Aged Care & Rehabilitation Clinical Services Plan 2007 Ã¢Â€Â“ 2012

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Aged Care & Rehabilitation Clinical Service Plan 2007 - 2012Figure 5.2AC&RS Continuum of Care – Core ServicesSYDNEY SOUTH WEST AREA HEALTH SERVICECORE AGED CARE AND REHABILITATION SERVICESCommunity / Residential CareEmergencyDepartmentAcute InpatientSub-Acute InpatientCommunity / Residential CareLocality basedcentralised intakeLocality basedcentralised intakeAged Care Assessment Teams (ACATs)Agedcare Services inEmergercy TeamAgedcare Services inEmergercy TeamOutpatient Geriatric andRehabilitation ClinicsAcute Aged Care UnitsOutpatient Geriatric andRehabilitation ClinicsDementia/DeliriumUnitsDay Hospitals andOutpatient TherapySub-Acute Aged Care/Geriatric Rehabilitation UnitsDay Hospitals andOutpatient TherapyHome Based Therapy Rehabilitation Units Home Based TherapyInpatient Geriatric ConsultationInpatient Rehabilitation ConsultationComPacksTransitional Aged Care ProgramDementia and Gerontology Clinical Nurse ConsultantsCommunity Dementia TeamsCommunity Dementia TeamsCentre Based Day CareCentre Based Day CareDementia Advisory Services (DAS)Respite and Support ServicesRespite and Support ServicesJanuary 2008Page 32
Aged Care & Rehabilitation Clinical Service Plan 2007 - 20125.2 Supra-regional ServicesSSWAHS operates a state-wide Brain Injury Rehabilitation Service and has developed specialistcapacity in other areas, such as Acute Burns. Expansion of specialist rehabilitation associated withthese and other services will complement the AC&RS structure in SSWAHS in the future. Theprovision of additional specialist services will enhance the current services available for patients andclients. It will also assist in attracting and retaining staff and educating students. Supra-regionalservices are discussed in greater detail in Section 7.5.3 Partnership/Associated ServicesAC&RS has close relationships with other internal and external service providers in the delivery ofservices. Many of these partners are essential in the delivery of core and supplementary servicesfor AC&RS clients. They include other Medical and Surgical sub-specialities, the Specialist MentalHealth Service for Older People (SMHSOP), Allied Health and Community Health Services. Servicepartners and associated services are discussed in greater detail in Section 8.5.4 Understanding and Interpreting the AC&RS Delivery ModelNew models of care are continually being developed for AC&RS. The evidence base for theseservices is variable, though some services may have the potential to alter current health serviceutilisation rates. Evaluation of emerging models is required, to determine if more effective models ofcare than those identified as core services can be implemented across the Area. As required, theService Delivery Model will be adjusted to take into account new evidence and best practice.Due to the complex funding and legislative environment in which AC&RS function, there is a lack ofconsistency in the way services operate. Some services are targeted at particular age groups. Forexample, Agedcare Services in Emergency Teams and Aged Care Assessment Teams primarilytarget people aged over 70 years. Different service criteria make it difficult to compare servicesacross program boundaries.There are a number of significant issues relating to Aged Care and Rehabilitation data at National,State and Area level. These include:• Different data management and information technology systems;• Different data definitions;• Different standards of reporting requirements eg. client registrations; and• Different service structures and models of care, resulting in data which cannot reliably becompared across locations.Data presented in this Plan is variable and not always reliable. A solution to address these issues isincluded within the Older Persons and Aged Care Services Clinical Redesign project.Page 33
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Aged Care & Rehabilitation Clinical Services Plan 2007 Ã¢Â€Â“ 2012

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