clinical focus
Pushing the envelope
Redcliffe Hospital , Brisbane North PHN and Queensland Ambulance Service staff at the relaunch of the Yellow Envelope on 20 June . Photo : Brisbane North PHN
Yellow envelopes and geriatric outreach are helping to minimise resident transitions .
Michele Smith interviewed by Patrick Avenell
24 agedcareinsite . com . au
Brisbane North PHN has recently rolled out two initiatives – Yellow Envelope and the Geriatric Outreach Assessment Service – to help or minimise the transition of aged care residents from facilities to hospitals .
“ The Yellow Envelope is a document in which residential aged care facilities can enclose a resident ’ s key healthcare information if they need to go to hospital ,” said Brisbane North PHN executive manager , aged and community care , Michele Smith . “ It supports safer clinical handover between the aged care facility and the hospital .
“ The Geriatric Outreach Assessment Service provides specialist medical advice and support to GPs who care for aged care residents in Chermside and surrounding suburbs to avoid the need to send residents to the emergency department to access this treatment .”
Aged Care Insite spoke to Smith about these initiatives and related issues , such as patient data security and privacy .
ACI : Can you give us an overview of the initiatives ? MS : Part of the Primary Health Network charter is to keep people well and at home and out of hospital . So we want to avoid people going to hospital if there ’ s a better care option , and we do a lot of work across the aged care and health sectors , both primary health and secondary . We talk to GPs in hospitals and residential aged care and community service providers , and try to get a feel for what the needs are in the local community .
A lot of the feedback that we received through that consultation process last year was that many people in residential aged care are transferred via ambulance to emergency departments for conditions that could be treated in their place of residence , in their home , if there were sufficient support services to do that . GPs are very busy in their practices and it ’ s difficult for them to get out and visit people . They have appointment schedules and so it ’ s hard for them to provide that service . Also sometimes it requires some specialist expertise that is difficult for them to access .
Likewise for the residential aged care facilities , staffing-wise it can be difficult for them to care for people , and emergency departments are not the best place for older people to be waiting around on trolleys , becoming more confused in an unfamiliar , chaotic environment .
Hospitals likewise , there ’ s a lot of evidence that says that people should be in hospital for the smallest possible amount of time ; it ’ s important to get people out fast . That ’ s particularly true for older people . It ’ s not good for people to be lying in bed longer than they need to . It puts them at risk of lots of complications .
Taking all of that into account , we worked with the people involved in consultation to come up with some strategies . One of those was that we needed a better handover process between residential aged care staff , the Queensland Ambulance Service and emergency departments . So for people who do need to be transferred , we had to have a better way of sharing that information about the person across the system , and then likewise on discharge , for that to go back to the residential aged care facility with some