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Disaster Recovery Program

Disaster Recovery Program. Mediation Process involving Residential Aged Care Facility, GPs, Pharmacy & the Division of GP Presented by Susan Denny Aged Care GP Panels Program Manager. HISTORY. Privately owned & managed residential aged care facility

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Disaster Recovery Program

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  1. Disaster Recovery Program Mediation Process involving Residential Aged Care Facility, GPs, Pharmacy & the Division of GP Presented by Susan Denny Aged Care GP Panels Program Manager

  2. HISTORY • Privately owned & managed residential aged care facility • Operated by large group with at least 30 other facilities throughout Australia • 167 bed facility – High, Low, Ageing in Place & Dementia specific • 2 large separate buildings over large area • Serviced by 18 GPs • 4 practices, 3 provide medical care to more than 95% of the residents

  3. GP PANEL • 2 GPs • Director of nursing (DON) • Manager of low care • Managing director of RACF • Pharmacist • Aged Care GP Panels program manager • 1 hour Bimonthly GP Panel breakfast meeting • Quarterly Medication Advisory Committee meeting

  4. GP ISSUES • GP owed scripts • Limited nursing support for GPs • Residents without medication • No dedicated area for GPs • All records are paper based centrally • No current GP model of care • Poor communication • No designated car parking for GPs • No IT system • Lack of utilisation of appropriate item numbers

  5. PHARMACY ISSUES • GP owed scripts • Potentially medico legally compromised by providing medications without scripts • Each pharmacy works to different standards • Residents without medication • Pharmacy losing money

  6. FACILITY ISSUES • GP owed scripts • DON not able to make certain decisions without consulting with managing director in Melbourne • All records are paper based centrally • Poor documentation • Lack of communication • Due for re-accreditation this year • Funding issues – Aged Care Funding Instrument (ACFI) • Inefficient systems in place • Limited staff education • Staff stress • Lack of protocols

  7. ISSUES FOR RESIDENTS • Having to pay for scripts when they have reached the safety net • No medication • Medication swapped-potential for medication mismanagement • New residents without GP • Transported to A & E due to lack of medical services • Family distress & frustration (often family unaware) • Overall compromised care

  8. CATALYST TO DISASTER • Pharmacy decided to stop supplying medications without a script • Certain residents without own medication • Medication sharing and swapping • GPs disenchanted & threatening to withdraw services • New residents without a GP Each player not aware, or understanding of each others roles and responsibilities

  9. Facility COLLISION COURSE Pharmacy

  10. NEED FOR MEDIATION • Decision to contact an independent mediator • Dr Jane Fyfield – Healthcare International MBBS; DGM; Grad Dip Health Admin; MPH Emial address - jfyfield@optusnet.com.au • Cost - $2,950 plus GST

  11. PROCESS • Mediator discussed issues with: • GPs from each clinic • Pharmacist • Managing director of facility • DON & manager of low care • Finance manager of facility • Aged care program manager • Report compiled and distributed to all parties • Mediation meeting with all parties to discuss: • Identified issues • Roles • Recommendations • Implementation

  12. WHERE TO FROM HERE? Recommendations • IT • GP Model of Care • Communication • Staffing

  13. WHO IS RESPONSIBLE? - Facility Accommodating GPs • Reserved car parking • Designated work area • IT interface with GP software • Nursing support for GPs • Availability Communication strategy • Communication book • Pigeon holes for clinics/GPs • Clinical pathways

  14. WHO IS RESPONSIBLE? - GPs • GP Model of Care • Sharing residents between GPs – maximise efficient use of time • After hours arrangements in place • Regular visiting times • Medication management • Utilise item numbers effectively • Good record keeping • IT implementation • Recall systems • GP involvement in GP Panels & Medication Advisory Committee

  15. WHO IS RESPONSIBLE? - Pharmacy • List for GPs currently owing scripts • New process for future script renewal, requests be provided to next medication advisory committee for discussion and dissemination • Pharmacy needs to have model for GPs to accept

  16. WHO IS RESPONSIBLE? - CWGDoGP • GP Model of Care • IT Committee

  17. How do we know when we are there? Acknowledgements: Department of Health & Ageing General Practice Victoria Healthcare International, GPs, DON, Manager low care, Facility Managing Director, Facility Finance Manager, Board Members & CEO of Central West Gippsland Division of GP

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