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An in depth look at the importance of CT scanning in the Forensic Medicine service

An in depth look at the importance of CT scanning in the Forensic Medicine service

An in depth look at the importance of CT scanning in the Forensic Medicine service and its role in helping to determine the cause of unexpected or unexplained deaths that are referred to the Coroner.

NSW Health Pathology’s Foren­sic Med­i­cine ser­vice works at the direc­tion of the Coro­ner to pro­vide post-mortem exam­i­na­tions and relat­ed test­ing in the event of unex­plained or unex­pect­ed deaths.

These post-mortem exam­i­na­tions can only be per­formed by spe­cial­ist foren­sic pathol­o­gists who are sup­port­ed by a high­ly qual­i­fied team that includes radi­og­ra­phers and radiologists.

CT scan­ning is an essen­tial tool to help deter­mine the cause of death and in this video, radi­og­ra­ph­er Tony Bux­ton and Foren­sic Pathol­o­gist Dr Allan Cala dis­cuss how it is used in the Foren­sic Med­i­cine service.

The Cutting Edge of COVID

The efforts of our Pathogen Genomics team throughout the COVID-19 pandemic saved thousands of lives and prevented further outbreaks.

As the first cas­es of COVID-19 began to emerge in NSW the NSW Health Pathol­o­gy pathogen genomics ser­vice joined forces with a mul­ti­dis­ci­pli­nary team of epi­demi­ol­o­gists and researchers to help cre­ate a new assay that would illu­mi­nate the spread of the virus.

The team employed an inno­v­a­tive lab­o­ra­to­ry method that was orig­i­nal­ly used to iden­ti­fy the source of food­borne out­breaks in NSW. They were quick­ly able to pro­vide ear­ly pathogen sequences direct­ly from infect­ed patients then grow the virus in order to map the entire genome.

Incred­i­bly, it took only two weeks for the first genomes to be devel­oped which allowed health experts to link peo­ple arriv­ing from over­seas to inter­na­tion­al hotspots. The team used more than 840 sam­ples from COVID pos­i­tive patients that allowed them to uncov­er 49 genom­ic clus­ters respon­si­ble for 91% of ear­ly cases.

“I think, at its core, this project was about col­lab­o­ra­tion. It was about tak­ing a real­ly inno­v­a­tive lab­o­ra­to­ry method and then pulling togeth­er dif­fer­ent pieces of health data to think about new ways that we could con­trol a kind of world-chang­ing event as it hap­pened,” said Dr Rebec­ca Rock­ett, who was part of the award-win­ning team.

The impor­tant work per­formed by the pathogen genomics team was shared across state lines as well as inter­na­tion­al­ly in order to bat­tle the rapid spread of the virus as it ignored all borders.

The unprece­dent­ed work earned the pathogen genomics team and their part­ners the NSW Health Secretary’s Award for Inte­grat­ed Val­ue Based Care ear­li­er this year.

How do you solve a problem like millions of COVID results? You call Liz.

NSW Health Pathology’s Liz Geddes was instrumental in pioneering the development of our award-winning COVID-19 Results Service that automatically delivers COVID-19 test results.

When the COVID-19 pan­dem­ic emerged, NSW Health Pathol­o­gy was thrust into an inter­na­tion­al health emer­gency of epic proportions.

Many of our incred­i­ble staff stepped up to meet the many chal­lenges being thrown our way, includ­ing Liz Ged­des, who led the devel­op­ment of an SMS ser­vice and call cen­tre to deliv­er results direct to patients. Both are a first for NSW Health Pathology.

And not just a few results, more than 7.8‑million and counting…

Liz’s out­stand­ing work earned her a final­ist posi­tion for NSW Health Awards Col­lab­o­ra­tive Staff Mem­ber of the Year in 2021.

These vital new ser­vices need­ed to meet two crit­i­cal challenges:

  • How to deliv­er neg­a­tive test results faster than sev­en days or more and reduce anx­i­ety and unnec­es­sary home iso­la­tion, and
  • Relieve lab­o­ra­to­ry staff and pub­lic hos­pi­tal staff from call­ing the up to 99 per cent of patients who had a neg­a­tive result.

This required hours of phone calls and divert­ed front­line health staff from their crit­i­cal  patient care roles.

The COVID-19 SMS Results Ser­vice and Call Cen­tre was devel­oped, pilot­ed and imple­ment­ed in two weeks, by a core team of tech­ni­cal, clin­i­cal and spe­cial­ist ICT experts – and led by Liz.

Stake­hold­ers across NSWHP, Min­istry of Health, local health dis­tricts, clin­i­cians, and patients also played an impor­tant role.

Launched in April 2020, the SMS Ser­vice has saved an esti­mat­ed 652,000 hours or the equiv­a­lent of 81,500 health work­er shifts.

Under Liz’s man­age­ment and in col­lab­o­ra­tion with part­ners, the ser­vice con­tin­ues to evolve.

Find out more here.

Supporting the community in Lismore floods

In February 2022, Lismore and the Northern Rivers region was hit by torrential rain that saw the Wilson River rise two metres above its previous record height.. NSW Health Pathology’s Lismore team worked tirelessly to ensure uninterrupted service for the community despite their own personal challenges.

Flood waters lapped at the front step of our Lis­more lab­o­ra­to­ry in Feb­ru­ary 2022 as lev­ee banks broke and large areas of the town went under water.

Staff sand­bagged the door­way and moved equip­ment to high­er ground so test­ing could con­tin­ue if the lab flooded.

Hous­es and busi­ness­es were destroyed leav­ing many peo­ple home­less, includ­ing some of our NSW Health Pathol­o­gy col­leagues who lost their homes and pos­ses­sions. Roads were cut leav­ing oth­er col­leagues strand­ed for extend­ed peri­ods. Near­by towns were iso­lat­ed pre­vent­ing spec­i­mens reach­ing our lab.

The town had­n’t even begun to recov­er when in March, the riv­er broke its banks again, inun­dat­ing the town and hin­der­ing the clean-up and any progress that had been achieved.

Heart­break­ing as it was, our Lis­more team was undaunt­ed because they knew peo­ple were depend­ing on them to con­tin­ue to pro­vide vital pub­lic pathol­o­gy services.

Gal­vanised by dis­as­ter and ener­gised by the cama­raderie of their close team and gen­er­ous sup­port from the teams at our Tweed, Grafton and Coffs Har­bour labs, they kept going.

Staff who were able to get to work cov­ered for col­leagues who were iso­lat­ed, work­ing their shifts to main­tain ser­vices. They part­nered with emer­gency ser­vices to retrieve spec­i­mens from iso­lat­ed com­mu­ni­ties, and with Lifeblood to restock blood supplies.

Despite the chaos, iso­la­tion and dis­rup­tion to their per­son­al lives, the team worked tire­less­ly to ensure undis­rupt­ed diag­nos­tic ser­vice for our North­ern Rivers patients and clinicians.

Boosting diabetes prevention

Samoan people are at higher risk of diabetes and often experience avoidable complications that can be fatal. NSW Health Pathology is partnering with Western Sydney University on a diabetes prevention and management program for Australian-Samoan communities in South Western Sydney.

NSW Health Pathol­o­gy is proud­ly pro­vid­ing Point of Care Test­ing to sup­port the suc­cess­ful West­ern Syd­ney Uni­ver­si­ty Pasi­fi­ka Dia­betes Pre­ven­tion Program.

Pro­fes­sor David Sim­mons and Dr Freya MacMil­lan at West­ern Syd­ney Uni­ver­si­ty estab­lished a pilot study to test a lifestyle dia­betes pre­ven­tion and man­age­ment pro­gram for Samoan com­mu­ni­ties deliv­ered through church­es in South West­ern Sydney.

Dr MacMil­lan and Prof Sim­mons’ team devel­oped a pro­gram called Le Taeao Afua or “the new dawn”.  Using church­es as a cen­tral meet­ing point, the evi­dence-based pro­gram is designed to help the Aus­tralian-Samoan com­mu­ni­ty to pre­vent and man­age diabetes.

A Samoan com­mu­ni­ty acti­va­tor trained 20 church vol­un­teers to become peer sup­port facil­i­ta­tors. Vol­un­teers devel­oped work­shops and more than 100 activ­i­ties cov­er­ing 12 pub­lic health mes­sages deal­ing with diet and exer­cise. Activ­i­ties includ­ed cook­ing class­es, intro­duc­tion to new veg­eta­bles, reviv­ing Samoan cul­tur­al dish­es or pro­mot­ing steam­ing and grilling instead of deep frying.

Of 187 par­tic­i­pants enrolled at the start of the pro­gram, 96% were over­weight or obese and 32% had Type 2 dia­betes and 13% did­n’t know they had dia­betes until they were tested.

After 3 to 8 months, the par­tic­i­pants had sta­tis­ti­cal­ly sig­nif­i­cant reduc­tions in aver­age blood glu­cose lev­els (HbA1c), show­ing the project had improved people’s health.

“By empow­er­ing com­mu­ni­ties, our goal is to embed this pro­gram into the health care sys­tem and sus­tain it. We hope it can then be trans­lat­ed across New South Wales and Aus­tralia,” Dr MacMil­lan said.

The pro­gram will be expand­ed to 48 more church­es of oth­er Pacif­ic com­mu­ni­ties across Greater West­ern and South East­ern Syd­ney. The team aims to reach more than 3,600 adults and their children.

Watch the sto­ry here: https://www.youtube.com/watch?v=IOU9RRnPUoI.

Take a bow Margaret

After a 39-year career in public pathology, Margaret Holschier has closed the door of our Deniliquin Lab for the last time.

After a 39-year career in pub­lic pathol­o­gy, Mar­garet Holschi­er has closed the door of NSW Health Pathology’s Deniliquin Lab for the last time on 1 July 2022.

Mar­garet has been a famil­iar face around the lab and Deniliquin Health Ser­vice, hav­ing worked many roles includ­ing Super­vis­ing Sci­en­tist, Hos­pi­tal Sci­en­tist and Tech­ni­cal Officer.

Mar­garet was drawn to work­ing in pathol­o­gy after a fam­i­ly mem­ber devel­oped a blood dis­ease and it made her curi­ous about this less­er-known profession.

Reflect­ing on her reward­ing career, Mar­garet is proud of the high stan­dard of pathol­o­gy test­ing and her role in look­ing after peo­ple –help­ing the doc­tors, nurs­ing staff and allied health teams to care for patients, and just being there to care for local peo­ple (at all hours of the day and night).

Mar­garet has pro­vid­ed an invalu­able rur­al and region­al per­spec­tive as part of NSW Health Pathology’s Micro­bi­ol­o­gy Clin­i­cal Stream, and she’s wran­gled COVID-19 and the logis­tics of pro­vid­ing test­ing in South­ern NSW, and across state borders.

We appre­ci­ate and thank you Mar­garet for your com­pas­sion, ded­i­ca­tion, sup­port and friendship.

We wish you a long and hap­py retire­ment that involves plen­ty of read­ing, sleep­ing, learn­ing the piano, trav­el­ling and crack­ing the dai­ly wordle!

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