History of Health Education
Since 1903 and still going strong - a long history of health education and whole-person health at the San
One of the guiding principles of the hospital and its mission since it opened in 1903 has been its focus on wholistic health. The hospital was called Sydney Sanitarium & Hospital for the first 70 years of its life, with the name ‘Sanitarium’ reflecting the emphasis on wellbeing, recovery and preservation of health. It was known in Sydney and further afield as “The home of health – the place where people learnt to live well”. Although the hospital was renamed Sydney Adventist Hospital following a major renovation and expansion in 1973, it is still fondly known as ‘the San’ today. The hospital continues the legacy established by its founders – to be both curative and preventative in its approach to healthcare to this day. Our whole purpose is whole-person health.
Health promotion through the years
In the early 1900s, patients would stay at the San for weeks, sometimes months, for convalescence and recuperation. There was an emphasis on hydrotherapy, fresh air, sunshine, a nutritious vegetarian diet, spiritual care, exercise and walks through the surrounding bushland, calisthenics on the hospital’s front lawn, and instruction regarding a healthy lifestyle. Over the years the San gradually expanded from its original 70 beds, adding new surgical wards, multiple operating theatres, a maternity unit, and upgraded and expanded imaging and diagnostics. A major redevelopment of the hospital from 1968-1973 saw the old wooden structure replaced with a nine-storey brick building (Clifford Tower) which increased hospital capacity by hundreds of additional beds.
At the same time as this redevelopment was taking place, many new health promotion programs commenced at the San. Notably among these was the 5-day stop-smoking program, based on a program from one of the San’s sister health institutions in Washington USA. So successful was this stop-smoking program, that local community organisations, churches and businesses began asking the San to run stop-smoking programs for them.
The San established a Health Education Centre and, in addition to the stop-smoking plan, introduced many other health-promotion programs. These included: weight management, stress management, exercise stress testing, personal fitness, dietary education, relationship counselling, therapeutic massage, and executive health checks. Not only did former patients and their families, staff and the local community attend these programs, but the San ran exec-checks and health education programs for many of Australia’s largest companies – including BHP, Lendlease, Commonwealth Bank, Reserve Bank of Australia.
The hospital was ahead of its contemporaries by introducing pathology and diagnostics for participants in these programs. The Health Education Centre also developed its own software program – the first of its kind in the world – which had a decision tree, produced automated reports for the doctors, and could track and compare previous results and participant’s progress. Over the years, health education programs at the San had a number of iterations and name changes. Numerous San staff, doctors and administrators – too many to mention here – devoted their expertise, time and commitment to improving the health of the community, with long-lasting and immeasurable health benefits to the community.
Changes over time
Changes to health education programs over time responded to the fluctuations in public demand and broader health trends. The average length of stay for patients in hospital went from many weeks in the early 1900s to just 10 days by the 1960s. This was in part driven by advances in surgery and improvements in healthcare delivery, but also, over time, long hospital stays were not permitted by government nor supported by private health funds.
The average length of stay in hospital dwindled further over the years to just 4.7 days in 2019. The proportion of day-only procedures also grew significantly, with many patients only spending a matter of hours in hospital. The upshot of this is that patients had less time in hospital in which they could be involved in health-promotion initiatives. The shrinking length of stay greatly imposed on the opportunity for health education for these patients. The emphasis began to shift more towards post-op rehabilitation, online and outpatient wellness initiatives.
Smoking rates dropped significantly, with Australia having one of the lowest smoking rates in the world, corresponding with little demand for stop-smoking programs. People’s knowledge about health increased, with 24/7 access to health information online contributing to the growing health consciousness among the general public.
One of the significant challenges to health education initiatives today is that private health funds and Medicare allocate very little funding towards health promotion. Most Australians think that if they spend on health, they should be able to claim from Medicare or their private health insurer. However, being able to claim rebates for disease prevention or health promotion is very limited or, in most cases, non-existent – despite much compelling research and effort spent lobbying over many decades.
Still going strong
In 1979 the San became the first private hospital in Australia to offer a comprehensive cardiac program that included diagnostic, medical, surgical and rehabilitation services. A strong commitment to patient education and cardiac rehabilitation was integral to the success of cardiac surgery at the hospital, and continues save lives and improve quality of life to this day.
In the early 1980s, the San established Operation Open Heart (later renamed Open Heart International) to provide surgery, health promotion, and health-workforce upskilling for developing countries. With the aim that these countries may gain self-sufficiency in the future, teams from the San have conducted outreach trips to 16 countries, providing cardiac surgery, eye surgery, women’s health, burns surgery, orthopaedic surgery, cleft palate surgery, primary health care and health education for countries that would otherwise not have these services.
The San has always maintained a comprehensive health promotion focus including physiotherapy, dieticians, hydrotherapy pool, post-op rehabilitation, counselling and chaplaincy/spiritual care services. The hospital is an accredited training centre for chaplains, and provides spiritual care services and support for patients and staff seven days a week. As part of the major redevelopment of the hospital in 2014, the Integrated Cancer Centre was established. In addition to chemotherapy, immunotherapy and radiotherapy, the centre provides – in the one location – interdisciplinary teams including specialists, nurses, dieticians, physiotherapists, massage therapists, stretch classes, exercise gym, counselling, chaplains and spiritual care services.
The San has trained nurses since the hospital opened in 1903, and also provides clinical placements for doctors and allied health professionals during their training. San staff and doctors have taken knowledge and skills about health and wellness with them as they travelled, worked and lived throughout Australia and the pacific. Educators and researchers at the hospital continue to contribute to skills and knowledge which will shape the future of healthcare. Heartfelt thanks to tens of thousands of nurses, doctors, allied health professionals, hospital staff, educators and researchers who committed to upholding the hospital’s mission of caring for the whole person. While we cannot name all of you here, each one of you has made a lasting and unmeasurable contribution to the health and quality of life to untold number lives in the communities we serve – whether locally in Sydney or more broadly throughout Australia and the surrounding regions. We thank you and look forward to continuing to inspire hope and wellbeing as we work to fulfill the hospital’s mission of whole-person health long into the future.
ELIA Wellness joins Adventist HealthCare
We believe everyone deserves to thrive and live life in abundance. This is why in 2016, ELIA Wellness was launched in Australia and New Zealand to empower people to whole-person health. ELIA stands for Empower Lifestyle Innovation Advocates and is a health promotion charity that helps to engage local communities face-to-face through local wellness partners. The broad community are now able to have direct access to evidence-based lifestyle medicine programs, whole-person health articles, educational resources, online Fitness workouts and more through the ELIA Wellness digital platform and mobile app.
In 2023, the ELIA Lifestyle Medicine Centre was launched at Sydney Adventist Hospital to provide evidence-based lifestyle medicine consultations, programs and interventions that address the root causes of chronic illness or disease. The interdisciplinary team of lifestyle medicine doctors, registered nurses, health coaches, exercise physiologists, dieticians and psychological care will help support and coach patients through the areas of nutrition, movement, mindset and connectedness. The 12-week clinical programs offered will include diabetes, breast cancer, prostate cancer, obesity and more.