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Implementation of Agency for Clinical Innovation (ACI) Orthogeriatric Model of Care Tracey Drabsch - PowerPoint PPT Presentation

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Innovation Poster Session HRT1215 – Innovation Awards Sydney 11 th and 12 th Oct 2012. Implementation of Agency for Clinical Innovation (ACI) Orthogeriatric Model of Care Tracey Drabsch. Orange. 1-1b_HRT1215-Session1_DRABSCH_ORANGE_NSW. KEY PROBLEM.

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Implementation of Agency for Clinical Innovation (ACI) Orthogeriatric Model of Care Tracey Drabsch

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Innovation Poster Session

HRT1215 – Innovation Awards


11th and 12th Oct 2012

Implementation of Agency for Clinical Innovation (ACI) Orthogeriatric Model of CareTracey Drabsch




In Mid 2010 within OHS there appeared to be issues surrounding:

Capacity for inpatient services to consistently provide multidisciplinary orthogeriatric care

Inconsistent patient discharge planning and goal setting

Handover to the NF was reportedly inconsistent and not multidisciplinary in nature

Understanding of resources and staffing available in NF was limited

Continuity of care between facilities, follow up and community care lacked clear process


Evaluate the implementation of the ACI Orthogeriatric Model of Care within Orange Health Service before and after the Sub-Acute Care Team (Senior Clinicians - Medical, Nursing, Allied Health) involvement

Establish baseline information within a regional hospital via medical record audit.

Pre Team June 2008 - June 2009 (n=50).

Post Team Sept 2010 - Feb 2011 (n=30).

Sub-Acute Care Team Hub and Spoke Model of Care from OHS

Multidisciplinary Handover

to Neighbouring Facilities & Teams

  • Orthogeriatrics

  • Collaborative Care

  • with the

  • Orthopaedic/Acute Teams

  • Sub-Acute Care Team

  • Multidisciplinary

  • Team

  • NF Teams

  • Outreach visits

  • Patient follow up

  • Education


Co-ordinator Sub-Acute Care Team


“THE HUB” ORANGE inpatient

Neighbouring Facility


Joint Question for

Outcomes & Evaluation

Statistically significant increase in:

Occupational Therapy involvement

Social Work involvement

Documentation of weight bearing status, pre-morbid mobility and pre-morbid function

Aperients given

Paracetamol charted

Medical discharge summaries sent to the General Practitioners

Handover information including the patient’s equipment needs, goals and contact details, physiotherapy, dietetics and social work discharge summaries


Outcomes & Evaluation

Statistically significant decrease in:

Nutrition assistant

Initiation of discharge planning

(3.9 days to 2.6 days)

Complications such as pressure ulcers, electrolyte imbalance and wound infection



Lessons Learned

Senior Multidisciplinary Clinical Teams are able to implement change

Guidelines with clinical validity and authority to work from provide a good platform to guide, build and sustain clinical practice changes within a service

Consistent communication of keeping patient care the focus is essential with change management

Consistency of team activity over a prolonged period is effective in maintaining service provision

Teams work well with teams

Networking is key to providing a more seamless patient journey


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