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Rural Innovations Changing Healthcare

A one day ‘virtual’ forum linking 17 satellite hubs across rural NSW, March 2014. View the program.

rural memory clinics Necessity is the mother of invention: how need drove the development of two rural memory assessment services
Keynote Speaker: Prof. Sue Kurrle, Senior Staff Specialist Geriatrician, Geriatrician Hornsby and Batemans Bay hospitals

Rural and regional areas are very poor in the supply of geriatricians, in contrast with the rich supply of geriatricians in urban areas. Eurobodalla is a popular retirement region in coastal southern NSW with a very high proportion of older people. Armidale is a university town and rural service centre also with a high proportion of older people. Neither have access to regular geriatrician services. This presentation looks at how this problem was addressed in two different ways, and how the services have improved access to specialist input, particularly for people with dementia.

3 way collaborationThree way collaboration for dental treatment for children 0 – 18yrs
Jenny Conquest, Strategic Development Planner Centre for Oral Health Strategy NSW

This partnership is collaboration between MLHD, CSU and the Centre for Oral Health Strategy NSW. In 2011, there were 349 children on waiting list at Wagga Wagga. Payment for a set of prescribed services has enabled students to provide treatments for 1,357 children since 2011. The program was extended to WNSW LHD in 2013.

10 Minute Trauma Topics10 Minute Trauma Topics – Structured Trauma Education in the Emergency Department

Vicki Conyers, Trauma CNC, Western NSW Local Health District

Emergency Departments are unpredictable environments and dedicated professional development time is challenging. The structured trauma education program has seen 83, 10 minute topics presented over 12 months across the multidisciplinary team – Nursing, Medical, Allied Health, Ambulance; average attendance 14 at each session.

Coordinated Discharge Package Co-ordinated discharge package to reduce re-admissions in the Medical Assessment Unit (MAU)
Dr Keegan Lee, Mid North Coast Local Health District

Key performance indicators were being breached for re-admission rates, so the MAU team developed a co-ordinated discharge package (CPD) where the JMO has routinely implemented a discharge consultation followed by a 48 hour call back. CPD has seen a reduction in re-admissions of almost 50% since March 2013 and has become permanent methodology at Coffs Harbour MAU.

Speech Pathology TeletherapySpeech Pathology Teletherapy: Working with schools and preschools to create health solutions for rural children
Donna Parkes, Rural & Remote Service Manager, Royal Far West
Dr Robyn Ramsden, Research and Evaluation Manager, Royal Far West

Royal Far West has developed a speech and communication therapy program; Come N’ See which was delivered to 152 children across 23 rural and remote preschools and primary schools in 2013. Six fortnightly therapy sessions are delivered via technology. Families, school principals, teachers and local agencies have become critical partners in delivering speech therapy services to schools.

Crossing OverCrossing Over: Seconding Nurses from the hospital to private General Practice – a partnership for nurse retention

Dr Hamish Meldrum, Director Medical Services, Ochre Health
Judith Caswell, Team Leader, Brewarrina Community Health Service
Heather Finlayson, Health Service Manager, Brewarrina Health Service

Brewarrina Health Service and Ochre Health have collaborated to create a Full Time Equivalent (FTE) position in which the FTE spends 24 hours per week in private practice to deliver Chronic Disease Management services and the balance in the LHD. The Nurse’s salary is fully recovered from Medicare item numbers, is additional to the LHD budget and sustainable with governance provided by WNSW LHD.

Nurse-Led PICCNurse Led Peripherally Inserted Central Catheter (PICC) Service in a rural hospital setting
Andrew Patterson, Acting Health Service Manager, Western NSW Local Health District
Leigh Hobden, Registered Nurse, Western NSW Local Health District
Dr Geoff Hardacre, Visiting Medical Officer, Western NSW Local Health District

Historically patients requiring PICC were placed on the ‘Emergency’ waiting list having the PICC inserted in the Operating Theatre with significant delays and complications. The PICC Service team consist of 2 credentialed RNs and one medical officer, with the nurses inserting the majority of PICC lines by the next business day after referral; saving $2,900 each PICC insertion based on Operating Theatre times, wages and bed days saved.

ACE CooperationACE Program – Co-operation can keep Aged Care residents well and out of hospital

Catherine Turner, Hunter Medicare Local

HNE LHD and Hunter Medicare Local are co-operating on broader implementation of the ACE program (Aged Care Emergency) utilising online clinical guidelines, and a Clinical Nurse Consultant and two Clinical Nurse Specialists funded by the Medicare Local to embed practices in RACF’s and with NSW Ambulance. Early results demonstrate significant reduction in admission rates of RACF residents.

New Graduate PhysiotherapyA rural Public / Private partnership for New Graduate Physiotherapists Recruitment and Education
David Schmidt, Rural Research Program Officer, Southern NSW Local Health District / HETI
Chris Cheung, Southern NSW Local Health District
Naomi White, Sapphire Coast Physiotherapy

A public / private partnership between SNSW LHD and Sapphire Coast Physiotherapy was formed to attract new graduate physiotherapists to Bega to work part time in both sectors. Education, management and support are shared between both sectors; offering a range of clinical experiences, a large pool of mentors and creating a certainty around staffing. The strategy plans to extend to student undergraduate placements.

Frequent User ManagementFrequent User Management

Kevin McLaughlin, Director Mental Health, NSW Ambulance
Paul Wildin, Implementation Manager FUM, NSW Ambulance

As a demand management strategy, data was extracted to identify most frequent callers to 000. Interagency planning meetings with the patient have established and implemented care plans which have seen a significant decrease in the number of calls to 000 and transport to EDs, with associated cost savings to Ambulance and flow on savings to LHDs.

Pre Hospital ThrombolysisPre Hospital Thrombolysis (PHT) for Rural NSW
Dean Pennell, Acting Manager Cardiac Program, NSW Ambulance

As part of the cardiac reperfusion strategy, 2000 paramedics have been trained to provide paramedic initiated accelerated reperfusion via two pathways: Pre-hospital assessment of Primary Angioplasty (PAPA) or Pre Hospital Thrombolysis (PHT). 3,000 patients have been enrolled in the primary angioplasty pathway and 200 patients have received paramedic administered thrombolysis in rural areas since 2011.