Disaster recovery program
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Disaster Recovery Program. Mediation Process involving Residential Aged Care Facility, GPs, Pharmacy & the Division of GP Presented by Susan Denny Aged Care GP Panels Program Manager. HISTORY. Privately owned & managed residential aged care facility

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Disaster Recovery Program

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Disaster recovery program

Disaster Recovery Program

Mediation Process involving Residential Aged Care Facility, GPs, Pharmacy & the Division of GP

Presented by Susan Denny

Aged Care GP Panels Program Manager


History

HISTORY

  • Privately owned & managed residential aged care facility

  • Operated by large group with at least 30 other facilities throughout Australia

  • 167 bed facility – High, Low, Ageing in Place & Dementia specific

  • 2 large separate buildings over large area

  • Serviced by 18 GPs

  • 4 practices, 3 provide medical care to more than 95% of the residents


Gp panel

GP PANEL

  • 2 GPs

  • Director of nursing (DON)

  • Manager of low care

  • Managing director of RACF

  • Pharmacist

  • Aged Care GP Panels program manager

  • 1 hour Bimonthly GP Panel breakfast meeting

  • Quarterly Medication Advisory Committee meeting


Gp issues

GP ISSUES

  • GP owed scripts

  • Limited nursing support for GPs

  • Residents without medication

  • No dedicated area for GPs

  • All records are paper based centrally

  • No current GP model of care

  • Poor communication

  • No designated car parking for GPs

  • No IT system

  • Lack of utilisation of appropriate item numbers


Pharmacy issues

PHARMACY ISSUES

  • GP owed scripts

  • Potentially medico legally compromised by providing medications without scripts

  • Each pharmacy works to different standards

  • Residents without medication

  • Pharmacy losing money


Facility issues

FACILITY ISSUES

  • GP owed scripts

  • DON not able to make certain decisions without consulting with managing director in Melbourne

  • All records are paper based centrally

  • Poor documentation

  • Lack of communication

  • Due for re-accreditation this year

  • Funding issues – Aged Care Funding Instrument (ACFI)

  • Inefficient systems in place

  • Limited staff education

  • Staff stress

  • Lack of protocols


Issues for residents

ISSUES FOR RESIDENTS

  • Having to pay for scripts when they have reached the safety net

  • No medication

  • Medication swapped-potential for medication mismanagement

  • New residents without GP

  • Transported to A & E due to lack of medical services

  • Family distress & frustration (often family unaware)

  • Overall compromised care


Catalyst to disaster

CATALYST TO DISASTER

  • Pharmacy decided to stop supplying medications without a script

  • Certain residents without own medication

  • Medication sharing and swapping

  • GPs disenchanted & threatening to withdraw services

  • New residents without a GP

    Each player not aware, or understanding of each others roles and responsibilities


Collision course

Facility

COLLISION COURSE

Pharmacy


Need for mediation

NEED FOR MEDIATION

  • Decision to contact an independent mediator

  • Dr Jane Fyfield – Healthcare International

    MBBS; DGM; Grad Dip Health Admin; MPH

    Emial address - [email protected]

  • Cost - $2,950 plus GST


Process

PROCESS

  • Mediator discussed issues with:

    • GPs from each clinic

    • Pharmacist

    • Managing director of facility

    • DON & manager of low care

    • Finance manager of facility

    • Aged care program manager

  • Report compiled and distributed to all parties

  • Mediation meeting with all parties to discuss:

    • Identified issues

    • Roles

    • Recommendations

    • Implementation


Where to from here

WHERE TO FROM HERE?

Recommendations

  • IT

  • GP Model of Care

  • Communication

  • Staffing


Who is responsible facility

WHO IS RESPONSIBLE? - Facility

Accommodating GPs

  • Reserved car parking

  • Designated work area

  • IT interface with GP software

  • Nursing support for GPs

  • Availability

Communication strategy

  • Communication book

  • Pigeon holes for clinics/GPs

  • Clinical pathways


Who is responsible gps

WHO IS RESPONSIBLE? - GPs

  • GP Model of Care

    • Sharing residents between GPs – maximise efficient use of time

    • After hours arrangements in place

    • Regular visiting times

    • Medication management

    • Utilise item numbers effectively

    • Good record keeping

    • IT implementation

    • Recall systems

    • GP involvement in GP Panels & Medication Advisory Committee


Who is responsible pharmacy

WHO IS RESPONSIBLE? - Pharmacy

  • List for GPs currently owing scripts

  • New process for future script renewal, requests be provided to next medication advisory committee for discussion and dissemination

  • Pharmacy needs to have model for GPs to accept


Who is responsible cwgdogp

WHO IS RESPONSIBLE? - CWGDoGP

  • GP Model of Care

  • IT Committee


How do we know when we are there

How do we know when we are there?

Acknowledgements:

Department of Health & Ageing

General Practice Victoria

Healthcare International, GPs, DON, Manager low care, Facility Managing Director, Facility Finance Manager, Board

Members & CEO of Central West Gippsland Division of GP


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