The implementation of a chronic wound service, mobile x-ray service, nurse navigator mediated case management and a Nurse-Practitioner position will allow the treatment of these older patients in the familiar surrounds of their own environment. Further development of clinical pathways will improve implementation of an evidence-based approach in the emergency department. This emergency substitutive care service and demand management program provides an ED equivalent assessment within the RACF. It aims to improve quality of emergency healthcare to this vulnerable geriatric population, whilst reducing exposure to the often frightening and high-risk ED environment.
CARE-PACT Expansion project
Initiative Type
Model of Care
Status
Deliver
Added
Last updated
Summary
Key dates
Jan 2016
Jan 2018
Implementation sites
Metro South Hospital and Health Service
Partnerships
Healthcare Improvement Unit, Brisbane South PHN
Aim
- Pilot of CARE-PACT, Wound Innovations and Brisbane South Primary Health Network ( PHN) collaboration to improve management of elderly patients with chronic wounds in Residential Aged Care Facilities (RACF) who would otherwise require Emergency Department ( ED) or hospital management.
- Institution of pilot mobile x-ray service in partnership with Aged Care Imaging to reduce demand on emergency services for provision of plain radiology to residents of aged care facilities who do not otherwise require emergency interventions.
- CARE-PACT focus on hospital avoidance and increase in acute substitutive care by:
- collaboratively developing ED and inpatient clinical pathways to improve implementation of evidence-based approach in ED and to increase appropriate acute substitutive care enrolment and appropriate hospital avoidance
- provide nurse navigator mediated case management for RACFs with high ED presentations and/or prior poor engagement with CARE-PACT services
- workforce capacity building through the establishment of a Nurse Practitioner (NP) candidate position, resulting in contribution of CARE-PACT to growing gerontic emergency NP workforce supporting QH EDs older persons emergency management.
Benefits
The implementation of the CARE-PACT Expansion Project will result in:
- Decreased burden on hospital resources and need for acute beds.
- Increased opportunity to increase collaboration with PHN providers and clinicians.
- Improved outcomes for target cohort of community patients resulting in decreased admissions and re-admissions.
- Opportunity to contribute to NEAT compliance.
Background
The increase in the frail, older population will pose a significant challenge to Metro South Hospital and Health Service (MSHHS) to provide health care needs in an environment of constrained resources. As the demand for healthcare will continue to rise, the need for alternate models of cost effective care must be implemented and optimised.
The Integrated Care Innovation Fund provides financial support to innovative projects that deliver better integration of care, address fragmentation in services and provide high-value healthcare. Funded projects also demonstrate a willingness to embrace and encourage the uptake of new technology alongside the benefits of integrating care and improving communication between health care sectors.
Solutions Implemented
- CARE-PACT, Wound Innovations and Brisbane South PHN collaboration in RACFs commenced late 2017
- Aged Care Imaging mobile x-ray service commenced late 2017
- CARE-PACT focus on hospital avoidance and increase in acute substitutive care implementations:
- The first ED-Inpatient Care Pathway was developed in June 2018 and is ready to be trialled.
- Nurse Navigator mediated case management for RACFs commenced
- Nurse-Practitioner candidate commenced April 2018.
