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Integrated Protocol No Wrong Door & Care Planning. www.nowrongdoor.org.au (under construction). No Wrong Door & Care Planning. Key Themes: Agreement on: Collaborative processes and pathways Relationships and Communication Role Clarification between agencies / staff
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Integrated Protocol No Wrong Door & Care Planning www.nowrongdoor.org.au(under construction)
No Wrong Door & Care Planning Key Themes: • Agreement on: • Collaborative processes and pathways • Relationships and Communication • Role Clarification between agencies / staff • Essence of a successful model • Seamless service provision – “no wrong door” • Definitions – eg case management / shared care / care plan etc • Consumer & Carer participation in design of protocol and experience • Secondary Consultation guidelines • Staff reciprocal arrangement program and joint training • Dispute resolution • Service information
No Wrong Door & Care Planning Processes for accepting and making referrals: • Eligibility • Referral & Entry • Triage / screening • Waiting lists • Assessment
No Wrong Door & Care Planning Information Sharing: • Support need in retelling of own story • Reflects privacy legislation • Usage of SCTT consent and templates
No Wrong Door & Care Planning Care Coordination - Integrated Treatment: - One clinician providing treatment for multiple conditions OR - Clinicians from multiple agencies collaborate to develop a single treatment plan
No Wrong Door & Care Planning Care Coordination - Documentation: Recognition that each agency has their own individual care plan / treatment plan / ISP etc. Agreement that treatment / care plans will: • Hold the same basic information • Compliment each other and link together • Be developed in collaboration with the client and other key providers. • Where possible, be transferable between agencies • Identify the plan for inter-agency communication & review
No Wrong Door & Care Planning Care Planning: Agreement that the basic treatment / care plans will include • Client demographics • List the agreed goals and plan • Identify roles and responsibilities against the goals • Include a crisis management plan • Have a clear review process
No Wrong Door & Care Planning Discharge / Exit Plan: • Done in consultation with the client and key providers • A period of adequate preparation • Should include a transition period • Client psycho-education • Written relapse prevention plan • Written crisis management plan • Details for follow up care and referral to other agency
No Wrong Door & Care Planning Benefits of shared care planning: • Everyone working to the beat of the same drum • Client has a clear understanding of who to go to for what • Crisis plan can be develop with the client and is then more likely to be successful when enacted. • Positive outcomes for the client • Builds agency relationships / trust
No Wrong Door & Care Planning Future Directions: • Sector support for regional adoption and roll out of protocol • Evaluation of Phase 1 & Development of Phase 2 • Implementation of Phase 2 & Evaluation • Web based interactive service response tool aligned with connectingcare e-referral project • Ensure long term sustainability.
No Wrong Door & Care Planning For further information: Renèe Williams - Northeast Health Wangaratta Care Coordination - Mental Health Services Business & Partnerships Development Manager P.O. Box 386, Wangaratta, VIC. 3676 Phone: 03 57220038 Mobile: 0448 57 33 66 Email:renee.williams@nhw.hume.org.au