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Health and Medical - Primary and Specialist category
 



NEVDGP is an
accredited organisation.
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  Aged Care Initiative
 

Austin/Northern MedGap Project

GP and ACH Resources

 Austin Hosp. Fast Track X-Ray

 Transfer to Hospital Envelope Austin Health: Residential Outreach Service

Allied Health and Dental Services (Medicare)

Consumer Resources 

Discussion Papers & Presentations

 
 
 
 
 
 
 
 
 
 
 

 

Aged Care Access Initiative
The aim of the Aged Care Access Initiative (ACAI) is to improve access to primary care (GP and allied health services) for residents of aged care facilities. This Commonwealth Government Initiative replaced the Aged Care GP Panels Initiative in July 2008. Details are contained in the Aged Care Access Initiative Program Guidelines (revised July 2009).
 
The ACAI supports improving access to GP and allied health services for residents of aged care facilities through two separate components as follows:
  1. A GP incentive payment to encourage GPs to provide increased and continuing services in Aged Care Homes; and
  2. A payment for Allied Health Professionals for clinical care services in Aged Care Homes, where these services are not currently covered by Medicare or other government funding arrangements.
The Guidelines contain details of the GP incentive component. See in particular pages 5 and 6 for more information about the GP incentive component. 
 
Contact: Clare Chiminello
Tel: (03) 9496 4333
email Clare
 
 Aged Care Facilities - locations and maps
 
 
 
A Good Death in Residential Aged Care:…
 
Optimising the use of medicines to manage symptoms in the end-of-life phase 
 
The North East Valley Division of General Practice is lead agency for this 2 year project which began in December 2008. Click here for Project Summary and click here for information pamphlet.
 
Contact Melanie Rayner or Diana Cooper on 9496 4333 for further information.
 
The Good Death in Residential Aged Care project is funded by the Australian Government Department of Health and Ageing under the Encouraging Best Practice in Residential Aged Care (EBPRAC) program.
 
Links:
  
 
 
These resources are for the the use of GPs and for the information and usa of aged care homes where appropriate. 
 
1.  Paper-based Forms
The following forms are for paper-based systems and are all in Word format.
2.  Medical Director Templates
Click here to go to Medical Director templates for Aged care. You will find:
- Instructions to download and install MD templates
- Residential Medication Management Review (RMMR)
- Comprehensive Medical Assessment (Aged Care)
- Comprehensive Medical Assessment (NEVDGP version)

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3.  Step-by-step Guides for GPs
The following step-by-step guides are all in Word format.
 
4.  MBS Schedule and Flow charts
 
MBS Schedule
 
MBS Flow Charts
The following flow charts contain a useful summary of the range of services GPs are able to provide which can be funded through Medicare. The relevant Item Numbers and rebate amounts as at March 2009 are provided.
The following flowcharts show how the CMA may link to other Medicare Items applicable to residental aged care, and the steps involved in an RMMR
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5.  Information Kits:
The following hard copy (paper) Information Kits are available from NEVDGP. Contact clare@nevdgp.org.au
  • Care Plans: Contribution and Review by GP at Aged Care Homes (Includes information on allied health and dental health items)
  • Case Conferences by GPs in Aged Care Homes
  • Comprehensive Medical Assessment (CMA)
  • RMMR
  • Information Technology Kit for GPs and Aged Care Homes
  • Medicare Information for Aged Care Homes and GPs
  • Advance Care Planning
  • Falls
  • Urine Testing
6.  How the Aged Care Home can help
7. Aged Care Home/Hospital Interface
Austin/Northern MedGap Project: Addressing gaps in continuity of medication management after transfer from hospital to residential care. Updated April 2010
 
The MedGap project, conducted by Austin Health, Northern Health, North East Valley Division of General Practice & Monash University sought to improve medication management for residents in the interim period following discharge from hospital to a residential care facilitiy. Baseline audits found that ≈ 20% of patients experience a medication delay or error after discharge. This was reduced to <5% with the supply of a hospital provided interim residential care medication administration chart. Locum medical attendance was also reduced from ≈ 33% to <12%. Provided below are copies of the full report, including Executive Summary and Recommendations, the Executive Summary and Recommendations only, and samples of documents developed for the project..
  • SOP - for Interim Residential Care Medication Administration Chart
  • Flow Chart - how to use the Interim Residential Care Medication Administration Chart
  • Example of Interim Residential Care Medication Administration Chart
  • FAQs
 
      Austin Hospital Fast Track X-Ray Service: for residents of aged care homes only

  Austin Health: Residential Outreach Service is available for residents of aged care homes who are at risk of ED presentation. The hours of the service are Monday-Friday 9am to 5pm. Phone 0422 006 655 (flyer) April 2009 (pdf)
      
 
 Aged Care Home Transfer-to-Hospital Envelope
Use as a container for the resident's documentation when transferring to hospital. It can be printed directly onto an envelope by printing the template below. Or purchase envelopes from Compact Business Systems - 1800 777 508 or email: sales@compact.com.au
 
  • Transfer-to-Hospital Envelope templates  - For size C4 envelope. 
    This template is in a format ready for commercial printing. FRONT / BACK

    This template can be printed directly onto an envelope. FRONT / BACK

  • Transfer-to-Hospital Envelope image example - FRONT / BACK open to view a colour image of front and back of the Envelope.

  • Transfer-to-Hospital Envelope Trial - Public Report - October 2008
    Use of the Aged Care Home Transfer-to-Hospital Envelope was evaluated for the Australian Commission on Safety and Quality in Health Care as part of the National Clinical Handover Initiative. This is the Public Report of the Trial.
    Click here to access the June 2009 MJA Supplement article on this Trial.

  • Transfer-to-Hospital Envelope Tools
    • Procedure for Useof Transfer-to-Hospital Envelope
      The Transfer-to-Hospital Envelope is a stand-alone tool with simple, clear instructions. However, this Standard Operating Procedure (SOP) for use of the Envelope has been developed which may be useful in settings where the Envelope has not previously been used.
    • Minimum Information Set for Transfer Form- to be included on Aged Care Home Transfer Form.

  • Australian Commission on Safety and Quality in Health Care
    Click here to access information on other National Clinical Handover Initiative Pilot Projects
 Discussion papers 
8. Urine Testing Protocol -  Draft Protocol for Residents of Aged Care Homes
Formal evaluation of this protocol is outside the scope of the Aged Care Project, hence it will remain as a Draft, however, we would be really pleased to hear any feedback or thoughts you have. Email any feedback to Dr Mary Belfrage at the NEVDGP (Email: Dr Mary Belfrage)

 9. Medication/RMMR
 10. Management of Challenging Behaviours
   11. Management of Diabetes

   12. Advance Care Planning

  • Flowchart for Advance Care Planning (for Aged Care Homes in Victoria) - This flowchart is to be used in conjunction with the Advance Care Planning Information Guide for Residential Aged Care Homes (Victoria) which was developed by Respecting Patient Choices, Austin Health, 2008 - August 2008 
      13. Allied Health and Dental Services (Medicare)
These resources have been sourced/developed to assist eligible residents of aged care homes to access a Medicare Rebate for up to 5 allied health items per year. Eligible residents may also access Medicare benefits of up to $4,250 in total over two consecutive calendar years for dental services. The resident must have a multidisciplinary care plan in place to which the GP has contributed/reviewed (MBS item 731).
 
   
  • Referral and Registration Forms - under EPC/CDM, includes:
    - Allied Health Referral Form
    - Dental Referral Form
    - Registration Form for Allied Health Professional

 Templates for Contribution to Care Plan in the Aged Care Home (Nov 06)

 
From 20 March 2008, there will be a new funding model for residential aged care, the Aged Care Funding Instrument (ACFI).  ACFI will replace the old RCS system.  The new ACFI system will be more reliant on documentation of diagnoses and management.  DoHA, the AMA and the NEVDGP have developed the following information sheets on ACFI on how this new funding model will impact on GPs.   
 
  • Aged Care Australia - this is the Australian Government Department of Health and Ageing’s premier online source of information for everything you need to know about aged care.
  • Aged Care Complaints Investigations Scheme - 1800 550 552. The Aged Care Complaints Investigations Scheme enables people to make a complaint about an issue that affects a person who is or was eligible to receive Australian government funded aged care services.
  • Aged Care in Victoria - this website contains information relating to Aged Care programs, policies and services for both professionals and the public.
  • Aged Care Information Line - 1800 500 853. Aged Care and Community Information Line provides basic assistance with queries about home and community care, daily fees, bonds/charges, income/means testing, access to care, residential classification scale, financial assistance and legislation.
  • Aged Care Online Directory Pty Ltd - this is useful if you are hunting for aged care beds in Victoria. It is a privately run company based in Melbourne Victoria whose core business is the development of a comprehensive online directory of aged care facilities and associated services. The site is targeted at people researching aged care services alternatives.


  • Care Link Centres - Commonwealth Respite and Carelink Centres are information centres for older people, people with disabilities and those who provide care and services.


  • Living Caring Working - this website was developed by Palliative Care Australia (PCA) to address the information needs of people living with a life threatening illness, their carers and work colleagues.

     
 
 
  • Aged Care in Victoria  - this website contains information relating to Aged Care programs, policies and services for both professionals and the public.

  • AGPN - The Australian General Practice Network (AGPN) represents a network of 110 local organisations across Australia including NEVDGP.

  • Alzheimer’s Australia- Alzheimer’s Australia is the peak body providing support and advocacy for people living with Alzheimer’s

  • Australian Pharmaceutical Advisory Council (APAC) – Guidelines for Medication Management in Residential Aged Care - 3rd edition, Nov 2002

  • Caresearch- a new website launched in March, 2007 by the Australian Government. Enables access to information about palliative care. Includes a section for GPs on quick clinical guidance, FAQs, and palliative care in practice. Also includes information for patients, carers, families and friends. This website will become the Australian Palliative Care Knowledge Network in 2008.

  • Commonwealth Carelink Centres

  • Continence Foundation of Australia - The Continence Foundation of Australia (CFA)’s vision is to bring together healthcare professions treating and managing incontinence in Australia

  • Department Health & Ageing - A collection of aged care related information on the DoHA website.


  • Drugs and Poisons Controls in Victoria- this site provides information for health professionals about the control of drugs, poisons and controlled substances in Victoria (link)

  • GP and Residential Aged Care Kit- this kit contains useful resources and tools for both GPs and ACHs

  • General Practice Victoria (GPV), Aged Care - links to services & resources. GPV is the state based organisation that represents Divisions of General Practice in Victoria including NEVDGP.

  • Minimising the Risk of Falls & Fall-related Injuries: guidelines for Acute, Sub-acute and Residential Care Settings from the Victorian Quality Council

  • Pain in Residential Aged Care Facilities - Management Strategies from the Australian Pain Society

  • Australian Commission on Safety & Quality in Health Care - The Commission was established by the Australian, State and Territory Governments to develop a national strategic framework and associated work program that will guide its efforts in improving safety and quality across the health care system in Australia. 
  • RACGP –Silver Book 4th edition (Nov. 05)- The Department of Health and Ageing has just approved the Medical care of older persons in residential aged care facilities Silver Book (pdf)

  • Seniors Website - provides a single point of access to Government and non-Government information and services for older Australians. This website is the Australian Government's premier source of information for older Australians

 

Discussion Papers & Presentations
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