Acute Demand Management System like Canterbury, New Zealand
People with acute health needs receive urgent care in their homes or communities, avoiding hospital admission or enabling early discharge from ED or medical or surgical assessment unit. Rapid response community nursing, community observation beds, hospital based specialist advice and rapid diagnostic tests. It was not hospital at home, as it is managed by primary care professionals rather than hospital outreach. This was cost saving - $191 per episode vs $340 for an emergency department presentation and $1180 per bed day.
A particular programme was for COPD. Peak admissions were Monday during hours. Developed care plans and fridge magent with normal O2 sats and ex tol. Ambulance aware of pathways. Telephone access to resp physician and decide if need ED, 24 hour surgery for observation or manage by GP.
Also have enhanced out of hours general practice - centralised nurse led triage system, extended opening hours and 24-hour GP surgery with observation beds and access to dianostic tests such as blood tests and x-rays. Electronic shared care record central to success of out-of-hours general practice.
Reduced ED presentations by 40%.
Why the contribution is important
Develop integrated care plans around the patient and allow primary care to take on greater responsability with support of ambulance and hospital system.
by anthonyrussell on August 12, 2019 at 11:08PM