Geri-Connect AN INNOVATIVE APPROACH TO CLINICAL SERVICE DELIVERY
… or how a region Introduced a new disruptive, clinical service model supported by technology into Residential Aged Care Facilities (RACF) which: Polypharmacy by up to 17% falls by up to 43% waiting times by two months access to clinical services by 90% new revenue And kept going….. !!!
Regional Bed Profile others TCP 4% 3% Acute Beds 25% Sub-Acute beds 1% About Us Loddon Mallee Region Aged Care 67%
Problem – Unmet Demand RACF Patients with Geriatric 2-3 month wait for a Decline in GP’s wanting to Medical input into care plans Geriatrician Outpatient visit RACFs Review Yes 5% No 95%
Where we started Health th Service ice 1st t Priori rity ty 2nd Prior ority ty 3rd d Prior ority ty Echuca Regional Health Geriatrician Services Pain Management Cancer Services Swan Hill District Health Geriatrician Services Fractures Clinic Cohuna District Health Service Geriatrician Services Pre-Surgical Consultations Skin Disorder Inglewood District Health Service Geriatrician Services Mental Health Kyabram District Health Service Geriatrician Services Huntington's Disease Orthopaedics Heathcote Health Geriatrician Services Mental Health Social Worker Boort District Health Service Geriatrician Services Aged Care Mental Health Kerang District Health Geriatrician Services Urgent Care Urgent Mental Health Kyneton District Health Service Geriatrician Services Trauma Support Urgent Mental Health Rochester and Elmore District Health Geriatrician Services Fractures Clinic Maryborough District Health Geriatrician Services Castlemaine Health Geriatrician Services Rehab Support Urgent Care GP Services into Aged Robinvale District Health Service Geriatrician Services Trauma Support Care
Solution Vision ion A self-sustaining specialist Geriatrician virtual service hub to improve equity & quality of care provided to older adults across regional Victoria Scope Initial scope of implementing a service into 15 public health service Residential Aged Care Facilities across the Loddon Mallee Region.
What we had to do it with No Geriatricians No money
Pillars for a sustainable clinical service model Clinical Workforce Desire (Market) Sustainable Concept Ability Service Model Recurrent Technical and Technology funding Financial Resource source
Pillars for a sustainable clinical service model Clinical Workforce Desire (Market) Sustainable Concept Ability Service Model Recurrent Technical and Technology funding Financial Resource source
Pillars for a sustainable clinical service model Clinical Workforce Desire (Market) Sustainable Concept Ability Service Model Recurrent Technical and Technology funding Financial Resource source
Financial Kick start funding required to Financially stable Scalability accelerate the program proposition proposition (provided by Better Care Victoria
Implementation/Change Management Approach GC Clinical Nursing Point of care Nursing Staff Coordinator nurses complete educated engage with Referrals Nursing staff Patients and on the value Families to of a Geriatric identify Specialist engages and Discuss/ Service (how suitable develops ongoing relationship and when to residents engage Referral Tria Consultation Care Plan Service engage) with GP with the yes Sent ged held implementted GP Ongoing conversations Copy of Specialist Specialist letter sent to approv No No Yes letter sent RACF ed to GP
Addressing risks Risk sk Did it eventuat ntuate? e? GPs won’t refer to the service No Not all Regional Health Services participate in the service Yes Unable to recruit sufficient clinical staff No (Consultants & Registrars) RACF Staff will not support the program Yes MBS items for telehealth no longer supported Not yet! Poor Technology acceptance No
What did we end up delivering? Initial ial Scope: 15 Loddon Mallee (Vic) region public health service RACFs RACFs = Residential Aged Care Facilities
Innovative
What has been the result A new disruptive, clinical service model supported by Diffusion / Integration technology/connectivity into Residential Aged Care in to Regional Health Facilities (RACF) which: Service provision Polypharmacy by up to 17% falls by up to 43% waiting times by two months growth of access to clinical services by 90% new funding
Looking Forward…… Stage 1 Stage 2 Stage 3 The Future Stages 2 and 3 • Increased scope of service • Virtual Medicine services to regional and remote health Hume 2019- Loddon Mallee 2017- 2019 on services 2019 onwards: Increased Access, Scope & Evaluation of Outcomes
Overall VIS ISION: Telehealth enabled shared platform NOT a telehealth service Geri- Connect At Home In Care Chronic Aged Disease Small care Management Rural RACFs Hospitals Dementia • Diagnosis • support Stage 2 & 3 Stage 1 Common Telehealth, Tele-monitoring & Technology Platform
Where we started… and where we are now Health Health Health th Service th Service th Service ice ice ice 1st t Priori rity ty 2nd Prior ority ty 3rd d Prior ority ty 1st 1st t Priori t Priori rity rity ty ty 2nd Prior 2nd Prior ority ority ty ty 3rd 3rd d Prior d Prior ority ority ty ty Echuca Regional Health Echuca Regional Health Echuca Regional Health Geriatrician Services Geriatrician Services Geriatrician Services Pain Management Cancer Services Pain Management Pain Management Cancer Services Cancer Services Swan Hill District Health Swan Hill District Health Swan Hill District Health Geriatrician Services Geriatrician Services Geriatrician Services Fractures Clinic Fractures Clinic Fractures Clinic Cohuna District Health Service Geriatrician Services Cohuna District Health Service Cohuna District Health Service Geriatrician Services Geriatrician Services Pre-Surgical Consultations Skin Disorder Pre-Surgical Consultations Pre-Surgical Consultations Skin Disorder Skin Disorder Inglewood District Health Service Geriatrician Services Inglewood District Health Service Inglewood District Health Service Geriatrician Services Geriatrician Services Mental Health Mental Health Mental Health Kyabram District Health Service Geriatrician Services Kyabram District Health Service Kyabram District Health Service Geriatrician Services Geriatrician Services Huntington's Disease Huntington's Disease Huntington's Disease Orthopaedics Orthopaedics Orthopaedics Heathcote Health Geriatrician Services Heathcote Health Heathcote Health Geriatrician Services Geriatrician Services Mental Health Mental Health Mental Health Social Worker Social Worker Social Worker Boort District Health Service Geriatrician Services Boort District Health Service Boort District Health Service Geriatrician Services Geriatrician Services Aged Care Mental Health Aged Care Mental Health Aged Care Mental Health Kerang District Health Kerang District Health Kerang District Health Geriatrician Services Geriatrician Services Geriatrician Services Urgent Care Urgent Care Urgent Care Urgent Mental Health Urgent Mental Health Urgent Mental Health Kyneton District Health Service Kyneton District Health Service Kyneton District Health Service Geriatrician Services Geriatrician Services Geriatrician Services Trauma Support Trauma Support Trauma Support Urgent Mental Health Urgent Mental Health Urgent Mental Health Rochester and Elmore District Health Rochester and Elmore District Health Rochester and Elmore District Health Geriatrician Services Geriatrician Services Geriatrician Services Fractures Clinic Fractures Clinic Fractures Clinic Maryborough District Health Maryborough District Health Maryborough District Health Geriatrician Services Geriatrician Services Geriatrician Services Castlemaine Health Castlemaine Health Castlemaine Health Geriatrician Services Geriatrician Services Geriatrician Services Rehab Support Urgent Care Rehab Support Rehab Support Urgent Care Urgent Care GP Services into Aged GP Services into Aged GP Services into Aged Robinvale District Health Service Robinvale District Health Service Robinvale District Health Service Geriatrician Services Geriatrician Services Geriatrician Services Trauma Support Trauma Support Trauma Support Care Care Care
Plus more Oncology MDT’s Tele - ICU Transition Mental Health Care (TCP) >250 Telehealth Endocrinology MDT’s Assessment Tele Paediatrics Aged Care Consultations, Assessments CDAMS Clinic Tele Palliative Care (ACAS) Assessments or MDT’s per month
Opportunity: Development of a Virtual Hospital and Ambulatory Outreach services
Loddon Mallee Virtual Hospital Architecture eConsults Multi- Mental Tele - UCC Tele - Disciplinary Assessments Heath Stroke Support ICU Teams Consultations Hospital in E-Advice the Home In Hospital Remote Patient telemetry Monitoring Remote Monitoring Electronic Quality Sepsis Community eCredentialling Patient Programs Program Health System Record Foundations Inpatient / Hospital Outpatient / Community
Ongoing Development Continuous Evaluation, QI & Research Educational Outreach, Feedback and upskilling - Staff and community Clinical Service Foundation
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