Acai lessons from the field aged care workshop 04 may 2010
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ISO 9001 Lic QEC22546 SAI Global. ACAI : Lessons from the field Aged Care Workshop 04 May 2010. What we will cover …. ACAI in other states and territories ACAI in NSW Operational models Growing areas of interest Successes Challenges Hints and tips. ACAI across Australia.

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Acai lessons from the field aged care workshop 04 may 2010

ISO 9001 Lic QEC22546

SAI Global

ACAI : Lessons from the field

Aged Care Workshop

04 May 2010


What we will cover …

  • ACAI in other states and territories

  • ACAI in NSW

    • Operational models

    • Growing areas of interest

  • Successes

  • Challenges

  • Hints and tips



Three models of administration in NSW

  • Contracting RACFs

  • Funding distributed by bed numbers

  • Contracting AHPS

  • Types of AHP determined by needs assessment or available workforce

  • Direct employment of AHPs

  • In collaboration with other programs MAHs, Rural Palliative Care, Advance Care Planning

  • Voucher systems can apply to all of the above as a means of demand management and tracking expenditure


Growing areas of interest…

  • Dental Health

    • Dental Assessment and treatment by Hygienist under supervision from Dentist

    • Treatment more challenging logistically – may require residents to travel outside facility to attend appointments, often requires xrays to be arranged prior to treatment

    • Equipment purchase often required

    • DOHA approval required

    • Divisions contract with service provider to deliver assessments and treatment

    • Macarthur, Hunter Rural, Barwon, Riverina


Growing areas of interest…

  • Mental Health

    • Provided as individual or group sessions

    • Using ATAPs staff or contracted AHPs

    • Positive impacts on wellbeing, depression, grief and loss, and challenging behaviours

    • Can be challenging to help RACF staff identify residents appropriate for Mental Health interventions as it is a new area for many

    • Eastern Sydney, Sutherland, Shoalhaven, GP Access, Southern General Practice Network, Bankstown


Growing areas of interest…

  • Falls prevention Programs

    • Provided as individual or group exercise

    • Physiotherapist and Exercise Physiologist

    • Evidence strong that ACAI activities have reduced falls (Hawkesbury Hills, Shoalhaven)

    • Links to NSW Health priority areas for falls prevention

    • Barwon, Shoalhaven, Central West, Eastern Sydney, Bankstown


Growing areas of interest
Growing areas of interest…

Heart Moves

  • Adapted to suit the low care residents

  • May be certificate 4 fitness trainers

  • Need DOHA approval

  • Overcomes workforce shortage issues

  • Has been approved for Riverina and GP Access

Nutrition

  • Dietician assessments for malnutrition in residents

  • Strong evidence of improved patient outcomes for both nutrition and overall health outcomes

  • Illawarra and NSW Central West


A note about Advance Care Planning…

  • Some Divisions have been approved to use ACAI funds to provide Advance Care Planning sessions

  • DOHA feel that this activity does not strictly meet the guidelines for provision of AHP services to low care residents

  • Divisions already approved can continue this work for the 2009/10 financial year, but may not have this approved for the 2010/11 financial years

  • DOHA recommend Divisions seek other sources of funding for this activity – rural palliative care program, State Health


Challenges…

  • Lack of education for RACF Staff

  • High care , low care split excludes patients who could benefit

  • Low administration funds make the program hard to promote

  • Time poor RACFs

  • Concern for the long term future and sustainability of ACAI

  • AHP Workforce shortages

  • GPs can be slow to approve the services for residents

  • RACF staff may not be experienced enough to identify appropriate residents for AHP services

  • Dental challenges

    • Requirement for hygienist to be supervised by a dentist limits the number of services that can be provided. Transport to Dental Surgery challenging.


Successes…

  • Strong relationships between RACF, Division and AHPs

  • Continuity of panels work in some areas

  • Linkages with other programs

    • MAHs, ATAPS, LMP, Heart Moves, rural palliative care program

  • Stronger links between primary care and AHS Aged Care Sector

  • Demonstrated evidence of improved patient outcomes

    • Reduction in Falls : by 49% in one facility (Hawkesbury Hills), 342 to 44 over 12 month period (Shoalhaven)

    • Decrease in number of residents who are malnourished (Illawarra, NSW Central West)

    • Mental health improvements: decrease in depression, increase in wellbeing, reduction of challenging behaviors (Shoalhaven, SESDGP, Sutherland)







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