Aged Care & Rehabilitation Clinical Services Plan 2007 – 2012

Aged Care & Rehabilitation Clinical Service Plan 2007 - 20122005/06 ActivityData on home based therapy services is collected as part of a larger data set and as such, is notable to be clearly identified.Current Emerging Issues• Hospital alternatives – the development and expansion of day hospital and outpatient therapyservices will reduce the demand on inpatient rehabilitation and sub-acute beds;• Chronic disease - with the introduction of the Rehabilitation for Chronic Disease Program inNSW, work is required across clinical streams to develop a model which can support thedemand for outpatient rehabilitation services for people with a range of chronic conditions eg.diabetes, cardiovascular disease, and respiratory disease. Frail older people are a particulartarget group for these cooperative services;• Ambulatory care – day hospitals can link closely with ambulatory care or community acute postacute care models. Further investigation is required to determine how these links can be bestmade and/or strengthened;• Workforce – there is a limited global pool of allied health staff to meet the demand for dayhospital and outpatient therapy services;• Parking – particularly at Liverpool Hospital and CRGH is difficult to access. Clients of AC&RSservices generally have mobility restrictions that make this a significant issue. Patients regularlycomplain about parking difficulties and report this as a disincentive for continuing their requiredoutpatient treatment;• Transportation – clients requiring outpatient therapy and day hospital services often experiencedifficulties in accessing services, due to their limited mobility and lack of access to public andprivate transport. Organised transport can assist in making these services more accessible; and• Data management – there is a need to improve data management to assist in performancereporting and service management.Projected Future ActivityDemand for day hospital and outpatient therapy services will continue to increase in line with ageingof the population and increasing numbers of people with chronic disease. By increasing activity,patients will be able to be effectively and efficiently transferred from the inpatient setting to receiveongoing care and support through outpatient services.Future Model of CareDay Hospital services should be provided to clients who require multiple therapeutic interventionsand are able to access centralised services. The benefits of this model to the patient includesocialisation and the convenience of access.Day Hospitals should be provided in association with hospital and community/home basedrehabilitation facilities, or in facilities with access to the range of services, infrastructure andequipment required, such as multidisciplinary staffing, food services and gymnasiums. Patienttransport must be provided to facilitate access to all day hospital and outpatient therapy services.Links with outpatient clinics, ACATs, ASET and Emergency Departments are vital to the success ofthe Day Hospital model of care.Day Hospital and outpatient therapy services should be staffed by comprehensive multi-disciplinaryteams including, but not limited to, physiotherapists, occupational therapists, speech pathologists,psychologists (neurological & clinical), dieticians, social workers and diversional therapists,alongside medical and nursing staff. These staff should work in conjunction with other staff fromhospital and community settings, particularly with regard to chronic disease management andrehabilitation, ambulatory care and falls management. Access to diagnostic services is essential forday hospitals.Recommendation – Day Hospitals and Out patient Therapy ServicesDay hospital and outpatient therapy services across SSWAHS are expanded at appropriatesites, in line with population growth and ageing6.1.6 Home Based Therapy ServicesHome based therapy (HBT) services complement day hospital and outpatient therapy services. Theyare particularly provided to people who are able to be treated in the community and who have anadequate support network but are unable to access centre based services. There are limited HBTPage 42