Consultation on the Model of Service Delivery for the University of Canberra Public Hospital (UCPH), and the

Rehabilitation, Aged and Community CareUCPH Model of Care

Summary Paper

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Feedback and enquiries on this document should be directed to:

Consultation on RACC Model of Care, and the Model of Service Delivery for UCPH

Attention Health Infrastructure Program

PO Box 11

Woden ACT 2606

Phone: 02 6207 1141

or email your feedback

All terms and acronyms used in this Consultation Summary are defined at the end of this document.

Contents

Purpose

A brief overview of the University of Canberra Public Hospital

Services at UCPH

Overview of Adult Mental Health Rehabilitation Services at UCPH

The Rehabilitation Aged and Community Care (RACC) UCPH Model of Care

The UCPH Model of Service Delivery

Next steps in planning for UCPH

Acronyms

Glossary

Purpose

The University of Canberra Public Hospital (UCPH) development represents a significant change to the delivery of Mental Health and Rehabilitation, Aged and Community Care (RACC) services in the ACT, with the relocation and expansion of some services as well as the introduction of new services.

ACT Health is interested to find out the community views on the proposed approach to provision of care and non-clinical services for UCPH. This Summary Paper has been designed as an overview of the more detailed documents:

  • RACC UCPH Model of Care
  • UCPH Model of Service Delivery

A ‘model of care’ describes how clinical services are delivered.

A ‘model of service delivery’ describes the clinical and non-clinical support services to support the model of care being delivered.

You can provide feedback by email

or by post to:

Consultation on RACC Model of Care, and the Model of Service Delivery for UCPH

Attention Health Infrastructure Program

PO Box 11

Woden ACT 2606

Phone: 02 6207 1141

These questions have been developed to assist you in framing your responses.

RACC UCPH Model of Care

  • Do you think the RACC UCPH Model of Careidentifies the key needs of the people for whom services will be provided?
  • What, if any, aspects of the RACC UCPH Model of Care would you modify?
  • What do you consider will work well within the RACC UCPH Model of Care?
  • Do you have any questions or comments relating to the RACC UCPH Model of Care?

UCPH Model of Service Delivery

  • Do you think the UCPH Model of Service Deliveryadequately describesthe clinical and non-clinical support services to support the models of care (for Mental Health, and Rehabilitation, Aged Community Care) to be delivered at UCPH?
  • What, if any, aspects of theUCPH Model of Service Delivery would you modify?
  • Do you have any questions or comments relating to theUCPH Model of Service Delivery?

Consultation on the Mental Health services that will be provided at UCPH took place in 2014. The Models of Care relating to these services have been endorsed. They are provided in the current consultation material for information only and are not for feedback.

A brief overview of the University of Canberra Public Hospital

Background:

In 2011, the ACT Government announced the decision to build a new sub-acute hospital, the first in the ACT. It will form part of a planned network of ACT Health hospitalsand health facilities designed to meet the needs of our ageing and growing population. By focusing on new and expanded sub-acute services, it will help to alleviate the pressures on acute facilities within the ACT region.

Location and accessibility:

In 2012, the University of Canberra campus was selected as the preferred location for the new facility, on the corner of Aikman Drive and Ginninderra Drive, following consultation with the community. Public transport is an important factor in the ease of access to UCPH. Details of public transportoptions are under development with Territory and Municipal Services.The University of Canberra will provide parking and it will accommodate the public, staff and government vehicles. Accessible parking and designated pick-up and drop-off bays will be provided. Way-finding and undercover walkways will be provided to enable ease of access to the facility entrances.

Opening Hours:

The hospital will operate 24 hours a day, 7 days a week. The majority of admissions into the inpatient wards will occur from Monday to Friday between 9am and 5pm, however on some occasions admissions will occuron weekends or after hours. Multidisciplinary therapy staff will provide services Monday to Friday, however it is possible that the hours of operation may be extended to include evening and weekend services in the long term.Visiting hours and guidelines will be consistent with the Canberra Hospital, which are currently from 6am to 9pm daily.

Education and Research:

UCPH will provide for research and teaching by the University of Canberra and ACT Health and other organisations. There will be an area of the building for the University’s faculty of Health which includes teaching rooms that will be shared by ACT Health and the University.

Future Growth:

UCPH facilities have been designed to accommodate future growth in services. The hospital will open with unused capacity, which will be increased as demand for services occurs.

Services at UCPH

Key services that will be provided at UCPH will include general and adult mental health rehabilitation and identified aged care services. These services will have inpatient units, day and ambulatory care services.

Additionally, the UCPH will be a teaching facility, allowing it to extend the scope of existing teaching partnerships and enable joint clinical training, teaching and research opportunities between the University of Canberra and ACT Health.

UCPH will deliver sub-acute services, aimedat improving patient mobility and functioning, often after surgery or other acute hospital admission. The services focus on improving quality of life. Services at UCPH will be characterised by:

  • Enhanced patient-centred care
  • Specific inpatient and ambulatory care provided from a single facility
  • Collocation and integration of services

People who come to UCPH for care might be:

  • Admitted for care that involves overnight stay (inpatients)
  • Admitted to a place in a day program
  • Attending as an outpatient or for sessions of therapy (for a clinic or consultation)
  • Attending to use facilities on an agreed basis (e.g. the Hydrotherapy pool)

UCPH will offer a supportive environment that assists people to return home, or to remain at home, and spend less time in hospital care. Its clinical focus will be on enabling and facilitating independence, whether through increased physical activity in the gym or hydrotherapy pool, learning new life skills or sharing meals with others.

Services that UCPH won’toffer:

The new hospital will not have an emergency department and will not deliver acute services, like surgery or intensive care. Acute Geriatric Medicine care and Older Persons Mental Health will be delivered in the existing locations at Canberra and Calvary Hospitals. While UCPH will deliver sub-acute services (adult rehabilitation and Geriatric Evaluation and Management) it will not provide psycho-geriatriccare or specialist palliative care.

Overview of Adult Mental Health Rehabilitation Services at UCPH

The Models of Care for the Adult Mental Health Rehabilitation Unit (AMHRU) and the Adult Mental Health Day Service (AMHDS) underwent development and consultation through a separate process in 2014,and were finalised in May 2015.These documents are provided in the current consultation material for information only and are not for feedback.

Adult Mental Health Rehabilitation Inpatient Unit:

The Adult Mental Health Rehabilitation Unit (AMHRU) will deliver effective recovery based treatment and rehabilitation to people with mental illness aged 18-65 years, whose needs cannot be met by less intensive community based mental health services. The primary goal of treatment will be the enhancement of the person’s quality of life and/or improvement in their functional status, through engagement in a variety of rehabilitation services. The service moving from a current ACT Health site incorporates areas of Brian Hennessy Rehabilitation Centre, currently situated on the Calvary Hospital Campus.

Adult Mental Health Day Service:

The Adult Mental Health Day Service (AMHDS) will provide services to people with mental illness aged 18-65 years, who would benefit from a period of intensive assessment, therapy, rehabilitation and recovery services.Care provision may be step-up (from community-based services) or step-down (from inpatient services) and may include monitoring and supervision for people commencing or receiving pharmacological treatments (e.g. Clozapine, Olanzapine) and psychotherapy programs. This service has already commenced at Belconnen Health Centre.

Referral and Eligibility for Mental Health services at UCPH:

Referral processes related to Mental Health services have already undergone consultation, however a brief description is provided below. Referrals to the AMHRU or AMHDS may be initiated from a number of points including, but not limited to:

  • Other services within Mental Health, Justice Health and Alcohol and Drug Services
  • General Practitioners
  • Allied Health Practitioners
  • Adult Mental Health Service Specialist Services

Referrals will be assessed and then a multidisciplinary team review will occur to enable a planned admission to a service or make recommendations back to the referrer. A comprehensive referral package will be made available for referring clinicians that describes the service functions, admission criteria and processes for referral and assessment.

The Rehabilitation Aged and Community Care (RACC)UCPH Model of Care

The RACC UCPH Model of Care provides an overview of the current state of RACC services in the ACT; however its main focus is on the RACC services to be provided at UCPH. It should also be noted that patients of UCPH may access a range of services that are not provided by RACC (e.g. other medical consultation services).

The RACC UCPH Model of Careoutlines the proposed future model of care. Operational detail to enable the provision of these services will be developed ensuring an effective and affordable approach to service provision.

The RACC vision for the future is to provide an integrated and coordinated territory wide range of rehabilitation, aged and community care services across the entire continuum of care. Patients accessing RACC services may commence treatment at any point along the care continuum and may move between different settings as required to meet their care needs. Strong links between all RACC services with relevant external services will be maintained to enable provision of the most appropriate clinically indicated care for all.

Services moving from current ACT Health sites:

A number of current RACC ACT Health services will be moving to UCPH, including the:

  • Rehabilitation Inpatient Living Unit (RILU)
  • Ward 12B (Rehabilitation Unit) at Canberra Hospital
  • Ambulatory rehabilitation services based at Canberra Hospital and Community Health Centres
  • Some services will also move from Calvary Hospital to UCPH.

New services provided by ACT Health:

The RACC day program represents a predominantly new service for RACC. It will be an alternative to inpatient care, enabling people to return home whilst still receiving rehabilitation services.

Rehabilitation and Aged Care Day Program:

The day service will provide an alternative to inpatient care and enable people to return home whilst still receiving rehabilitation services.

The Rehabilitation and Aged Care Day Program will be provided as a full or half-day program, typically over 2-5 sessions per week. Treatment will focus upon functional improvement, delivered through a goal-directed, time-limited coordinated program.

The division of the Rehabilitation and Aged Care Day Program into clinical specialtieswill ensure that multi-disciplinary teams with specialised therapeutic expertise can best meet the care needs of patients.

Sessional services will be available for patients who require less intensive intervention than those patients attending the day program. Patients may attend for single discipline sessional therapy or single session service (for example, aspinal review clinic or spasticity clinic).

There will also be a number of other services based onsite or providing in-reach services to UCPH patients. These will include a Driving Assessment Rehabilitation Service (DARS), Vocational Assessment Rehabilitation Service (VARS)and multi-disciplinary Prosthetic Clinics. Geriatric outpatient services will include a Memory Assessment Service (MAS) and a Falls Injury and Falls Prevention Service.

A Hydrotherapy pool will be included on the UCPH site. The pool will be used for individual and group therapy sessions for inpatients and ambulatory patients attending arranged appointments. External providers will also have access to the pool through application and agreed terms. Hydrotherapy programs will be patient focused and goal orientated and may include the following:

  • Water assisted or resisted strengthening and range of motion exercises
  • General endurance training and reconditioning
  • Functional retraining in a buoyancy assisted environment

Rehabilitation and Aged Care Inpatient Units:

Neurological Rehabilitation Unit - will provide care for patients with a range of neurological conditions including stroke, brain injury, spinal cord injury, motor neurone disease, multiple sclerosis and Guillain-Barre syndrome.

General Rehabilitation Unit - will provide care for patients with a range of conditions including amputations, de-conditioning and disability associated with medical illness, surgery or trauma.

Older Person’s Rehabilitation Unit - will provide older age appropriate rehabilitation services for patients who have a range of medical co-morbidities associated with ageing, such as cognitive impairment, hip and other fractures, post surgery or non-operative management, ortho-geriatric conditions, de-conditioning and Parkinson’s Disease. Services will include Geriatric Evaluation and Management.

Slow Stream Rehabilitation Unit - will provide rehabilitation services for patients with limited tolerance or ability to participate in rehabilitation. Patients may include those with non- weight bearing restrictions and patients who require services to maintain their condition whilst awaitingfinalisation of arrangements for their ongoing care.Patients will have a planned and accepted place of discharge prior to admission.

Medical emergencies:

While patients in a sub-acute hospital setting will be of a lower medical acuity, processes and protocols will be developed to safely manage patients whose condition deteriorates. This may be required for the following:

  • Medical emergency e.g. in the event of acute coronary and cerebral events, falls, delirium and other unanticipated events.
  • Non-urgent deterioration e.g. increased pain or wound breakdown.

Minimising patient transfers is a goal underpinning the RACC UCPH Model of Care, however sometimes patients who require investigations or a higher level of medical and nursing care will be transferred to an acute care hospital after initial stabilisation. Patients who improve and can be safely cared for at UCPH may continue their stay at UCPH whilst undergoing treatment.

Pre-emptive advanced care and/ or end-of-life care planning and limitations of medical treatment planning will be considered for all patients. Some patients may seek transfer to Clare Holland House to receive sub-acute specialist palliative care services.

Referral and Eligibility for RACC services at UCPH:

Referral processes relating to RACC services will be submitted through a centralised integrated intake point consistent with a whole-of-organisation approach in order to undertake the administrative processing of referrals.

Communication and education will occur to ensure that referrals to RACC services are undertaken in a timely and appropriate fashion. The importance of early referral and commencement of appropriate care in a timely manner will be emphasised.

People requiring access to RACC services at UCPH can be referred by the following sources:

  • Interstate facilities
  • ACT hospitals (public and private)
  • Self/ family
  • Medical Specialists
  • GPs
  • Other sources

All referrals submitted to RACC will be screened and prioritised to ensure that people will be seen by the appropriate service.

Considerations regarding each patient’s ability to benefit from Rehabilitation and Aged Care sub-acute services include:

  • The patient has a recent impairment of functional ability due to illness or injury
  • The patient has a condition that is likely to be responsive to rehabilitation
  • The patient has reasonable prospects for functional gain within a reasonable timeframe
  • The patient requires the input of a multidisciplinary rehabilitation program to achieve functional gain
  • The patient cannot be managed in a more appropriate lower level of care (for example, cannot be safely and effectively managed in a community based rehabilitation service)

General eligibility criteria for the Rehabilitation and Aged Care inpatient units at UCPH are: