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Implementation of Agency for Clinical Innovation (ACI) Orthogeriatric Model of Care Tracey Drabsch

Innovation Poster Session HRT1215 – Innovation Awards Sydney 11 th and 12 th Oct 2012. Implementation of Agency for Clinical Innovation (ACI) Orthogeriatric Model of Care Tracey Drabsch. Orange. 1-1b_HRT1215-Session1_DRABSCH_ORANGE_NSW. KEY PROBLEM.

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Implementation of Agency for Clinical Innovation (ACI) Orthogeriatric Model of Care Tracey Drabsch

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  1. Innovation Poster Session HRT1215 – Innovation Awards Sydney 11th and 12th Oct 2012 Implementation of Agency for Clinical Innovation (ACI) Orthogeriatric Model of CareTracey Drabsch Orange 1-1b_HRT1215-Session1_DRABSCH_ORANGE_NSW

  2. KEY PROBLEM In Mid 2010 within OHS there appeared to be issues surrounding: Capacity for inpatient services to consistently provide multidisciplinary orthogeriatric care Inconsistent patient discharge planning and goal setting Handover to the NF was reportedly inconsistent and not multidisciplinary in nature Understanding of resources and staffing available in NF was limited Continuity of care between facilities, follow up and community care lacked clear process

  3. AIM OF THIS INNOVATION Evaluate the implementation of the ACI Orthogeriatric Model of Care within Orange Health Service before and after the Sub-Acute Care Team (Senior Clinicians - Medical, Nursing, Allied Health) involvement Establish baseline information within a regional hospital via medical record audit. Pre Team June 2008 - June 2009 (n=50). Post Team Sept 2010 - Feb 2011 (n=30).

  4. Sub-Acute Care Team Hub and Spoke Model of Care from OHS Multidisciplinary Handover to Neighbouring Facilities & Teams • Orthogeriatrics • Collaborative Care • with the • Orthopaedic/Acute Teams • Sub-Acute Care Team • Multidisciplinary • Team • NF Teams • Outreach visits • Patient follow up • Education Outreach Co-ordinator Sub-Acute Care Team members “THE HUB” ORANGE inpatient Neighbouring Facility www.gwahs.health.nsw 4 Joint Question for

  5. Outcomes & Evaluation Statistically significant increase in: Occupational Therapy involvement Social Work involvement Documentation of weight bearing status, pre-morbid mobility and pre-morbid function Aperients given Paracetamol charted Medical discharge summaries sent to the General Practitioners Handover information including the patient’s equipment needs, goals and contact details, physiotherapy, dietetics and social work discharge summaries 5

  6. Outcomes & Evaluation Statistically significant decrease in: Nutrition assistant Initiation of discharge planning (3.9 days to 2.6 days) Complications such as pressure ulcers, electrolyte imbalance and wound infection 6 6

  7. Lessons Learned Senior Multidisciplinary Clinical Teams are able to implement change Guidelines with clinical validity and authority to work from provide a good platform to guide, build and sustain clinical practice changes within a service Consistent communication of keeping patient care the focus is essential with change management Consistency of team activity over a prolonged period is effective in maintaining service provision Teams work well with teams Networking is key to providing a more seamless patient journey 7

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