clinical focus
interim medication management strategies, just to make that all
work a lot better for the residents.
That’s where the Yellow Envelope came into play. Ultimately,
My Health Record may provide the long-term solution, but in the
meantime we have this system of a yellow envelope, so it stands
out, where the care plan, the person’s usual functional status and
medications, all that sort of clinical information, along with any
advanced health directives, or enduring power of attorney type
information, can all go in the envelope and then be handed over
to staff at the hospital.
Likewise, the information goes back to the residential aged care
staff about what changed while that person was in hospital. So,
what happened? What medications may have been changed?
What treatment is required? And so it’s useful for the staff, for the
facilities, but also for the GPs when they come back out and see
their patients. So that’s the Yellow Envelope.
We’re using it across all of the Metro North Regions from
the river up to Caboolture, so at Caboolture, Redcliffe, Prince
Charles and Royal Brisbane hospitals. We’ve just done a launch
recently and we’ll be going out and doing lots of education and
promotion across the hospitals and also residential aged care
facilities to increase the uptake. So far the response has been
great. The residential aged care staff say it’s going to make things
much easier for them, and likewise for the staff in the emergency
department, and also for the Queensland Ambulance Service, that
it’s not so difficult for them to get the information that’s needed
for them to hand over.
I know there’s a lot of concern regarding patient privacy and
the security of documents that detail people’s health. What
precautions have you taken to ensure this physical resource
is secure?
Well, historically, whenever anyone has gone to hospital,
they’ve needed some information with them – like their usual
medications, for instance – so that the treating medical staff in
the emergency department know what it is that they’re ordinarily
on and can do a proper assessment. But the envelope keeps it
all together in a visible way that is then taken from the secure
file in the facility, through the Queensland Ambulance Service
staff’s hands, to the emergency department where it once again
joins the physical medical file, and then likewise on the way back.
So it’s probably more secure than what was happening before,
because it is like a central, easily recognisable place to hold
that information.
Has there been a call to expand this initiative outside your area
and go statewide or national?
Yes, there has. We’ve been working with Queensland Health and
the Health Improvement Unit to look at the opportunity on a state
level, certainly.
I understand you have several other initiatives?
As a result of that consultation work and workshops, we’ve
established a jointly funded geriatrician-led outreach service from
Prince Charles Hospital to the Prince Charles catchment area.
That provides a geriatrician, a registrar and two clinical nurses,
and they provide support for general practitioners who would
like some advice on how to manage the patients they have in the
facilities, and it’s also to provide advice for the residential aged
care staff. They can go out and do physical outreach visits to
implement care, do a full geriatric assessment, implement some
Suzi Richens, clinical development manager at Peninsula
Palms aged care facility (Rothwell). Photo: Brisbane North PHN
interim care, conduct some staff training and support, and can,
over a seven-day period, provide that kind of ongoing support.
The service commenced on June 12, and so far about 20
people have avoided going to hospital. For the few people who
have needed to go to hospital, they bypass the emergency
department and go straight to the ward or the diagnostic
services that they need, so they’re not waiting around emergency
departments. It’s streamlining the care in that way.
Also, people are able to be discharged back home quickly. It
reduces the amount of time they need to be in hospital for to
receive care that can be provided with support back in their home,
which is the residential aged care facility.
Would you like to add anything more?
The feedback so far is that the general practitioners who have
referred to the service are really very happy with it and have found
it to be a great support, because it does still keep them as the
central coordinator of the person’s care and recognises their role
in that.
Also, the staff in the facilities find the service extremely useful,
and also the training that they get when the staff come out is
good at building their capacity and to manage people in those
facilities.
The residents themselves have also reported a great deal of
satisfaction with that service, so we’re very encouraged by that.
We’re hoping t hat we’re going to collect some really good data
about the health outcomes improvement that might then inform
investment into having a whole regionwide approach across
the various hospitals, so that’s what we’re hoping the ultimate
outcome might be.
Is there a website that people can go to if they’d like to
learn more?
Yes, certainly. There’s some information on the Brisbane North
PHN website (brisbanenorthphn.org.au) under Community Care.
There’s a phone number and an email address where we can
be contacted. ■
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