Torres Strait Islander peoples.

This year saw new Board and senior management appointments that greatly enhanced operations and governance. Energised by our new strategy and possibilities to shape the future, we have embarked on our work to bring the strategy to life in ways that foster innovation, belonging and agility in times of change.

On Solid Ground

Raising the Bar with Tech

As we embark on a new year, we look to the challenges and opportunities ahead with enthusiasm. We are honoured and proud to lead our remarkable organisation and do so with a clear strategy in place and a strong sense of purpose.

Last year, following research into some of the world’s best rehabilitation facilities, we communicated our ambition to bring life-changing technologies to our shores and lift the standard of rehabilitation. In November 2020, Royal Rehab became the first organisation in Australia to make available the latest generation of advanced robotic exoskeleton technology from Ekso Bionics, EksoNR, and offer it as part of our physiotherapy programs. This pioneering move represents the inception of exciting longer-term plans announced this year to build technology-driven rehabilitation centres of excellence. The first of these centres is set to be established at our Ryde campus, transforming the facility into a world-class destination for rehabilitation.

Despite the challenges of the pandemic, our organisation continues to prosper. We have grown our team, and our values-based culture shines brightly, supported by a new online wellbeing and recognition program. We launched new services and remained committed to education and research — including the announcement of a new $30,000 PhD scholarship with the University of Notre Dame for research into resilience after traumatic injury rehabilitation.

Our 2020/21 financial resilience reflects prudent financial management and ethical stewardship of our resources. We are committed to working diligently to ensure ongoing viability.

We express our gratitude to the Royal Rehab Board of Directors, our executive and senior management teams, and our staff, volunteers, partners and donors. We are sincerely thankful to The Honourable John Alexander OAM, MP and The Honourable Brad Hazzard, Minister for Health and Medical Research for their ongoing support and guidance.

Pictured: CEO Matt Mackay (left) and Chairman Tony Staveley.

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Expanded Horizons

As we continued to navigate the COVID-19 pandemic, our commitment to protect the people we serve, our staff and the wider community was unwavering. Additional safety measures were implemented across our facilities, and our community took up the opportunity to get vaccinated as the best line of defence against the virus. We are proud to play an important role in supporting the NSW Ministry of Health’s response to the pandemic by welcoming patients with complex rehabilitation needs from acute facilities.

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If ever there was a year to prove the adage that ‘change is the only certainty’, it was 2020/21. With change comes progress and growth, which leads to exciting destinations, and this was true at Royal Rehab this financial year.

Resilience, Resolve and Wellbeing

A N N U A L

A Message From the CEO and Chairman

Not only did we launch a bold new six-year strategy and an inspiring new vision statement, we also raised the bar in rehabilitation. A first-to-market approach with advanced robotic equipment represents the beginning of our ambitions. We are proud of how our team continues to navigate what has become a prolonged battle to mitigate the COVID-19 pandemic. This has tested our team’s resilience and drawn us closer, while reaffirming our unwavering commitment to the people we serve.

Research Highlights Royal Rehab’s research covers many domains, including spinal cord injury (SCI), traumatic brain injury (TBI) and rehabilitation practices. We have a long history of leading research projects and collaborating with other researchers to expand our services.

Education and Research Education and research continue to be priority objectives at Royal Rehab, supported by our long-term supporter the Ducati Owners Club of NSW. Energised by the new organisational strategy, and with leadership from our Director of Research and Innovation, Julie Pryor, we began the process of embedding education and research deeper into the fabric of our operations. Not only will this approach provide richer evidence to inform the services we deliver, but it will also foster greater levels of creative thinking and a culture of inquiry.

Evaluating the Determinants of Meal Satisfaction in Inpatient Rehabilitation Researchers: Priya Iyer, Margaret Nicholson, Murray Fisher and Chui Long Mak Malnutrition is a worldwide issue for patients in rehabilitation settings. Although patients are provided with nourishing meals, hospitals find food goes uneaten, leading to the risk of inadequate nutrition for some patients. This cross-sectional study conducted in collaboration with the University of Sydney, sought to assess patient meal satisfaction in relation to flavour, taste, appearance and perceived quality; and to investigate the association between meal satisfaction and food left on the plate. Among the findings, it was revealed that meal satisfaction was related to patient expectations. Larger studies are being considered to examine the findings further.

Deteriorating Patients in Rehabilitation: A Retrospective Cohort Study

Journal articles published

Textbook chapters published

Health maintenance tools produced

Researchers: Daniel Walsh, Murray Fisher and Julie Pryor This study sought to investigate unplanned readmissions to inpatient rehabilitation facilities. In a three-year period 114 individual patients, most with comorbidity, were found to have experienced one or more unplanned readmissions to acute care. There was wide variability in how long these patients had been in

Verbosity, Traumatic Brain Injury and Conversation: A Preliminary Investigation Researchers: Dr Scott Barnes, Jason BransbyBell, Janine Mullay, Christine Taylor, Rebecca McNeil and Zia Gallagher Beverley. The complexity of communication symptoms associated with TBI makes cognitive-communication disorders challenging to conceptualise. One behaviour associated with these disorders includes excessive verbal output, known as verbosity. There is little evidence on the specific behaviours through which speakers achieve verbosity. This research found that verbosity can happen when people overuse normal conversational behaviours; for example, using phrases such as ’um’ to hold the floor during conversation. Further research is important to identity patterns of verbosity that can be used to guide speech pathology intervention.

Utilisation of the Brannagan Executive Functions Assessment in Increasing Self-Awareness in Relation to Goal of Return to Work in Individuals Post Traumatic Brain Injury Researchers: Fiona Mason, Stacey George and Julie Pryor Reduced self-awareness has been found to impact the successful return to work following TBI. While occupation-based treatments are commonly used, evidence for these approaches is limited. Using case study design and mixed methods, this pilot study found that despite contrasting differences in self-awareness between the study participants, all benefited from the Brannagan Executive Functions Assessment in relation to returning to work. These promising findings indicate further research with a larger sample size, with varied levels of self-awareness and therapists, is warranted.

Pictured top: Julie Pryor, Director Research and Innovation.

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The SCI Wellness Project was an initiative of Royal Rehab in partnership with the John Walsh Centre for Rehabilitation Research at the University of Sydney, with financial support from icare. This project produced a consumer-friendly Health Maintenance Tool to support people living with SCI and their families and carers, as well as general practitioners. The tool provides guidance on self-management for optimal health maintenance and helps identify when people with SCI should seek further medical attention. Work is now underway on a digital app-based version of the Health Maintenance Tool.

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Researchers: James Middleton, Mohit Arora, Melissa McCormick and Dimity O’Leary

rehabilitation before they required readmission. This research highlights the importance of ongoing close monitoring to detect any early warning signs of clinical deterioration.

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SCI Wellness Project (Phase 1)

Commitment to Education

2. Social Processes that Promote and Preserve Personhood in Traumatic Brain Injury Nursing Care in Hospital and Rehabilitation Settings — a PhD student project In collaboration with the University of Sydney

3. The Early & Intensive SCI-MT trial In collaboration with the University of Sydney and funded by the NSW Health SCI Research Grants Program

4. Evaluating Meal Satisfaction in Patients within Specialist Rehabilitation – a Master of Nutrition and Dietetics student project

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In collaboration with the University of Sydney

5. Are Home-Based Physiotherapy Sessions Provided at an Intensity to Evoke Cardiorespiratory Stress in Patients Post-Stroke? – a Master of Clinical Rehabilitation (Neurological Physiotherapy) student project In collaboration with Flinders University

6. An Exploration of the Expectations, Experiences and Perceptions of People with Newly Acquired Sudden Onset Disabilities in Relation to their Transition from Inpatient Rehabilitation to Home in Rural NSW – a Bachelor of Nursing (Honours) student project

During the year, we provided clinical education for nursing and allied health students from leading universities. We are proud of our clinical professionals who held appointments and lecturing positions at higher education facilities.

PhD Scholarship with the University of Notre Dame In April 2021, we announced a new research scholarship partly funded by Royal Rehab in collaboration with the University of Notre Dame Australia. The tax-free scholarship, valued at $30,000 per annum for up to three years, was open to applications from candidates interested in pursuing a PhD under the direction and supervision of an expert academic and clinical team based at the University of Notre Dame Australia and Royal Rehab. Centred around inner strength, connectedness, hope and spiritual wellbeing, the research seeks to explore these factors with rehabilitation inpatients, and address ways to enhance resilience among individuals with spinal cord injury or traumatic brain injury.

In collaboration with the University of Sydney

Training in Advanced Robotics

7. Spinal Cord Injuries Australia Peer Support Program Evaluation

In late 2020, the first group of Royal Rehab physiotherapists embraced the opportunity to undergo comprehensive training in using the advanced robotic exoskeleton, EksoNR, in preparation for a first-to-market launch in Australia. EksoNR is designed to be used in conjunction with clinical therapy to deliver better and faster rehabilitation outcomes for people living with neurological conditions, paralysis or lower limb weakness. The comprehensive program required 40 hours of training, plus over 15 clinical sessions during an eight-week period. Due to COVID-19 restrictions, this training was completed via an online approach for the first time ever. A second group of physiotherapists commenced their training early in 2021 and by March, Royal Rehab had eight fully qualified EksoNR physiotherapists. It is a tribute to the team members’ agility and commitment to learning that they all passed with flying colours. Five more physiotherapists have since commenced an EksoNR train-the-trainer program.

In collaboration with the University of Sydney and funded by icare

8. Patients’ Preferences for the Introduction of Spirituality into their Healthcare Journey In collaboration with St Vincent’s Hospital and the University of Notre Dame Australia, and funded by St Vincent’s Health Australia

9. Exploring a Novel Wellbeing Intervention for People with Spinal Cord Injury – a PhD student project In collaboration with the University of Sydney

10. Electrical Stimulation Combined with Strength Training to Increase the Strength of Very Weak Muscles in People with Recent Spinal Cord Injury. A randomised controlled trial In collaboration with the University of Sydney and Neuroscience Research Australia, and funded by the Slater and Gordon Foundation

EksoNR Live Webinar with Ekso Bionics In July 2021, our Senior Physiotherapist and Technology Lead, Jason Redhead, spoke live at an Ekso Bionics webinar on the topic: How to Successfully Integrate Robotics and Transform your Clinical Services. This popular event drew more than 400 delegates from across Europe, the Middle East, Asia and Oceania, including consumers, healthcare professionals and researchers. Jason discussed how the EksoNR advanced robotics exoskeleton has driven significant transformations in clinical outcomes and the expansion of services offered at Royal Rehab. He also shared how robotics has changed the way Royal Rehab has approached rehabilitation and helped advance clinical expertise.

MetroRehab Hospital Partners with Stroke Recovery Association NSW In the last financial year, MetroRehab Hospital staff presented at several webinars run by the Stroke Recovery Association NSW. This included the launch of Move with Metro, a digital webinar series where health professionals from MetroRehab Hospital provided past and present stroke clients with tips on living with a stroke and encouraged the audience to participate in a physical exercise challenge. In March 2021, MetroRehab Hospital’s stroke and neurological coordinator presented to the association’s members on the role of occupational therapy in stroke recovery.

RACGP Education Accreditation During the year, Royal Rehab successfully gained accreditation with the Royal Australian College of General Practitioners to provide continuing professional development (CPD) activities to general practitioners. The RACGP CPD Program supports GPs to maintain and improve their professional knowledge and skills. Royal Rehab looks forward to beginning education activities and supporting GPs with the provision of high-quality primary healthcare.

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In collaboration with Neuroscience Research Australia

Guided by a culture of continuous improvement, Royal Rehab has a long history of sharing knowledge and research, and embracing opportunities for learning and development for our staff, students and external clinicians.

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1. Life Expectancy after Spinal Cord Injury

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New Research Projects

establishing new clinical pathways and governance processes. Key to this success was the creation of the new role of Assistive Technology Lead, to which Senior Physiotherapist Jason Redhead was appointed in September 2020. With the support of Sarah Fereday, Professional Leader Physiotherapy, the physiotherapy team and the wider organisation, Jason’s dedication underpinned the work necessary to bring the EksoNR mobility program to life.

Guided by the pioneering spirit of our founders, this year Royal Rehab raised the bar in rehabilitation to a whole new level with a first-to-market launch of advanced robotic technology and a bold announcement of plans to build technology-driven rehabilitation centres across the country. The seed of the idea to be a leader in the provision of advanced technology for rehabilitation first started to grow in 2019. The CEO of Royal Rehab, Matt Mackay, along with Royal Rehab senior executives, attended the American Congress of Rehabilitation Medicine conference in Chicago followed by visits to some of the best rehabilitation centres in the United States. They were able to see the latest technological advancements in rehabilitation practice and were inspired by what they saw. Upon their return home, due diligence was undertaken to ensure feasibility over the long term. In September 2020, they began conversations with Ekso Bionics, an industry leader in robotic exoskeletons, and by November, two EksoNR exoskeletons were purchased and shipped to Australia. The EksoNR represents a flagship device in exciting plans for a technology-driven rehabilitation centre at the Ryde campus, which is slated to be operational by early 2022. Satellite sites across the country are planned for future years.

Accelerating Rehabilitation EksoNR is designed for clinical use under the supervision of a certified EksoNR physiotherapist in conjunction with traditional physiotherapy, specifically to help re-teach the brain and muscles how to walk again. Approved for use across a spectrum of injuries and disabilities — including stroke, spinal cord injury, multiple sclerosis and Parkinson’s disease — EksoNR’s sophisticated software captures data from the patient’s movements and provides real-time feedback. When combined with customised assistance from EksoNR and greater therapeutic dosage, patients are supported to retrain their muscles, helping them to move better with less support.

Bringing the Vision to Life General Manager of Royal Rehab Ryde, Selina Rowe, was instrumental in facilitating the operational requirements around the incorporation of EksoNR into Royal Rehab’s services, including bringing together clinicians and

Adventurer Rajiv Victorious and Hopeful From summitting Mount Fuji to learning to fly a plane, 31-year-old Rajiv had already amassed an incredible number of accomplishments.

Spreading the Word The Royal Rehab marketing team delivered an extensive multi-channel campaign to build awareness and drive demand for EksoNR with different audiences. These groups included the public, the medical community, patients and their families, and associations such as MS Australia and the Stroke Foundation. In addition to creative direct marketing, advertising and social media campaigns, a media outreach campaign was launched, resulting in substantial coverage on television and in industry publications. Between March and June 2021, publicity included national exposure on Channel 7’s Sunrise program and the Channel 9 News, and in feature articles in Private Hospital News, Link Magazine, Hospital & Healthcare Bulletin and Freedom2Live.

Now, the EksoNR advanced robotics exoskeleton is helping him live better with multiple sclerosis (MS). Life was an adventure for Rajiv until he noticed some physical changes in his body four years ago. Concerned, Rajiv saw his doctor who diagnosed him with Primary Progressive Multiple Sclerosis, a rare type of MS. “Mum saw a story about EksoNR on the news. I thought, ‘Wow, this could really help me’,” Rajiv said. He immediately contacted Royal Rehab for an appointment. Rajiv said the difference to his mindset and confidence was immediate after using EksoNR. “I feel like the Terminator,” he said with a laugh. “I haven’t walked on my own two feet in years but since starting EksoNR, I am getting better at walking.”

Enquiries for EksoNR have come from across the country, with demand continuing to grow. The organisation looks forward to an exciting future re-imagined with life-changing technology for the people we serve.

Five sessions in, the physiotherapy team are helping Rajiv to retrain his brain and muscles to walk better. He is relearning the walking sequence from shifting his weight forward, to swinging his legs, to striking the ground with the heel. The EksoNR assists his weight and offers feedback, so he can correct his posture and leg movements while walking during therapy.

“Our vision is to create a centre of excellence in rehabilitation technology that empowers people living with disability, injury or illness with unparalleled levels of freedom and independence.”

“EksoNR adds to my wellness. To feel that again — learning to walk, to move — it feels mentally powerful. I am also walking better between sessions. My leg lifts a little higher and my body is a little stronger. This is leading bionic technology,” Rajiv said. Pictured above: Assistive Technology Lead and Senior Physiotherapist Jason Redhead with client Rajiv.

Royal Rehab CEO Matt Mackay

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Client Story

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Leading a Tech Revolution in Rehab

Excitement around EksoNR across our workforce was palpable. Eight physiotherapists embraced the opportunity to become credentialed in the technology, undertaking a comprehensive virtual training program. After being accredited, they enrolled in a train-the-trainer program, which is ongoing. Significant training was also provided to Royal Rehab medical staff and allied health teams on how EksoNR could be used in therapy and the important role they played in assessing patient suitability and safety.

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Specialist Training and Development

of residents, clients, staff and the wider community remained the key driver as the team strictly followed the guidelines and took all necessary precautions. Embracing the Royal Rehab value of Innovative Thinking, the team made every effort to keep morale up and our people connected. There were video-making sessions where residents recorded the humorous side of their experiences in lockdown, baking afternoons, virtual catchups with family and friends, and endless acts of kindness. As a strong advocate of the COVID-19 vaccine, Royal Rehab actively encouraged and facilitated the vaccination of staff members, residents, clients and their families as soon as it became available to priority groups. The Disability Services team is to be applauded for their dedication, teamwork and agility in challenging times.

It’s said that ‘home is where the heart is’, but for people with disability that can be a hard place to find. While housing stress is a trending issue, people with disability face additional pressures — such as high rates of unemployment, limited housing options and specific support needs — which put them at increased risk of homelessness.

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people provided with specialist housing and support services

homes across 20 Sydney suburbs and growing

Since 1899, Royal Rehab has been committed to supporting people with disabilities to find secure and comfortable places to call home, with the right supports. Today, our Disability Services division proudly carries on the legacy of our founder, Susan Schardt. Our accommodation and support services provide a guiding light for people with disabilities in finding places where they can be free to be themselves and live life with choice and control.

Unwavering Care and Support Throughout the peaks and troughs of the protracted COVID-19 pandemic, the Disability Services team has ridden the storm with an unwavering commitment to the care and support of the people we serve. Prioritising the safety and wellbeing

Jessica brought with her over 15 years of experience at Royal Rehab, where she has held a variety of positions, including Clinical Nurse in the brain and spinal injury units, Clinical Operations Manager of the Brain Injury Unit, After-Hours Nurse Manager, and Director of Nursing. In the Director of Nursing role, Jessica was responsible for managing Royal Rehab’s on-site supported accommodation, Weemala Building One.

“I am passionate about supporting people with disabilities to live life as independently as possible. It’s a privilege to work for an organisation with over 120 years of commitment to this cause.”

Jessica Scanlan, General Manager Disability Services

A Guiding Light In September 2020, Disability Services underwent the comprehensive and rigorous three-year accreditation process against the National Disability Insurance Scheme (NDIS) Practice Standards and the Australian Community Industry Alliance (ACIA) Standards.

Following months of preparation and three days of auditing — all of which were completed remotely due to COVID-19 restrictions, including interviews, documentation and process reviews, and observations — the team is to be acknowledged for passing with flying colours.

New Community Centre Announced After many years located at Ryde, the team began the process of looking to move to a new purpose-fitted space, with plans for an exciting new community centre for clients. The vision is to create a custom-built space that will give our clients the opportunity to come together, relax and socialise as one family in a friendly and comfortable setting. This will also be a welcoming destination for clients to participate in recreational and educational activities — including life skill workshops — with topics such as healthy cooking, assistive technology, social skills and much more. For staff, the new space is set to feature a dedicated training area for onboarding and professional development. 13

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Disability Services

The NDIS Practice Standards specify the quality standards to be met by registered NDIS providers to deliver supports and services to NDIS participants. ACIA Standards focus on the key issues required to deliver high-quality, individualised services, with compliance demonstrating the achievement of high-quality, low-risk service delivery and a culture of continuous improvement.

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As part of the senior management restructure that took place in December 2020, we farewelled Nick Edwards from the role of General Manager Disability Services. We recognised Nick for his leadership of the Disability Services team as he moved to his new role of General Manager/Director of Clinical Services at MetroRehab Hospital. We welcomed Jessica Scanlan into the role of General Manager Disability Services following her transition from the position of General Manager Royal Rehab Inpatient Services.

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Change of Leadership

Upgrades to Facilities Continued Work to refresh our accommodation homes continued to be a focus this financial year. With extensive lockdowns in Sydney, the aim was to make spending more time indoors more pleasant. The team has been working with housing providers to ensure homes have been repainted and contemporary new furniture has been fitted. In homes that needed extra attention, the team organised for bathrooms, flooring, walls and ceilings to be renovated. The refresh of the homes has been well received by residents, staff and families alike.

Horsing Around Helps Our People Become Great Leaders

Through a series of individual and team-building exercises with a majestic group of horses, the team explored concepts such as the power of body language, respect and perception; all of which have great relevance in the workplace. In other areas of learning and development, a new Education and Training Coordinator role was established, and we welcomed Marcella Grech to the position. Bringing with her a wealth of experience, Marcella led the delivery of a comprehensive orientation program designed to aid in attracting and retaining support workers and promoting engagement with new starters. The program also supports the provision of the essential knowledge, skills and competence that underpin high-quality service delivery in line with national standards.

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As part of our ongoing commitment to the professional development of our staff members, the Disability Services team attended various conferences and

educational workshops to upskill and grow as leaders. A highlight was time spent at an equine-assisted learning centre. Here the team benefitted from a unique approach to learning and gained valuable interpersonal, life and leadership skills.

“The staff care, understand and provide continuous support. I feel like I belong. I am supported to enjoy doing things I love — singing, socialising and helping others. Royal Rehab makes this all possible for me.”

Andrew, long-term resident

Client Story

Shan Shines With Royal Rehab Support

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“Here at her fully supported home, staff go above and beyond their job requirements — it feels like family.”

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Richard, Shan’s husband

From acute hospital, to aged care, to a purposebuilt supported home — it has been a long journey for the close family who have found ‘a home away from home’ with Royal Rehab for their beloved wife and mother following a life-changing event in 2018.

rehabilitation therapy. Here, she received a tailored program from the multidisciplinary team of allied health professionals. Or, as husband Richard told us, “It was practically every allied health profession you could poke a stick at supporting Shan!”

An accomplished academic, Shan moved to Australia from China when she was just 20 years of age. Over the years, the talented statistician rose to become a world expert in data and predictive modelling.

In 2020, a vacancy became available at one of Royal Rehab’s disability support homes in Ryde and Shan’s family was delighted. At the modern, purpose-built facility, Shan receives 24/7 support with her everyday needs and benefits from ongoing speech therapy and physiotherapy. Her speech and physical strength have improved, and she has her sights set firmly on her next goal: “I want to walk again.”

After returning to the office following a work lunch one day, Shan suddenly experienced a severe headache. She was diagnosed with a haemorrhagic stroke, which greatly impacted her movement, speech and breathing functions. She underwent a surgical procedure to assist with breathing and was unable to speak. Shan was moved into a high-care aged care facility, after which her doctor referred her to Royal Rehab for

Shan continues to defy the odds. Richard is beyond thrilled with the care and support Shan continues to receive and describes our team as, “large, supportive and highly professional. Everyone is working together, so that Shan continues to improve.”

Spinal Injury Unit

COVID-19 Response

Total admissions

Average length of stay:

113 days

The Royal Rehab Spinal Injury Unit is one of only two units in New South Wales dedicated to providing specialist rehabilitation services to people who have sustained a spinal cord injury (SCI). Sudden and life-changing, SCI often causes permanent loss of strength, sensation and function below the level of the injury, resulting in longterm disabilities. However, with specialist rehabilitation and assistive devices, people with SCI can go on to lead productive, independent lives.

Falls, motor vehicle accidents and spinal cord infections were the most common reasons for admissions.

Average age of inpatients:

Gender of inpatients:

72% male 18

As the COVID-19 pandemic continued to evolve, the Spinal Injury Unit responded in true Royal Rehab spirit. Demonstrating an unwavering commitment to the safety and wellbeing of clients, staff and the wider community, the team took precautionary measures and strictly followed the guidelines of NSW Health while remaining focused on delivering high-quality healthcare. During the year, Royal Rehab played an important role supporting the broader healthcare system by welcoming additional rehabilitation patients from other facilities as part of NSW Health’s COVID-19 response plan. We are proud of our Spinal Injury Unit staff who provided invaluable support in this process, demonstrating agility and enthusiasm by stepping up and supporting patients with complex rehab needs.

Change of Management In December 2020, the spinal and brain injury units farewelled Jessica Scanlan from the role of General Manager Inpatient Services and Director of Nursing. We acknowledged Jessica for her leadership and welcomed Selina Rowe into the new role of General Manager Royal Rehab – Ryde, which covers operations of the spinal and brain injury services, Royal Rehab Private Hospital, and Community Rehabilitation Services. Selina brings with her over 15 years’ senior management and executive experience. In May, Carmel Kennedy was appointed to the new role of Director of Clinical Services, bringing with her a passion for rehab nursing practice and a wealth of experience from across the public and private sectors.

The on-site trial of a suite of Tyromotion robotic therapy devices was also enthusiastically embraced by the team. This advanced robotics enable clients to be guided through the rehabilitation process with greater intensity. The team continue to use ‘smart’ devices to show clients cost-effective and readily available options to assist with everyday tasks around their homes. Additionally, the Spinal Injury Unit Recreational Therapy team expanded the range of recreation options for clients to include a power-assisted, electric hand cycle.

Accreditation In March 2021, Royal Rehab underwent the rigorous process of accreditation process against the National Safety and Quality Health Service (NSQHS) Standards. The NSQHS Standards provide a quality assurance mechanism that assesses whether relevant systems are in place to ensure that expected standards of safety and quality are met. The comprehensive and intensive accreditation process, which is completed every three years, involves measurement against eight standards, covering highprevalence adverse events, healthcare-associated infections, medication safety, comprehensive care, clinical communication, responding to clinical deterioration and more. Following months of preparation and a period of in-person audits, interviews, documentation and process reviews, and observations, Royal Rehab’s teams are to be acknowledged for a successful outcome.

Processes, Improvements and Partnerships During the year, the Spinal Injury Unit implemented several initiatives, improvements and partnerships. While prioritising strong rehabilitation outcomes and client care, several processes have helped to streamline service delivery and improve efficiency. • I n collaboration with Royal North Shore Hospital, the team completed a project to improve client transfers to the Spinal Injury Unit and provide a seamless, personalised experience for clients and their families.

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There was a broad mix of age groups among clients, from teenagers through to seniors. As part of our continuous professional development program, the team undertook training with Westmead Hospital’s Adolescent Unit to ensure the latest evidence-based practices were in use to address the unique needs of younger age groups.

During the year, the Spinal Injury Unit team enthusiastically embraced new robotic technology, in the form of the EksoNR exoskeleton, when it became available in Australia for the first time through Royal Rehab. Following an intensive training and accreditation process for physiotherapists, clients of all ages in the unit benefitted from the device as part of their personalised therapy programs. The opportunity to work with advanced technology has been an exciting experience for clinicians in terms of their professional development.

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During the year, the Spinal Injury Unit supported 57 clients who had experienced SCI resulting in quadriplegia or paraplegia. The average length of stay was 113 days, and the majority of clients were male. Falls, motor vehicle accidents and infections of the spinal cord were the most common reasons for admission. A large proportion of clients admitted with quadriplegic injuries had very high-level SCI, and the team rose to the complex clinical demands with professionalism and ease.

Embracing Rehabilitation Technology

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The Spinal Injury Unit at Royal Rehab is renowned for its specialist rehabilitation expertise, delivered through a multidisciplinary team of healthcare professionals including rehabilitation doctors, nurses and allied health professionals. Individually tailored and goal-based rehabilitation programs focus on enabling clients to achieve outcomes that are meaningful in their lives.

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•T he Multidisciplinary Collaborative Practice Project was initiated to establish a comprehensive set of guidelines around interdisciplinary processes. The aim is to provide a framework for best practice processes between the various allied health disciplines, with a view to optimising clinical outcomes. •T he client education program, Learning Together, was refreshed with refined topics and educational resources. This valuable series aims to empower clients with practical skills and knowledge in areas such as returning to driving; sexuality and intimacy; bladder, bowel and skin management; and mental wellbeing. While Royal Rehab has a zero-tolerance approach to abuse towards its staff, during the year the Spinal Injury Unit managed several incidents that had the potential to undermine the safety of our frontline workforce. In response, the team developed a client-facing framework of expectations for behaviour based on Royal Rehab’s organisational values. Positive outcomes of this work have been felt across the department with a significant reduction in the number of aggressive incidents.

Developing and Sharing The Spinal Injury Unit continued to focus on providing opportunities for professional development for staff members. This included supporting secondments based on personal professional development goals, training on goal-setting and planning processes, and ongoing training in clinical practice. A large group of staff attended the virtual International Spinal Cord Society Annual Scientific Meeting 2020. The team also welcomed university students across a range of disciplines into our facilities, where they gained practical experience. Staff were involved in several significant research projects during the year. One highlight included the Early and Intensive Motor Training Trial, which is investigating the impact of additional intensive motor training to enhance neurological recovery in people with recently acquired SCI. Senior Physiotherapist Donna Rainey is the site principal investigator, and the research is funded by the NSW Ministry of Health and led by collaborators from the University of Sydney.

There’s No Place Like Home for Gloria Zipping about in a new car, life was good for Gloria until October 2020 when the 77-year-old says “it all went belly up”. It was 2am when her grandsons — one a paramedic, the other a nurse — had her taken to hospital because of unbearable pain.

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•A review of handover practices was undertaken to encourage deeper client engagement in decisions about their care and setting daily goals.

Client Story

“It was seven and a half months before I went home again,” Gloria chuckles. “It was a very long night.” She had surgery to remove a growth on her spine. When Gloria fell in a heap a few weeks later, they found a haematoma on her spine near the surgical wound. It was back to surgery.

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•T he Spinal Injury Unit Client Timetable Project was initiated during the year in recognition of the value and importance of nursing care for people with SCI as part of a holistic approach to rehabilitation. This beneficial project helps clients and staff members to better understand the nature of nursing care and the positive impacts it has.

“A doctor told me I would likely never walk again. He gave me the kick up the bum I probably needed — I was determined,” she said.

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•A comprehensive range of quality improvement initiatives were implemented around clinical observations. This led to improved client safety, earlier detection of deteriorations, a reduction in unplanned transfers to acute hospital care, and earlier escalation and treatment.

Seeing her spirit, the hospital recommended Royal Rehab. The whiteboard in her room helped overcome her initial overwhelm. “They said ‘here, follow this’. It listed my sessions with the occupational therapist, social worker, doctors and psychologist. It was hard work but I did everything they asked.” Today, while Gloria can no longer drive and life is different, she can walk with a frame and lives independently. “The Royal Rehab team are fantastic,” she said. “The grounds are beautiful with that big duck pond.” On her birthday, her grandsons were able to bring a surprise visitor — her 14-year-old cocker spaniel. “In the last few weeks there I was given room number 1. I knew I was on my way home.”

COVID-19 Response

Total admissions

Brain Injury Unit

Accreditation Average length of stay:

94 days Falls, road-related accidents and sport incidents were the most common reasons for admissions.

Traumatic brain injury (TBI) is a cause of disability among people of all ages. Physical, cognitive and behavioural wellbeing can be severely altered, and lifelong disabilities are common.

Average age of inpatients:

Royal Rehab’s Brain Injury Unit is a highly specialised service providing inpatient TBI rehabilitation to adults aged 16 to 65. It is one of only three statewide services in New South Wales dedicated to empowering people with skills, function and confidence to live life as independently as possible following TBI.

Gender of inpatients:

74% male

In March 2021, the Brain Injury Unit underwent the rigorous process of accreditation process against the National Safety and Quality Health Service (NSQHS) Standards. The Standards provide a quality assurance mechanism that assesses whether relevant systems are in place to ensure that expected standards of safety and quality are met. The comprehensive and intensive accreditation process, which is completed every three years, involves measurement against eight standards, covering high-prevalence adverse events, healthcare-associated infections, medication safety, comprehensive care, clinical communication, responding to clinical deterioration and more. The Brain Injury Unit is to be acknowledged for the successful accreditation outcome that follows months of preparation.

Solidifying Partnerships Royal Rehab continues to be involved with the University of Sydney Susan Wakil School of Nursing and Midwifery through research and evidenced-based publication projects. Leading this

work is the Brain Injury Unit’s Clinical Nurse Consultant, Duncan McKechnie, in conjunction with Royal Rehab’s Clinical Associate Professor and Director of Research and Innovation, Julie Pryor, and nursing scholar in residence Associate Professor Murray Fisher. Highlights of the research and projects during this period include published research that examined the nature and characteristics of patients readmitted to acute care from inpatient brain injury rehabilitation. Going a long way in ensuring the future of local healthcare professionals, Royal Rehab has been working with Macquarie University since 2018 in the clinical education of talented speech pathology students. The team’s own speech pathologist, Janine Mullay, has dedicated much of her time to supporting a student group within the Brain Injury Unit. This partnership continues to benefit students, patients, and speech pathology staff, and we expect it to continue doing so for years to come. Royal Rehab has supported a six-month secondment for Janine in the speech pathology student unit at St Joseph’s Hospital. The experience of this secondment will no doubt be beneficial for the ongoing clinical education of students at Royal Rehab.

Growing Team Capability This year, the Brain Injury Unit employed Clinical Nurse Educator Simran ‘Sim’ Atwal as a new addition to the multidisciplinary rehabilitation group and one that we anticipate will have long-term benefits for the team and our patients. Sim comes to us with 10 years of acute neurological nursing experience. Sim will be involved in coordinating education for the nursing team and is devoted to evidence-based and contemporary clinical nursing practice to provide the best possible care to our clients. Sim also assists with the inhouse education of the allied health team. With this new role, we know that the talented team at Royal Rehab will propel themselves even further into providing excellence in healthcare.

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There was a slight increase in the number of patients admitted during the year compared to the previous period, and the average length of stay was constant at 94 days. The most common causes of admission continued to be falls, road-related accidents and sport incidents. Men dominated the cohort, accounting for 74 per cent of admissions. While the case mix remains consistently complex year on year, 91 per cent of patients were discharged home following their rehabilitation stay. The remaining clients were either discharged to an acute/rehabilitation hospital closer to their home, or to specialist accommodation where they benefitted from ongoing support.

Simran Atwal, Clinical Nurse Educator, Brain Injury Unit

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Delivering Quality Care

“I aspire to empower staff to deliver the very best evidencebased, holistic rehabilitation care for our clients, in addition to supporting the nursing team to achieve their educational goals”

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As the pandemic evolved throughout the year, the team continued to monitor developments, take precautionary measures, and ensure strict guidelines were followed to protect clients, staff members and the wider community. With experience gained during the previous year, the team was ready to swiftly respond when needed with preventive measures such as the use of personal protective equipment, visitor restrictions and enhancements to the already rigorous infection control procedures. The devotion to ensuring a safe environment and the ability to continue providing clients with an exceptional level of care is a testament to the team’s commitment. Part of this care was the initiation of the Virtual Visitors’ Program, which ensured clients were able to remain connected with their loved ones during lockdown periods.

Client Story

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Louis is Getting His Life Back After a Crash

Team Members who Shine The Brain Injury Unit team has been participating in a research project funded by the National Health and Medical Research Council to improve the way we provide lower limb strength training using ballistic strength. This is a significant project because mobility impairments, such as difficulty walking, are often present following a traumatic brain injury. Such impairments can be a permanent disability — impacting everyday tasks and restricting social, employment and sporting activities. Low muscle power generation is the main factor in mobility impairments, and strengthening exercises performed quickly — called ‘ballistic’ training — play a key role in rehabilitation.

Royal Rehab is incredibly proud of Bridget Sticpewich, Brain Injury Unit Senior Physiotherapist, who has been a key investigator and site convenor on the research project, which is expected to have a positive impact on clinical practices for our clients.

Looking Forward With COVID-19 restrictions leading to the cancellation of the annual Wall of Fame event in 2020, the team is looking forward to future events to be held again at a time when it is safe to do so. The Wall of Fame Ceremony provides an opportunity to reflect on and celebrate the incredible journeys some of our clients have undertaken in their recovery following a brain injury. The patients’ experiences are immortalised through stories they share at the ceremony and through digital media displays in the Brain Injury Unit.

Opening the front door to hear your 16-year-old was critically injured in a car accident is a parent’s worst nightmare. Trish and Greg Kenney remember everything about the October 2020 night Louis was airlifted to hospital and his harrowing weeks in an induced coma while doctors dealt with his ruptured spleen and broken bones, and assessed his brain injury. Louis remembers little. “I was in Year 11, played rugby league and was about to start an electrician apprenticeship. I remember being at my mate’s house, then I didn’t know what happened for a few months. It was confusing.” A few weeks after the accident and now awake, Louis’ response to a therapy dog led to his transfer to Royal Rehab’s Brain Injury Unit. Being admitted is one of a few

sketchy memories Louis has of this time. Completely dependent on others when he arrived, Louis worked hard with his therapists to walk, talk and eat again. He was one of the first Australians to use the EksoNR robotic exoskeleton in rehab. His parents describe Royal Rehab as ‘the complete package’. “The staff were unbelievable and went above and beyond. We’d walk in and see them brushing his teeth — it was a totally different level of care. We felt safe leaving him because we could see he was being treated like he was their own,” Trish said. With a wide smile, Louis talks about starting his apprenticeship soon, and how he’s less than 20 driving hours away from getting his provisional licence. With grit, focus and determination, Louis is getting his life back.

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MetroRehab Hospital MetroRehab Hospital is a boutique specialist rehabilitation facility with a reputation for delivering strong clinical outcomes. Acquired by Royal Rehab in 2019, MetroRehab offers both inpatient and day programs, and specialises in neurological conditions such as stroke and Parkinson’s disease. It is also renowned for its rehabilitation programs for people with cancer and cardiac disease, and its pain management and reconditioning programs.

99%

ranking in the 2019 Stroke Foundation’s national audit

of patients gained extra function

98%

90%

of clients would recommend MetroRehab’s day program and return if needed*

of inpatients said MetroRehab met or exceeded their expectations*

*Patient Feedback Satisfaction Survey 2020/21

•C are provided by a dedicated stroke/neurological team — we provide an evidence-based treatment program and have a dedicated stroke and neurological manager. These ensure patients receive the recommended practice to maximise their recovery and that they are linked to support services for their ongoing care after discharge.

Despite the challenges of the pandemic, MetroRehab continued to deliver strong clinical outcomes and high patient satisfaction rates. Impressively, 90 per cent of inpatients said MetroRehab met or exceeded their expectations, and patients treated for neurological conditions returned home sooner and with greater function than the national average.

Enhancing Customer Experience

Change of Management

MetroRehab Hospital adopted an exciting new model of care delivery during the year with the introduction of rehabilitation care coordinator roles. As part of our commitment to providing patients with exceptional customer experience, these knowledgeable professionals provide each patient with a familiar face and a constant source of support throughout their rehabilitation journeys.

As part of a senior management restructure, in December 2020, we farewelled Denise Thomas from the role of General Manager. We recognised Denise for her 13 years of leadership as she moved to the new role of Chief Operating Officer at Royal Rehab. Nicholas Edwards was welcomed as General Manager & Director of Clinical Services, bringing with him over 25 years of healthcare experience in the public and private sectors. This experience includes a variety of senior management and executive roles, such as clinical nurse consultant in an intensive care unit, CEO of several private hospitals, and national quality and risk manager for a private healthcare provider.

Exceeding National Stroke Standards

The dedicated rehab care coordinators — Caleb Showyin, Brittany Ainge and Virginia Agosti — are allied health professionals with expertise in rehab areas covering neuro, cancer, brain tumours and more.

MetroRehab’s exceptional standards in stroke rehabilitation are widely known and this financial year, the hospital achieved the top ranking in the 2019 Stroke Foundation’s National Audit for setting goals collaboratively with stroke survivors and their families. MetroRehab successfully performed against the four key pillars underpinning the national audit: •A ddressing psychological needs — we ensure all client moods are assessed and referrals made promptly to our clinical psychologist. We also offer music therapy to support healthy emotions and wellbeing.

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MetroRehab was proud to support the Sydney Local Health District and play an important part assisting the broader healthcare network in the COVID-19 response by welcoming patients from acute hospitals. MetroRehab’s established partnership with the local health district and renowned neurological expertise made it a good fit to take patients with high care needs.

• I ncorporating information and education — we are trained to provide information to patients and their families about stroke prevention and recovery. This includes education on returning to work, driving and intimacy.

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Throughout the year as the COVID-19 situation evolved, the team remained resolute in their commitment to safety while delivering high-quality services and keeping our community connected. Numerous preventative measures were put in place, including enhanced personal protective equipment, visitor restrictions and COVID-19 screening measures. Staff also embraced the opportunity to access vaccines when they became available to priority groups.

•A dhering to current clinical guidelines — we have an ongoing training program, supported by a dedicated stroke and neurological program manager who monitors compliance with guidelines, and updates them as the body of evidence improves.

Caleb Showyin

Brittany Ainge

Virginia Agosti

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Prioritising Care and Safety

Virtual Steps For Stroke Wellness

recovery. The event wrapped up with an online meeting celebrating the accomplishments of the participants with presentations from several people, including Her Excellency Margaret Beazley AC QC, Governor of New South Wales.

Embracing the Royal Rehab value of Innovative Thinking, the annual Stroke Wellness Walk took a different form this year because of the COVID-19 health crisis. Rather than a physical gathering of patients, friends and supporters, we partnered with Stroke Recovery Association NSW to hold a virtual event, called ‘Move with Metro’.

Shaking It Up for Parkinson’s

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The focus of the virtual challenge was retraining the brain after stroke, using one of the most significant rehabilitation techniques — repetition of daily movements. Throughout the week-long campaign, dozens of past patients signed up to set themselves a personal daily repetition goal such as a certain number of steps or arm raises, or lifting a cup to drink. Each person was able to check in with MetroRehab clinicians to support their ongoing

In April 2021, MetroRehab Hospital, along with Royal Rehab Private Hospital, was a proud sponsor of the Shake It Up Foundation’s Pause 4 Parkinson’s event during Parkinson’s Awareness Month. Renowned for specialist expertise in Parkinson’s rehabilitation programs, MetroRehab recognises the importance of supporting fundraising campaigns that raise awareness and vital funds to reduce the impact of Parkinson’s.

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Specialist Stroke Rehab Gets 90-year-old Teresa Home In March 2020, Teresa found herself unable to get out of bed. Her daughter, Susan, called an ambulance, and Teresa presented at hospital with dizziness, nausea and balance problems. The independent 90-year-old had experienced a right lateral medullary stroke.

Teresa benefited from a multidisciplinary approach at MetroRehab Hospital under the direction of Rehabilitation Medicine Physician Dr Darren Lee. Her therapies included occupational therapy, physiotherapy, speech pathology, dietetics, clinical psychology, social work and music therapy.

Teresa was later referred to MetroRehab Hospital where she was supported for three months as an inpatient with a personalised rehabilitation program.

Teresa is now back living at home with her husband and daughter, and credits the entire team at MetroRehab Hospital for her progress.

With her balance severely affected, Teresa could no longer walk without assistance or manage her daily activities. She also had trouble talking and swallowing, and experienced constant dizziness. The MetroRehab Hospital team worked patiently with Teresa to understand her goals. For this energetic gardening and cooking enthusiast, that meant being back at home in her beloved garden and kitchen.

“Mum has been so determined to get her old strength back,’’ explained Susan. ‘’She’s now back doing all her usual activities around the house with barely any support. You definitely wouldn’t think she was 90 years old!”

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Client Story

Accreditation

The team rose to the challenges of the evolving pandemic with professionalism and resolute commitment to keeping everyone safe. As the restrictions tightened, the team responded with precautions such as enhanced personal protective equipment, visitor restrictions and COVID-19 screening measures. When vaccines became available to priority groups, staff embraced the opportunity to be vaccinated as the best line of defense against the virus.

In March 2021, RRPH underwent the rigorous process of accreditation against the National Safety and Quality Health Service (NSQHS) Standards. The process involved extensive team-wide preparation and a period of in-person audits, interviews, and documentation and process reviews. The team is to be congratulated for the successful outcome.

RRPH was proud to play an important role in the NSW Ministry of Health’s response to the pandemic from mid to late 2020, welcoming patients from Royal North Shore Hospital with spinal cord injuries or complex neurological conditions. Staff members are to be commended for adjusting to the more complex case mix with ease.

RRPH took part in the 2019 National Stroke Audit, an initiative led by the Stroke Foundation to capture the current state of play in stroke care and review best practice guidelines. It explored all facets of stroke care within our health system to ensure patients are adequately cared for. RRPH is proud to not only meet the standards but in many cases exceed them.

Despite the challenges, RRPH’s strong clinical and customer satisfaction results remained impressively high; a reflection of the teams’ unwavering commitment to putting patients first.

• Availability 7 days — RRPH offers physical rehabilitation therapy every day of the week and now has additional occupational therapy on weekends.

Offering both inpatient and day programs, RRPH specialises in multidisciplinary neurological rehabilitation for conditions such as stroke, Parkinson’s disease, multiple sclerosis and traumatic brain injury. RRPH is also recognised for its orthopaedic, and reconditioning programs. This modern facility offers a fully equipped gymnasium with the latest in rehabilitation equipment, and a heated hydrotherapy pool.

Selina Rowe was welcomed into the new role of General Manager Royal Rehab – Ryde, which covers the operations of RRPH, the brain and spinal injury services, and Community Rehabilitation Services. Selina brings with her over 15 years’ senior management and executive experience.

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100%

• Post-discharge rehabilitation — RRPH provides easy and regular access to day rehabilitation services and referral to our sexuality clinic, hydrotherapy and a driver assessment and training service, as well as a series of other post-discharge options. • Education and training — RRPH prides itself on providing our staff with access to training and education in all facets of rehabilitation. During the year, staff members undertook training on sexual health, reproduction and carer support to assist clients in intimacy matters post-stroke.

In May, Carmel Kennedy was appointed to the new role of Director of Clinical Services. Carmel has a passion for rehab nursing practice and a wealth of experience from across the public and private sectors.

of patients said the intensity and frequency of therapy was good or excellent

of patients said the facilities were good or excellent

96%

93%

of patients said they would recommend RRPH

of patients said they felt involved in the goal setting around their program

*Patient Feedback Satisfaction Survey 2020/21

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Royal Rehab Private Hospital (RRPH) is an established specialist rehabilitation facility that is renowned for its strong clinical outcomes, outstanding facilities, and skilled team of professionals.

As part of a senior management restructure in December 2020, we farewelled Jessica Scanlan from the role of General Manager Inpatient Services and Director of Nursing. We recognised Jessica for her leadership as she moved to her new role of General Manager Disability Services.

• Addressing psychological needs — RRPH provides all patients with access to dedicated clinical psychologists who ensure our work extends beyond the physical challenges experienced post-stroke.

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Change of Management

Exceeding National Stroke Standards

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Royal Rehab Private Hospital

COVID-19 Response

Education that Matters

Shaking It Up for Parkinson’s

As part of our commitment to continuous professional development, staff members across the facility were given comprehensive training and refresher updates throughout the year. We are proud of our skilled and knowledgeable workforce which embraces the opportunity for ongoing learning. Some of the areas of study this year included personal protective equipment, medication safety, manual handling and transfers, and pressure area care.

In April 2021, RRPH, along with MetroRehab Hospital, was a proud sponsor of the Shake It Up Foundation’s Pause 4 Parkinson’s event during Parkinson’s Awareness Month. Renowned for specialist expertise in providing Parkinson’s rehabilitation programs, RRPH was proud to be involved in the event.

Wayne considers himself to be a lucky man. The 67-year-old has a wonderful family and he is happily married to the girl he met almost five decades ago. When he started to experience pain in his shoulders and cramps in his feet at night he thought it could have been due to the physical nature of his work as a postie — a job he loved for almost 50 years. It wasn’t until he developed a tremor in his foot and hand that he went to the doctor and was diagnosed with Parkinson’s disease.

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Wayne Credits Rehab for Slowing Parkinson’s “I was losing ability to use my right hand for things like doing up buttons and sometimes I’d drop my fork while trying to have a meal,” said Wayne. “I also found it really hard to hold a razor and turn it into position to shave. I mentioned it and the team gave me exercises using bolts and nuts of different sizes that I had to undo and retighten.” Luke Maddalena, Senior Exercise Physiologist, said Wayne’s decision to seek therapy soon after diagnosis was key to his good results.

In January 2021, Wayne was referred to Royal Rehab Private Hospital to benefit from a personalised multidisciplinary therapy day rehabilitation program.

Wayne said a lot of living with Parkinson’s is mindset. “‘What’s the point’ thinking means you’ve given up. It isn’t how I see things. In 12 months, I want to be close to where I am now, so I keep at it.”

At Wayne’s first session, the Royal Rehab team assessed his function and the impact of Parkinson’s on his quality of life before helping him to set goals for his program. Wayne wanted to improve his balance to reduce the risk of falling, retain his fine motor skills, and regain strength in his speech.

At the end of his program, Wayne’s condition had improved significantly. He is moving his arms much better, and this has improved his stability and gait. Wayne also participated in speech therapy which helped him increase the volume of his voice and improve his ability to communicate more confidently.

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Sexuality Service Launched

COVID-19 response In 2020/21, CRS responded to the pandemic with professional agility and a resolute commitment to keeping everyone safe while continuing to deliver high-quality clinical support. With extensive knowledge and experience gained last year, the team was ready to prioritise essential face-to-face visits under strict COVID-safe guidelines and ramp up telehealth models of service delivery as required. Two of the most popular group programs, Stepping On and Strength2Strength, were successfully adapted to digital formats which had the added benefit of providing social connections for our vulnerable clients at times when it was most needed. Staff across Royal Rehab stepped up with enthusiasm when the call came to support NSW Health’s response to the pandemic, by welcoming patients with complex rehab needs from acute facilities. The change in case mix required a rapid redeployment of staff with different skill sets, and the CRS team is to be applauded for their efforts.

This service is lead by qualified therapists with postgraduate qualifications in psychosexual therapy. It offers personalised support through one-on-one and couples counselling, training and education for clinicians, sexuality retreats and a specialised sexuality clinic.

1,800+

clients supported across individual and group programs

597

telehealth sessions

16%

growth in clients admitted to Community Therapy program

The Sexuality Service is committed to providing holistic support by attending to the biological, psychological, social and spiritual domains of clients’ sexual health and wellbeing. The multidisciplinary team provides thorough assessment and evidence-informed education and interventions. Welcoming clients from diverse sexual backgrounds, identities and lifestyles, the service is provided in non-judgmental and confidential environments designed to support clients to feel accepted and empowered.

Community Therapy

Advanced robotic technology introduced

1,620 hours of group therapy delivered

The Community Therapy program provides a range of allied health therapies for people with chronic and complex disabilities. Clients benefit from programs tailored to their rehab goals incorporating the most appropriate mix of disciplines. In exciting developments during the year, the team embraced new technology with the introduction of advanced robotic exoskeleton EksoNR made available through the newly established Mobility Clinic in CRS, and accessible through other services at Royal Rehab. Following extensive planning, comprehensive training and a successful first-to-market launch in Australia in March 2021, the team responded to strong demand for the technology, which delivers better and faster rehabilitation outcomes for people living with neurological conditions, paralysis or lower limb weakness. Clients continued to embrace our personalised programs, which this year included equine activities for physical strengthening, social integration and cognitive stimulation. Drone photography was also a popular and rewarding experience for clients.

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Royal Rehab’s Community Rehabilitation Service (CRS) provides specialised programs to support people who have experienced injury, illness or disability to rebuild confidence, independence and strength. Sessions occur in the convenience of our clients’ homes, at our Ryde campus and in the community. Many of our services promote social inclusion and community participation.

Recognising the need for the provision of sexual health and relationship services for people with injury, illness and disability, Royal Rehab was proud to launch its Sexuality Service during the year.

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Innovative new service offering Qualified psychosexual therapists S exuality counselling, clinic, retreats and education

Home-based and Outpatient Programs

5,859 hours

of individual or group-based therapy provided through home-based and outpatient programs

411

Transitional Aged Care Program

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Driver Assessment and Training Service

78%

21%

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people attended Stepping On group sessions

In March 2021, our Home-based, Outpatient and Stepping On services underwent accreditation against National Safety and Quality Health Service (NSQHS) Standards. The accreditation process involves measurement against eight standards, covering comprehensive care, clinical communication, responding to clinical deterioration and more. Following team-wide preparation and a period of in-person audits, interviews and documentation and process reviews, all programs were assessed as meeting or exceeding the standards.

of clients supported to remain living in their own homes

increase in assessments

12,563 hours

80%

of therapy provided to clients on community Transpac Northern Sydney program

of clients were successful in gaining their licence with modifications

4,638 hours

Royal Rehab’s Driver Assessment and Training Service supports people with disability or illness to commence or return to driving. Run by driver-trained occupational therapists and rehabilitation driving instructors, the team assesses, advises, and offers support through all the necessary steps towards independent driving. Demand continues to grow for the service, with support on vehicle modification and equipment modifications proving popular. The team partnered with local supplier and installer of vehicle, Total Ability, for a series of wellreceived educational sessions for clients. The sessions covered topics such as the driver assessment process and the wide scope of modifications available to enable people to return to or learn to drive independently

of individual and 500 hours of group therapy provided to Transition Care Unit clients

The team continued the successful partnership with Northern Sydney Local Health District (NSLHD) to deliver the therapy component of the Transitional Aged Care Program. The program supports people over 65 years of age to return home after hospital, through goal-based multidisciplinary therapy and by providing equipment and care services. A focus of the team this year was the Improved Health Literacy Management Project. A key deliverable of this project was the development of a new checklist designed to ensure documentation is consumer-friendly.

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309

clients received therapy via home-based and outpatient programs

Our Home-based Rehabilitation and Public Outpatient programs are multidisciplinary services that CRS administers on behalf of NSLHD. The team continued to run hydrotherapy, general fitness, self-management, educational and communication groups. In a significant move, work began on a goal-setting pilot for all clients of the Outpatients department. This pilot allows the implementation of a more client-centric practice by incorporating an increased set of goals from the perspectives of both clients and clinicians.

Training, Education and Leadership During the year, the team trained in neurodiversity and sexuality, dementia and sexuality, and frailty in rehabilitation. Managers also commenced further professional development coaching through a series of team culture workshops, with the aim of fostering a positive and supportive workplace and growing leadership skills. Among the many examples of knowledge sharing

during the year, one highlight was a presentation by Senior Social Worker Professional Leader and Psychosexual Therapist Candice Care-Unger Clinical Nurse Consultant and Psychosexual Therapist Arlyn Owens, and Dr Grace Leong at the Continence Foundation Conference in May 2021. Their topic ‘Sexuality and Spinal Cord Injury’ attracted an audience of more than 100 people and generated very positive feedback. Pictured above: Psychosexual Therapist Arlyn Owens, and Social Worker and Psychosexual Therapist Candice Care-Unger.

In-Voc

Spinal Outreach Service

Exploring Possibilities After Spinal Cord Injury

As the COVID-19 pandemic evolved throughout the year, the SOS team remained committed to taking precautionary measures and following the guidelines of relevant authorities for the safety of all, while continuing to provide support to people living with SCI in rural and remote locations. Telehealth appointments were made available to all clients, and essential face-to-face visits were delivered in a COVIDsafe manner. The Rural Spinal Cord Injury Service converted the regular in-person fly-in clinics to digital modes of delivery. Many rural clinics were conducted remotely, including those in Dubbo, Wagga, Tamworth and Port Macquarie. With more than 350 admissions to the service during the year, the team is to be acknowledged for their agility and professionalism in the face of the health crisis.

Strengthening and Streamlining

A focus throughout the year was on improving efficiencies and processes. •A priority escalation process for clients with skin and urology issues was reviewed, enabling SOS clinicians to manage urgent health matters with greater efficiency in digital systems. •A critical information transfer system was trialed in case conferences based on the standardised ISBAR (Introduction, Situation, Background, Assessment and Recommendation) framework, with the aim of improving efficiencies and streamlining case discussion. •A nursing outreach development pathway was established to enable registered nurses to gain the clinical nursing specialist credential. This increased specialised spinal nursing expertise in SOS.

Accreditation

Throughout the year, relationships across other specialty services within Royal Rehab and with external partners were strengthened as part of the team’s commitment to continuous improvement. SOS sought to find new and innovative ways of working without compromising our commitment to providing high-quality care. Innovative thinking from the team has achieved a number of notable service improvements and a streamlined approach to clinical processes. One highlight was the collaborative project between the University of Sydney, SOS and icare that led to the creation of the Health Maintenance Tool Kit. The kit is designed to support people with SCI to understand and troubleshoot commonly experienced health and

In March 2021, SOS underwent accreditation against of National Safety and Quality Health Service (NSQHS) Standards. Following team-wide preparation and a period of in-person audits, interviews, and documentation and process reviews, SOS passed with flying colours.

Looking Forward In the year to come, the team looks forward to exploring more ways to effectively utilise telehealth across the service. The team is excited to be involved in a nursing-led project, Spinal Compass, which is set to consolidate and standardise resource folders provided to clients across all spinal units in NSW. This is expected to lead to an enhanced and more seamless customer experience for people living with SCI.

In September 2019, 77-year-old Ian fell from a 1.5-metre-high fence, breaking his neck and skull. The retired Australian Federal Police officer had already survived prostate cancer, so the freak fall was a crushing mental blow.

In-Voc also embraced the opportunity to work with Royal Rehab’s Director of Research and Innovation, Dr Julie Pryor, in the development of a theoretical framework and model for the service that explores how In-Voc interventions contribute to outcomes and results. This work informed the development of a readiness to work/study/ volunteer scale, which has proven to be a valuable tool for our vocational consultants to better understand and support participants.

Drawing on his police training to push through the intensive hospital physio sessions, a discouraged Ian initially felt “like a burden” to his wife Di and their family. After an in-home assessment, a multidisciplinary program of physiotherapy and occupational therapy was developed for Ian. “They lifted me from the doldrums,” the soon to be great-grandfather said of the Royal Rehab team. Bit by bit, hard work with spring-loaded steering wheels, power walking sticks, and virtual driving and karaoke sessions — with ‘Let it Be’ on repeat — helped Ian to build his arm strength and lung capacity. Tips from Olympic coaches and meditation powered him to manage pain.

“My workshop was modified to include a push button bike hoist that has allowed me to return to work. The network of people involved and the can-do attitude of those I was surrounded by allowed for a change in my headspace.”

“To put my arm around my wife again… type with more than one finger... drive... go clay shooting — these were my aims,” Ian said. “Two years on, there’s still work to do, but life’s liveable. This is our time and this isn’t going to hold us down. “It’s about adapting. You achieve if you want to achieve.”

Michael In -Voc client

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wellbeing issues that they may encounter throughout their lives.

Whilst the focus during the year remained on providing early intervention in acute spinal injury units, telehealth and virtual platforms increased the services’ reach beyond the inpatient stay. A virtual workshop series, Working and Studying with SCI, was held during the year and designed to empower community participants with knowledge and practical vocational skills. The value of this workshop is reflected in the high rates of attendance and positive delegate feedback.

Career conditioning, Nordic walking sticks and a Beatles classic have helped selfdescribed “luckiest unlucky man” Ian to reclaim life in retirement after a spinal injury.

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COVID-19 Response

Ian is Driving, Shooting and Hugging Again

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Client Story

The NSW Spinal Outreach Service (SOS) provides specialist statewide support for people with spinal cord injury (SCI), their carers and local clinicians throughout metropolitan Sydney and rural and regional New South Wales.

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Royal Rehab’s specialist vocational rehabilitation service — In-Voc — is dedicated to supporting people with new or established spinal cord injury (SCI) to explore work, study and volunteering options.

Launch of Pain Clinic

Telehealth was an integral component of service delivery for one-on-one therapy sessions, allowing clients to access specialists and continue their rehabilitation without interruption. At a time when remaining connected was more important than ever, BICRT was also able to transition therapy groups to telehealth, including the Social Support Group, the communication-focused News Group and the Return-to-Work Group. In addition, the team remained committed to delivering essential face-to-face visits during the pandemic as required. It is a credit to our BICRT staff members that despite the heath crisis, the service effectively managed a 21 per cent increase in the number clients during the year, with strong clinical outcomes for clients and positive feedback. Of the clients discharged, 87 per cent improved their total Mayo Portland Adaptability Inventory score — an outcome measure that detects changes in physical, cognitive, emotional, behavioural and social challenges in people with a brain injury.

Client Story

Enhancing Customer Experience With client experience always top of mind, during the year BICRT redesigned its model of care, which outlines best practice care and services for the client cohort. The aim of the redesign was to improve the efficiency and consistency of operational processes and to enhance the experience of clients accessing the service. The redesign involved a thorough process of file audits, staff and consumer interviews, and benchmarking with other brain injury rehabilitation services. A comprehensive clinical pathway was developed which helps the team to ensure standardised time points in clients’ rehabilitation journeys. A core feature of the new clinical pathway is the focus on early functional goal setting for each client, and frequent goal monitoring. Currently being trialed for a six-month period, the new clinical pathway will be formally evaluated next year.

Laura’s Living Loud and Clear Since Aneurism

During the year, Royal Rehab was proud to trial a new model of care for managing chronic pain in collaboration with the Agency for Clinical Innovation — the Be Pain Smart Clinic. This new initiative is designed to address the negative effects of pain via a multidisciplinary assessment and management service for people with spinal cord injury and/or traumatic brain injury across NSW. Supported by funding from the icare Foundation, the service provides education for clinicians, supporting them to be well-informed on best practice in this area.

The Cowboy Shuffle might now trump a Boot Scootin’ Boogie, but Laura is line dancing again after working her achy breaky heart out with Royal Rehab. Pandemic unfolding, Laura, aged 64, was working parttime in corporate services at a private hospital. In March 2020, the mother-of-three awoke, dizzy, before collapsing in the bathroom. Husband John found her unconscious.

Accreditation

Rushed to hospital for lengthy surgery, Laura was told she had suffered a brain aneurism.

In March 2021, BICRT underwent accreditation against National Safety and Quality Health Service (NSQHS) Standards. Following a comprehensive period of in-person audits, interviews, and documentation and process reviews, the service was successfully accredited. This was a tribute to the team’s hard work and dedication.

Afterwards, Laura’s short-term memory wasn’t the same. She couldn’t remember people from the day before and her speech was soft and slow. “I could hardly stand. I had a high-back wheelchair because of my floppy neck,” she said. Laura was referred to Royal Rehab’s Brain Injury Community Rehabilitation Team (BICRT) for a customised, goal-oriented program to help her recover from acquired brain injury. When she began her program in September 2020, Laura’s goals included returning to work in some capacity and returning to line dancing and bushwalking.

Education and Research Continuing their commitment to research, BICRT speech pathologists recruited for a large study designed to develop effective online resources to support people with brain injury to have more positive interactions, both face-to-face and online.

Her program consisted of a range of therapies including physiotherapy, occupational therapy and recreational therapy. BICRT’s multidisciplinary team focused on improving Laura’s mobility, function, memory and organisational skills to increase her independence and enable her to get back to the things she loves.

Special mentions go to Jason Bransby-Bell, Senior Speech Pathologist BICRT; Janine Mullay, Speech Pathologist BIU; and Dr Scott Barnes, Macquarie University, who presented virtually at the second Cognitive-Communication Disorders Symposium on the findings of their study, Investigating Verbosity after TBI.

“The team is so dedicated, professional and kind,” Laura said. After 10 months, Laura’s memory is slowly improving. She’s now volunteering as an administrative assistant, and is back doing bushwalking and line-dancing, She has even taken up crocheting!

The team upskilled via the many internal learning opportunities offered by Royal Rehab including Sexuality and Sexual Wellbeing workshops and Brain Injury Rehab Service (BIRS) Interdisciplinary Training and Education sessions. 41

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educational sessions for clinicians

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Following the preparation and response to the pandemic in early 2020, BICRT was well equipped to offer flexibility of service delivery as the health crisis continued to evolve. This ensured that the team was able to continue to provide optimal care and rehabilitation in a safe way that minimised risk to both staff and clients while maximising clinical outcomes.

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Debilitating pain is common after traumatic injury. It can keep people from engaging in activities that help the healing process and can worsen common symptoms of anxiety and depression.

The Brain Injury Community Rehab Team (BICRT) provides comprehensive multidisciplinary rehabilitation for people who have sustained a traumatic brain injury (TBI). The team offers a range of holistic, personalised programs delivered in clients’ homes, in the community and at Royal Rehab facilities — all designed to build confidence and independence.

COVID-19 Response

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Brain Injury Community Rehab Team

The Impact of COVID-19

Sargood on Collaroy is a resort like no other. Located on the stunning headland of Collaroy Beach on Sydney’s Northern Beaches and proudly operated by Royal Rehab, this facility is purpose-built to provide world-class accessible holidays and short-term accommodation and assistance for people with spinal cord injury, and their families and carers. complete the resort experience and put the fun back into travel for people living with disability.

Sargood on Collaroy is a collaboration between the Sargood Foundation, icare and a private benefactor. Designed from the ground up to be fully accessible, the resort features spacious and beautifully appointed apartments with modern amenities and advanced home automation technology. A wide range of accessible recreation and leisure activities and a state-of-the-art gym

Whilst the facility is only four years old, it is already a global leader, with a number of awards under its belt and an impressively high customer satisfaction rate year on year, with many returning guests.

Accreditation During September 2020, Sargood underwent its first Disability Services accreditation, under the NDIS Practice Standards and the Australian Community Industry Alliance (ACIA) Standards. These standards create benchmarks for providers to assess performance, and to demonstrate quality and safe supports and services to NDIS participants. Congratulations to the team for passing with flying colours!

Due to the outbreak of COVID-19 in Northern Beaches during December 2020, Sargood closed its doors for a second time, reopening in mid-January, with strict COVID-safe measures in place. Over the following months, guests returned with enthusiasm and Sargood experienced its best May occupancy rate on record. Unfortunately, the financial year ended with a third closure following restrictions across Greater Sydney.

While the effects of the COVID-19 pandemic were felt across the board, there were many positives that resulted from the last year.

An opportunity to upgrade During periods when the facility was not able to accept guests, these times were used as an opportunity to refresh our magnificent facility. Furnishings were upgraded and new state-of-the-art equipment was installed for all to enjoy.

During the closures, Sargood’s highly skilled staff members were redeployed to other areas of Royal Rehab including Royal Rehab Private Hospital, the Spinal Injury Unit, Disability Services and MetroRehab Hospital.

‘Stay, work and play’ introduced Sargood recognised the need for people to escape working from home. Guests embraced the opportunity to work from Sargood in the beautiful beach-side or garden-view rooms with the added benefit of recreational activities in between.

“What an amazing experience. We didn’t want to leave! Even though the room, services, facilities and location were all exceptional, it’s the staff at Sargood that made our stay feel so welcoming and wholesome. Thank you for always putting a smile on our faces. World class!”

Club Sargood new offerings The team took the opportunity to grow our exercise physiology and physiotherapy offerings through Club Sargood, both on-site and through at-home visits. Since reopening, Club Sargood has proven to be popular, with the number of clients more than doubling.

Adapted community recreation During closure periods, the Sargood team continued to support Club Sargood clients by setting up the recreation trailer — which houses off-road powerchairs, kayaks, fishing rods and bikes — at a local park. Club Sargood members were able to enjoy some well-deserved recreational activities at a time that it was needed more than ever.

Anita, June 2021

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Sargood on Collaroy

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Sargood’s doors closed temporarily at three different times during the year, the first being March 2020. It re-opened mid-September operating at less than a third of its capacity, and with further heavy restrictions and operational adaptions. This included the use of masks, reducing recreation to one-on-one activities, and visitor restrictions.

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During 2020/21, COVID-19 significantly affected our operations however the team navigated the challenging periods in true Royal Rehab spirit. As the health crisis evolved in 2020, Sargood responded by taking precautionary measures and strictly followed the guidelines of NSW Health with a clear goal to prioritise the health and wellbeing of guests, staff and the wider community.

Client Story

of guests said their stay at Sargood on Collaroy had a positive impact on their life

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overall score for quality and efficiency of service

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would recommend Sargood on Collaroy

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Sargood on Collaroy Gives Belle her Confidence Back

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• adapted mountain biking • a sex and intimacy course • ceramics sessions • Kids School Holidays Week.

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If the pandemic has taught us anything, it would be that social inclusion and recreational activities are paramount in the wellbeing of people. Sargood is proud to add a number of new programs and courses including:

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New Programs and Courses

In addition, an advanced scuba diving course will now be offered to those who have attended the beginners course, enabling this group to enjoy the magic of open water dives. A new intensive exercise course is also now being run by NeuroMoves.

Recognition of Staff We are proud of staff members Rita Cusmiani and Anthony Robertson, who received awards through the Sargood Foundation’s Sheree Hurley Staff Awards for their exceptional and consistent care of guests.

Looking Forward In the coming year, the focus is on lifting the resort’s occupancy rate, which has been impacted by the COVID-19 health crisis. The team is excited to see Sargood on Collaroy flourish once more — welcoming back old friends, meeting new ones and evolving the offering to continue providing the very best experience for people with SCI.

Cathy and her family have been to Sargood many times since it first opened in 2017. In fact, it’s become one of their favourite places. Cathy’s daughter, Belle, was just three and a half years old when she was hit by a truck and suffered a spinal cord injury, leaving her paralysed below the waist. Their first visit to Sargood was the start of a whole new way of holidaying. It has been a godsend, not just for Belle but also for Cathy, her husband, Troy, Belle’s nine-year-old brother, Nate, and their extended family. “The kids love all the activities — cycling, swimming, snorkelling, tennis and riding on the beach buggy,” Cathy said. Belle knows that Sargood is designed for her and that it’s the one place where she isn’t going to miss out on anything due to her injury.”

Sargood has given Belle the confidence to see what she is able to achieve. “She can try the bikes and test out the various technologies and equipment, and see what’s out there that she may be able to use in the future.” The family also enjoys meeting other families who have a child with an SCI. “It’s really nice to share our experiences. We have met a number of other families through Sargood over the years that we keep in touch with,” Cathy said. “It really is a wonderful place. Our whole family loves Sargood and I don’t think we would holiday anywhere else.”

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Igniting Imagination and Restructuring The bold new organisational strategy announced for Royal Rehab in early 2021, inspired the workforce to reimagine the future for people with illness, injury and disability. To best support the success of the strategy, a restructure of roles and responsibilities took place at the senior executive level. The changing structure of Royal Rehab was developed for the future, with a view to bring the strategy to life in ways that prioritise performance and service innovation. •D enise Thomas was appointed to the new role of Chief Operating Officer (previously, General Manager MetroRehab Hospital). •S elina Rowe was appointed to the new role of General Manager Royal Rehab — Ryde (previously General Manager Community Services and Director Allied Health & Clinical Informatics). •N ick Edwards was appointed General Manager/ Director of Clinical Services (DON) MetroRehab Hospital (previously, General Manager Disability Services). • J essica Scanlan was appointed General Manager, Disability Services (previously, General Manager Inpatient Services and Director of Nursing).

Advancing Wellbeing and Recognition We were pleased to launch a new reward and recognition program titled Our Royal Rehab during the year. The platform offers employees a raft of benefits including discounts at more than 300 retailers, and a wellbeing centre with resources intended to help them be their best selves at work and at home. We also introduced a program to make it easy to celebrate our co-workers — through eCards, a Social Recognition Wall and nominations for awards. Various disciplines of our diverse workforce were celebrated throughout the year. One highlight included International Nurses Day which was acknowledged with festivities and awards at several of our facilities. We extend our thanks to the generous sponsors: HESTA, a leading health super fund; and Maxxia, Australia’s largest salary packaging provider.

Empowered by Tech The excitement generated by technological enhancements to Royal Rehab’s offering throughout the year was palpable. Our teams were inspired by the announcement of the plan to build a centre of excellence in rehabilitation at the Ryde campus, which will offer a vast range of advanced rehabilitation technology. In preparation for the new build, our chief executives and support service teams relocated to new premises at Milson’s Point, providing space for the new fit-out to begin.

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While this year brought with it both positive and challenging times, our workforce responded in ways that would no doubt have made our founder, Susan Schardt, incredibly proud.

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Our Values

Our people are at the heart of everything we do. Across our organisation, our skilled workforce is guided by our values and committed to delivering the very best to the people we serve. Time and again, we are reminded how the warmth, personal attention and support demonstrated by our staff is a source of motivation and strength for people facing some of life’s biggest challenges. Whether on the frontline or behind the scenes, every day our people continue to change lives for the better.

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Celebrating our People

Progressive Pandemic Response The COVID-19 pandemic transformed our work practices and workplaces. Guided by exemplary leadership, the united team responded with an unwavering commitment to keeping clients, staff and the wider community safe. Royal Rehab was proud to play an important role supporting the broader health network when NSW Health called on us to take patients with complex rehab needs into Royal Rehab Private and MetroRehab Hospitals. Staff across our facilities are to be

acknowledged for stepping up with enthusiasm to undertake new duties when requested. Morale of our workforce was boosted with regular communications from our CEO giving messages of thanks and support. An innovative new internal podcast series, The Royal Wrap, was also launched, which served to showcase some of the remarkable work that took place during this unique period and the talented individuals behind it. Additionally, our team was supported with a new Work from Home Policy, which prioritised flexible working arrangements.

“I’m passionate about disability services, and supporting and empowering people to live their best lives.”

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Stephanie Mock, Physiotherapist

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“Being the first in the country to have such amazing, new robotic tech has made me proud of my role at Royal Rehab.”

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Kathy Kim, Accommodation Manager Disability Services

“I’m excited about the professionalism and passion that I see from our teams and how these factors contribute to amazing results for our patients.”

Matthew Toose, Clinical Operations Manager Spinal Injury Unit

Acknowledgement and Recognition of our Volunteers

Nominated: City of Ryde Council Volunteer Awards 2020, Young Volunteer category

Nominated: The Centre for Volunteering NSW Volunteer of the Year Awards 2020 — Corporate Individual category

Nominated: The Centre for Volunteering NSW Volunteer of the Year Awards 2020, Young Volunteer category

Volunteer of the Year: City of Ryde Council Volunteer Awards 2020

Nominated: City of Ryde Council Citizen of the Year Awards, Young Citizen of the Year category

Christine Wyness — Green Thumb Support

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Edwin has volunteered since December 2017. Despite living with his own disabilities, Edwin travels to visit one of our Disability Services residents every week to provide valuable connections and friendship. Special Commendation Award: City of Ryde Council Volunteer Awards 2020 Nominated: The Centre for Volunteering NSW Volunteer of the Year Awards 2020, Adult category

The history of Royal Rehab is enriched by passionate and dedicated volunteers. As an organisation, we are indebted to the enthusiastic team who generously give their time to the people we serve through acts of companionship, practical support, sharing of talents and so much more. welfare phone calls to clients and residents, the passion of our volunteers found new purpose.

Whilst the 2020/21 financial year was certainly challenging for everyone, our team of volunteers responded with agility and remained committed, supporting our services in ways they could across our services. From the continuation of the Lifestyle Choir via Zoom sessions to regular

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We are grateful for the acknowledgement our volunteers received through award nominations and celebrations throughout the year.

Thank you to our wonderful volunteers who have continued to contribute positively to our community this year. 50

Tommy Lang — Exercise Buddy Tommy assisted clients with their physiotherapy exercises under clinical instructions, helping them with their goals to gain strength, mobility and independence. Nominated: The Centre for Volunteering NSW Volunteer of the Year Awards 2020, Young Volunteer category Rob Jacobs — Sargood on Collaroy Every week since July 2017, Rob has generously donated his time at Sargood on Collaroy, our resort for people with spinal cord injury, where he entertains guests with his singing and guitar talents. Nominated: The Centre for Volunteering NSW Volunteer of the Year Awards 2020, Volunteer of the Year Adult category Elaine Todd — Lifestyle Choir Elaine assists with administration tasks and supports one of our community home residents, providing transport and accompanying her to Lifestyle Choir rehearsals. Finalist: The Centre for Volunteering NSW Volunteer of the Year Awards 2020, Senior category

Christine has provided invaluable support by donating her time since 1999 to help build and maintain the Royal Rehab Productive Garden. Recognised: City of Ryde Council Citizen of the Year Awards Nominated: City of Ryde Council Volunteer Awards 2020, Individual Category Sarthak Vashist — Companionship Sarthak started volunteering in May 2018 as a high school student, supported by an adult mentor, to be a companion and assist Disability Services residents to our Productive Garden on a weekly basis. During lockdown, Sarthak continued to volunteer by phoning socially isolated residents to chat and to help reduce the pressing issue of loneliness. Young Volunteer of the Year: City of Ryde Volunteer Awards 2021 Exercise Buddy Volunteer Team These volunteers assist with setting up groups with therapy equipment and encouraging clients to repeat their exercises and participate in group activities as instructed by clinicians. Nominated: City of Ryde Council Volunteer Awards 2020, Group category Nominated: The Centre for Volunteering NSW Volunteer of the Year Awards 2020, Team category Lifestyle Choir Volunteers Team Each fortnight, a group of volunteers donate their time to support Royal Rehab Disability Service residents and members of the community during Lifestyle Choir rehearsals. The volunteers assist participants throughout sessions and help to create a welcoming and inclusive atmosphere. Nominated: City of Ryde Council Volunteer Awards 2020, Group category

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Edwin Ikwu — Home Visitor

Volunteer Services

Helena has been volunteering at Royal Rehab since June 2016, in a wide variety of roles while working at Boehringer Ingelheim, Roche (registered Corporate Volunteers) and Maridulu Budyari Gumal (SPHERE).

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Marika has volunteered at Royal Rehab since April 2017. She has been an incredible support to many of our residents throughout this time, including helping to set up the digital platform for the Lifestyle Choir and making every rehearsal fun.

Helena Malinowska — Corporate Volunteer (Individual)

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Marika Blonner — Lifestyle Choir

Matt Mackay, Chief Executive Officer of Royal Rehab

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Royal Rehab Foundation

This year, the Royal Rehab Foundation was proud to merge with the White Knight Foundation (WKF). Founded by the Knight family after a devastating attack on their son Liam, the WKF has been supporting individuals and organisations on their road to recovery from random acts of violence since 2015.

The Royal Rehab Foundation strives to inspire the community to support us in our work empowering people living with disability, illness or injury. Whilst the pandemic impacted many fundraising activities, our supporters continued to demonstrate generosity and commitment. We are exceptionally grateful to our supporters for standing alongside us.

New Grant Program

•T he installation of a hoist that enables faster and more independent transfers in and out of bed for a client with spinal injury.

In late 2020, the Royal Rehab Foundation launched a new grant program to support clients and their families in financial hardship with funding for daily living expenses and rehabilitation equipment. In the first six months of this program, 16 grants were awarded to clients from our Brain Injury and Spinal Injury Units, Spinal Outreach Service and Disability Services. Some examples of the life-changing benefits of these grants include: •A portable wheelchair ramp that allowed a former patient to access greater areas of his home and spend more quality time with family and friends.

•R enovations of the Royal Rehab Productive Garden, which is used to incorporate the many psychological and physiological benefits of gardening into clients’ programs.

This inspiring foundation has donated close to $500,000 to home renovations, rehabilitation equipment, counselling and mentoring services. The WKF has educated and empowered over 6,000 young Australians on how to better deal with difficult and sometimes dangerous situations. The merger will see the Royal Rehab Foundation continue the great work of WKF by delivering grant funding to victims of crime across Australia.

Kids of Royal Rehab Program Another highlight of the year was the launch of a new program titled Kids of Royal Rehab, which supports children of patients who have experienced brain and/ or spinal cord injury. Delivered during school holiday periods, the program offers children a break from the hospital environment and provides adjustment supports. We are grateful to the Lottery Office for donating substantial funds towards this program.

Wall of Fame Ceremony Due to restrictions in Sydney brought about by the COVID-19 pandemic, the Foundation was unable to host the annual Brain Injury Wall of Fame Ceremony. Brain Injury Awareness Week was instead recognised through a social media series that showcased the remarkable rehabilitation journeys of past Wall of Fame ambassadors. The Foundation looks forward to holding bigger and better in-person Wall of Fame ceremonies as soon as it is safe to do so.

Advanced Tech As part of Royal Rehab’s bold vision to build rehabilitation centres of excellence filled with a range of advanced technology devices, the Foundation was pleased to contribute $1 million in bequest funds towards the project. Funded through two generous

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The White Knight Foundation

The Ducati Owners Club of NSW

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Despite the challenging fundraising environment, our most generous long-term donor, the Ducati Owners Club of NSW, overwhelmed us with its commitment to raising funds for the Foundation. Key to the success of this fundraising was the club’s annual Thunder Rally Raffle which was pivoted to an online platform. The annual raffle — a fantastic riding and camping event — has grown enormously in popularity over the past 35 years, and when it was last held in person, it attracted more than 9,000 attendees who rode a combined total of 8 million kilometres.

“It is an honour to welcome the White Knight Foundation into the Royal Rehab Foundation and carry on the legacy of the charity’s impactful work. While senseless acts of violence continue to wreak havoc in our communities, we will remain committed to delivering our services and empowering people to regain strength, independence and dignity. We look forward to raising funds and bringing attention to this cause through the Royal Rehab Foundation.”

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bequest donations from a past patient and family members, the funds will go a long way towards enhancing and accelerating the rehabilitation journeys of those we serve.

Thank You Our heartfelt thanks go to our generous donors who support us to empower people to reach their potential.

Estate of Barbara Kathleen Throsby Young

Estate of Bernard David Rothbury

White Knight Foundation

James Carmichael

Ainsworth4Foundation

Michael Meyer

Ducati Owners Club NSW

Katherine and John Douglas

The Lottery Office

Edith Hill Trust

Flinders Lane Productions

James Rogan

RA Gale Foundation

Pamela Grant

Gina Collins

Paul Hunt

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Clive and Patricia Austin

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Donors

Gifts in Kind Our sincere thanks go to the following for their in-kind donations: Active Mobility Systems

Lyn Dowd

Aidacare

Mara Lyone

Aleena Wiratunga and Keira Jones

TurnKey Promotions

Francesco Agostino

Vincent Zhu

John Leahy

Supporters

Our Leaders

Tony Staveley

Anthony Wehby Vice-Chairman MAICD

Clive Austin AM Director LLM FAICD

Matthew Mackay

Glen Stoddart

Denise Thomas

Chief Executive Officer

Chief Financial Officer

Chief Operating Officer

Dr Clayton King

Jessica Scanlan

Gregory Anderson Director ACA CA

Merilyn Speiser Director BEc FCA CHAHRI

Prof Steven Faux Director MBBSBA, FRACGP, FAFRM, (RACP), FFPMANZCA

Pamela Grant Director BA BLegS DipSocSc

Katrina Williams Director BEc LLB GAICD

Director of Medical Services & Medical Director, Brain Injury Unit

General Manager Disability Services

Selina Rowe General Manager, Royal Rehab Ryde

Nick Edwards General Manager & Director of Clinical Services, MetroRehab Hospital

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Chairman MComm Grad Dip (Land Econ) FAPI FRICS MAICD JP

Executive

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Royal Rehab Board

Help us empower people to reach their potential. Donate via our website Commit to a regular gift Explore a corporate partnership Join our volunteering team Leave a gift in your will Support our community fundraising Royal Rehab is a registered charity and all donations over $2 are tax deductable.

235 Morrison Road, Ryde NSW 2112 | royalrehab.com.au For more information please contact us at: foundation@royalrehab.com.au | (02) 9808 9643