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Counties Manukau DHB Community Living Service (CLS) Presenter: Ian McKenzie, Dr Margaret Aimer Hospital: (Fury) Key contact person for this project: (Ian McKenzie, IMcKenzie@middlemore.co.nz, ++64 9 270 9125). 14 October 2005 - Melbourne. KEY PROBLEMS.
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Counties Manukau DHBCommunity Living Service (CLS)Presenter: Ian McKenzie, Dr Margaret AimerHospital: (Fury)Key contact person for this project:(Ian McKenzie, IMcKenzie@middlemore.co.nz, ++64 9 270 9125) 14 October 2005 - Melbourne
KEY PROBLEMS • Acute inpatient unit constantly over capacity, leading to • Difficulties accessing inpatient care • Increased level of acuity managed in the community • LOS demand rather than clinically driven • Workforce issues - industrial action • Quality of inpatient care issues • Lack of suitable housing/discharge options created delays in discharge/ added to acute demand • People remained waiting in the inpatient unit for vacancies in Residential Rehab facilities. • Fragmentation between clinical (DHB) and support (NGO) services.
HOW WE DID IT • Project Started: • July 2004 – partnership between planning and clinical service • Staffing: • 24 FTE in the Community Living Services (six different NGO’s) • Funding: • For NGO FTE and Flexifund $3.1million per annum • Duration: • Implementation complete July 2005. Evaluation and review by June 2006
INNOVATIONS IMPLEMENTED • CLS responsible for: • Situations of housing loss and homelessness • Delivering intensive community supports in the community • Building natural supports • Working closely with clinical teams • Working closely with each other • Increased capacity of NGO sector (shared workforce development initiatives). • Developed alternative housing options. • Increased throughput of existing residential rehabilitation services. • Integration of clinical and support services. • Maintain community housing during inpatient episode.
LESSONS LEARNT • Recommendations: • Clinical/ support service integration • Structured to ensure alignment/ relationship • Clear roles and responsibilities • System view of patient flow planned approach to service design. • Recognition of importance of relationships and inclusive change management processes • What we would do differently • Baseline evaluation framework • Recognition of time/ cost of service design/ implementation