The Integrated Respiratory Service currently provides holistic care to patients and their families in the Logan catchment area for diagnosis of COPD, asthma, bronchiectasis, pulmonary fibrosis, lung cancer, pulmonary hypertension, sleep disorders; prescribed home oxygen; and smoking cessation. However, due to year on year increases in referrals, there is currently a demand/supply mismatch for integrated respiratory services in the area. Continued delivery of high quality care is dependent on the expansion of service capacity.
The Integrated Respiratory Access Initiative will expand the existing Integrated Respiratory Services model by increasing the number of clinics that are provided and by tranforming the way that current services are provided.
The innovation requires a number of services to be provided together, in a coordinated manner. The following is proposed:
- Twice-weekly Rapid Access Clinics will enable the review of patients for early discharge and provide direct referral from GPs for acute patients. The Rapid Access Clinic aims to provide the prompt assessment of patients who require urgent review but are not acutely unwell.
- A dedicated outpatient category 3 (recommended wait < 365 days) clinic: attending to those patients who are classified as being ‘long wait’ patients (patients who have waited > 365 days)
- The expansion of the existing post-discharge home visiting service: enabling increased capacity to review patients and escalate care for deteriorating patients
- Early intervention of a respiratory nurse and scientist for patients in the Medical Assessment and Planning Unit (MAPU): a respiratory nurse and scientist will attend the Medical Assessment and Planning Unit (MAPU) to provide spirometry to confirm previously un-diagnosed respiratory disease and ensure subsequent prescribing of appropriate inhaled medications for these patients. Furthermore, ensure patients are appropriately educated on their disease prior to discharge and provided with support, where necessary, post-discharge.
This initative aims to reduce avoidable Emergency Department presentations and alleviate General Practitioner and patient concern.