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The increase in the frail, older population will pose a significant challenge to MSHHS to provide healthcare needs in an environment of constrained resources. As the demand for healthcare will continue to rise, the need for alternate models of cost-effective care must be implemented and optimised.
The current CARE-PACT model of care has been externally assessed by Deloitte. The report concluded this model of care will generate a 610% return on investment for every Queensland Health dollar invested, with a total value of savings over the first two years of the project (including implementation phase) of $17.1 million. This will be realised in released capacity. CARE-PACT aligns with hospital avoidance and integrated care strategies, and aims to increase quality of care to frail older persons in residential aged care facilities (RACF) while reducing demand on the hospital sector.
The implementation of a chronic wound service, mobile x-ray service, nurse navigator mediated case management and a Nurse-Practitioner position will allow the treatment of these older patients in the familiar surrounds of their own environment. Further development of clinical pathways will improve implementation of an evidence-based approach in the emergency department (ED).
This emergency substitutive care service and demand management program provides an ED equivalent assessment within the RACF. It aims to improve the quality of emergency healthcare to this vulnerable geriatric population, while reducing exposure to the often frightening and high-risk ED environment.
This project is funded by the Integrated Care Innovation Fund (ICIF) and is being conducted in partnership with Queensland Health's Healthcare Improvement Unit and the Brisbane South PHN.
This project will aim to:
1. Pilot the collaboratioin of CARE-PACT, Wound Innovations and Brisbane South Primary Health Network to improve the management of elderly patients with chronic wounds in RACFs who would otherwise require ED or hospital management.
2. Institution of pilot mobile x-ray service in partnership with Aged Care Imaging to reduce demand on emergency services for provision of plain radiology to residents of aged care facilities who do not otherwise require emergency interventions.
3. CARE-PACT focuses on hospital avoidance and increase in acute substitutive care by:
a. collaboratively developing ED and inpatient clinical pathways to improve the implementation of an evidence-based approach in ED and to increase appropriate acute substitutive care enrolment and appropriate hospital avoidance
b. providing nurse navigator mediated case management for RACFs with high ED presentations and/or prior poor engagement with CARE-PACT services
c. building workforce capacity through the establishment of a Nurse Practitioner (NP) candidate position, resulting in the contribution of CARE-PACT to growing gerontic emergency NP workforce supporting Queensland Health EDs' older persons emergency management.