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AN INTRODUCTION TO

AN INTRODUCTION TO. ANGIE PATRAS Divisional Support Officer, Aged Care apatras@gptasmania.com.au. TASMANIAN AGED CARE NETWOTK. GENERAL OVERVIEW MODELS TO DATE ACHIEVEMENTS TO DATE CONSTRAINTS PRIORITIES. GENERAL PRACTICE TASMANIA. A network of 5 organisations across Tasmania.

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AN INTRODUCTION TO

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  1. AN INTRODUCTION TO ANGIE PATRAS Divisional Support Officer, Aged Care apatras@gptasmania.com.au

  2. TASMANIAN AGED CARE NETWOTK • GENERAL OVERVIEW • MODELS TO DATE • ACHIEVEMENTS TO DATE • CONSTRAINTS • PRIORITIES

  3. GENERAL PRACTICE TASMANIA A network of 5 organisations across Tasmania

  4. GENERAL PRACTICE TASMANIAN NETWORK (CONT) • 5 ORGANISATIONS • COROPERATION AND CONDUCT AGREEMENT UNDERPINS THE COLLABORATION AND PARTNERSHIP ARRANGEMENT FOR THE NETWORK • 3 DIVISIONS 1GP WORKFORCE 1 SBO

  5. DIVISIONAL BOUNDARIES FOR TASMANIA

  6. GENERAL PRACTICE SOUTH AGED CARE GP PANEL INITIATIVE MODEL 2005 - 2008 AGED CARE GP PANEL INITIATIVE REFERENCE GROUP To determine and monitor direction of the initiative and prioritise issues to be addressed by Aged Care GP Panels KEY PEOPLE: GPs, ACF Staff, Pharmacists, Consumers, Allied Health Professionals INVITED: Geriatrician, Aged Care Assessment Service, Other as identified • PRIORITY AREAS • GP – ACF – Resident relationship, communication and access • Medication management/pharmacy • Documentation • IT/Infrastructure • Improved understanding of team members roles and limitations • Standardised protocols across a range of issues • Education for GPs and ACF staff, eg • behaviour disturbance • falls prevention • end of life planning • chronic disease management • Aged care standards GENERAL PRACTICE SOUTH COORDINATION GP ADVISOR ROLE: GP champion and provides expert advice DIVISION PROGRAM OFFICER: To coordinate implementation of the model To provide support and liaison to regional panels To liaise with ACF, Pharmacists, AHPs in the Division boundary NORTH ACF staff Glenview, Mary Ogilvy, St Anne’s-Compton Downs, Barrington Lodge, Rosary Gardens, Uniting Aged Care-Strathaven, Uniting Aged Care- Strathglen, The Gardens, Karingal, Corrumbene, Midlands MPs, Ouse, GPs Pharmacists and AHPs EAST ACF staff Adards, Uniting Aged Care-Lillian Martin, Uniting Aged Care- Ningana, Freemasons, Bellview Manor, Queen Victoria, Bowditch, Oakdale, May Shaw, Tasman MPS, GPs, Pharmacists and AHPs SOUTH ACF Staff Bishop Davies Court, Guilford Young, Mary’s Grange, Esperance MPS, Huon Eldercare, Hawthorn Village, Sandown Village, St Ann’s, Snug Village, Vaucluse, GPs, Pharmacists and AHPs RESIDENTIAL AGED CARE FACILITIES ROLE: To liaise with Divisions Aged Care Program Officer Participate in relevant Aged Care GP Panel activity Implement appropriate and agreed recommendations

  7. GENERAL PRACTICE SOUTH ACHIEVEMENTS CONSTRAINTS AND PRIORITIES • GP: • ACF: • PANELS : 3 AREAS (N) (E) (S) 1 CORE REFE. GROUP • ACHIEVEMENTS: • Advanced Care Planning • Introduction of electronic patient records • Transfer envelopes • CONSTRAINTS • Work hours • Development of communication channels • Workforce issues outside of our project scope impact on operations (both GP and nursing) • PRIORITIES •  AH Engagement • ACFI training • GP Rationalisation • Electronic prescribing • Palliative care/falls prevention • Clinical resource

  8. GENERAL PRACTICE NORTH AGED CARE GP LIAISON GROUP MODEL 8 GP LIAISON GROUP RACFs REGIONAL STAKEHOLDER COMMITTEE RACF GP SERVICE PROVIDERS LEGEND: GP LIAISON GROUP: Number of GPs selected to provide a liaison role for the nominated RACF/s and to other Aged Care Service providers. The group will also liaise with other RACF GP service providers. RACFs (Residential Aged Care Facilities): Individual RACFs will have either direct representation on or be able to feed into the Regional Stakeholder Committee. REGIONAL STAKEHOLDER COMMITTEE: Committee comprised of RACF reps, Pharmacy reps and GP Liaison Group reps. Focus of the committee will be to advance identified issues in a collaborative manner and to thus feed back to the respective stakeholders.

  9. ACHIEVEMENTS CONSTRAINTS AND PRIORITIES 9 • GP: • ACF: • PANELS : GP liason group rep 6-10 core GP’s feeds info to regional Stakeholder committee • ACHIEVEMENTS: • ECG trial • Streamlining access for GP’s and RACF • education to RACF • CONSTRAINTS • Generating motivation • Workforce issues outside of our project scope impact on operations (both GP and nursing) • PRIORITIES •  AH Engagement • ACFI training • GP Rationalisation • Palliative care/falls prevention • Clinical resource • Advanced Care Planning

  10. AGED CARE GENERAL PRACTITIONER PANELS INITIATIVE GP ADVISOR GP ADVISORY PANEL Burnie/Somerset Wynyard Breakfast Group GPs 3 ACH Pharmacists NWRH – Burnie Guests Central Coast Breakfast Group GPs 3 ACH Pharmacists Dementia Support Hospital Mersey Leven Breakfast Group GPs 4 ACH Pharmacists NWRH – Mersey Palliative Care Medical Officer Position Dr Keith McArthur Pilot Project NW Dementia Unit Diabetes Resource Packages Protocols & Respite Queenstown Smithtown Sheffield King Island • Breakfast Meetings – focus and activity • Forum for ACHs, GPs and Providers – specific focus for each area • Multiple topics – Streamlining of GPs visiting homes, respite register and aged care manual • - Geriatrician and Psycho-Geriatrician education. IT focus – Medical Director • Municipalities experiencing minimal difficulties. Good communication and relationships established due to close proximity of GPs to ACH • Education – Geriatrician and Psycho-Geriatrician, sharing of outcomes/resources • Areas of elected activity under the ACGPPI Program with nominated focus groups • Diabetes Management Resource Packages for RACFs in conjunction with Diabetes Aust-Tas to enhance the care of ACF residents with diabetes • Producing agreed protocols for the area egwarfarin, digoxin • Medical Officer Position – Doctor employed at Umina Park Nursing Home • Medical Director onsite, Remote Access – GPs, Pharmacy, GP Assist, Radiology & Pathology – role expanded to Somerset and Wynyard • Pilot Project – Establishment of a NW Dementia Unit for patients experiencing challenging behaviour • A working group of nine members has been formed to progress the pilot and comprises of key stakeholders (DHHS/RACFs/GP/Allied Health)

  11. ACHIEVEMENTS, CONSTRAINTS AND PRIORITIES • GP: • ACF: • PANELS : 3 AREAS 1 CORE REFE. GROUP (GP ADV) • ACHIEVEMENTS: • Protocol development for medication warfarin,charts etc • Establishment of Medical Officer ACF / REAccess • Transfer envelopes • CONSTRAINTS • Work hours PO Position vacant for 6 months • Re-establishment of meetings • Lack of access to dementia specific care in rural area • PRIORITIES •  AH Engagement • ACFI training • GP Rationalisation • Electronic prescribing • Palliative care • Management of challenging behaviour

  12. GENERAL PRACTICE TASMANIA CONDUIT FOR 2 WAY COMMUN ICATION Leadership and support. Constraints: Capacity of role Establishment of relationships Priorities 2008 Nurse practitioner Medication management Establishment of relationships with AH peak

  13. QUESTIONS 13 ANGIE PATRAS Divisional Support Officer, Aged Care apatras@gptasmania.com.au

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