13Health and EDs

As an emergency department physician, I’m interested in the reasons patients attend our Emergency Departments.  I understand that 13HEALTH direct a significant proportion of callers to attend their local ED, and it would be interesting to know if these referrals were clinically appropriate. In addition, I understand that 13HEALTH utilises a similar medical priority triage system to the QAS, and it would be helpful to understand if the current triaging guidelines align with those of the QAS. It would be good to work with 13HEALTH and QAS to see if some patients can be provided with alternative care options.

 

Why the contribution is important

Important to understanding and have confidence that referrals to EDs from 13Health are consistent with the principle that EDs are for emergencies.

by collierj on August 06, 2019 at 05:11PM

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Average score : 4.6
Based on : 6 votes

Comments

  • Posted by Churchtl August 09, 2019 at 16:52

    Agreed James. If there were reviews done on this service perhaps we could streamline the process to make it service that filters out what doesn't need to be in ED, instead of filtering most calls into ED.
  • Posted by mcrice August 12, 2019 at 20:24

    If the 13HEALTH service had an algorithm that led to getting advice from a doctor, a lot of visits could be saved. WAY cheaper to have a doctor on the line than an ED attendance
  • Posted by kathyk August 13, 2019 at 15:02

    Does the 13HEALTH service have a doctor/s on site to provide advice? Could also be a way of diverting from ED
  • Posted by kathyk August 13, 2019 at 15:05

    Oops, I meant to add: it would be more robust to review the QAS and 13HEALTH triage systems at the same time, to determine similarities/differences, how they could complement and strengthen one another, rather than duplicating
  • Posted by nurse11 August 14, 2019 at 08:07

    I agree, although I think a big part of the success of 13HEALTH referring patients to attend a GP or ED ultimately depends on the patient. They may have been advised by 13HEALTH to be reviewed by a doctor within 8-12 hours - most people would possibly wait to book in with their GP. If it's review within 4 hours - most people would be likely to present to ED, particularly if it's overnight.

    The parameters for 13HEALTH nurses to suggest a timeframe is fantastic IF they work - a patient would be likely to attend ED because they know their own GP is fully booked. So often my clients tell me they can't get an appointment with their GP on the same day they call - we usually joke that you have to know you're going to be unwell in advance.

    I think closer work with the PHN and 13HEALTH to engage patients to attend GP appointments would help. Not sure of the FTA rate at GP practices, but even bulk billing I'm sure they occur. Most GP practices have a fee for FTAs - easy for patients - they just find a new GP practice.
  • Posted by chalmevi August 19, 2019 at 15:41

    13 HEALTH has extensive protocols for a comprehensive nursing assessment, we also have extensive options to provide to callers alternatives to see a GP in the after hours period and we have extensive data on call volume, nature of call, recommended care level, demographics of callers, etc, etc, etc. We share this data per PHN on a quarterly basis to assist with their service planning and understanding the demands of their community. Yes the clinical decision support system used by the nurses of 13 HEALTH is aligned with that of QAS assessment and dispatch system. But to date there has been little opportunity to better integrate the systems and practices of QAS and 13 HEALTH - 13 HEALTH has a number of ideas of possible integration and the benefits to the overall health system including ED's.
    The limitations of Federal/State funding arrangements and scope of practice of nurses and/or telehealth models of care can mean in some circumstances that face-to-face care is needed. If it is not easy to get a GP appointment or it involves GP plus pharmacy plus something else people do look for the comprehensive option.
    13 HEALTH would be very willing to participate in a review of recommended care levels and appropriateness of referral to ED. About 75% of callers to 13 HEALTH being triage assessed are recommended a non-emergency level of care even though the majority of callers to the service occur in the after hours period.
  • Posted by el August 20, 2019 at 16:39

    One challenge in using 13Health is access to interpreters. CALD community members have tried calling 13Health but failed to get through to talking to the nurse because they were unable to connect the interpreter and the nurse at the same time. Also when one calls 13Health if they do need an interpreter they have to stay on the phone for a good 30sec, listening to pre-recorded message, before they actually talk to the operator, I am not sure if someone who is not proficient in English will stay on the line for that long.
    Finally, some community members think that it's a call centre, not aware that they will talk to a nurse.
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