barbara anderson - integrated care branch, nsw ministry of health - keynote address| enhancing the...
DESCRIPTION
Barbara Anderson delivered the presentation at 2014 Transition Care Conference: Improving Outcomes for Older People. The 2014 Transition Care Conference: Improving Outcomes for Older People formed a National account of the consumers' transition care journey within the current aged care environment, highlighted new initiatives to improve TCP access and quality of care, and showcased innovative service delivery models across jurisdictions. For more information about the event, please visit: http://www.informa.com.au/transitioncareconference14TRANSCRIPT
3rd Annual Transition Care Conference
ENHANCING THE PROFILE OF TRANSITION CARE
Barbara Anderson Principal Policy Adviser – Ageing & Disability Aged Care Unit Integrated Care Branch NSW Ministry of Health
30 May 2014
Transition Care in this time of reform
• Bridging the gap between acute care and community services
BUT….
• Is it as well utilised as it might be?
• Should more be done to promote this valuable service and, if so, what?
My Aged Care website
“ When you have been in hospital, often the most desirable place to go when you leave is to your own home … but sometimes you might need extra help to recover. This is where the Transition Care Program may be able to help.”
• Even in discussions of a more streamlined national aged care system, the role of Transition Care seems overlooked.
• Do hospital clinicians and discharge planners know when to give an older inpatient the option of being discharged to Transition Care?
• Including time to make a decision about their long term accommodation arrangements?
National Health & Hospital Reform
Older people tend to be seen as ‘bed blockers’
Noeline Brown, Ambassador for Ageing
• Transition care gives older people that rare commodity, namely time.
• Time to reflect, to think through decisions, to consider options.
Transition Care is not care awaiting placement
We need greater promotion of its benefits and its eligibility criteria so that Commonwealth Guidelines governing its operation are more widely understood.
• Currently a dearth of published arOcles providing evidence of the benefits of TransiOon Care.
• Anecdotal evidence that some older inpaOents with potenOal to benefit are not being recognised.
• Also easier to refer to short-‐term State-‐funded support services post hospitalisaOon meaning they miss out on the benefits of goal-‐oriented, restoraOve therapy focused on re-‐ablement and improved capacity to remain living independently in the community.
More research and evaluative studied needed
Acute to Age-Related Care Services (AARCS) • Specialist aged health staff employed in NSW public
hospitals to facilitate access to community and residential aged care
• Help identify the older inpatient potentially likely to benefit from Transition Care and to facilitate timely referral to ACAT when medically stable.
• Good working relationships between Transition Care services and hospital specialist staff important.
Addressing the needs of Aboriginal and CALD patients
• Avoid residenOal TransiOon Care units being viewed as ‘insOtuOons’ and address the fear of isolaOon from family and community.
• Reassure older people that they will be returning home aXer their short stay in TransiOon Care.
• Promote a culturally-‐appropriate environment. • By 2026, one in every four people over age of 80 will be from a non-‐English speaking background.
• Ensure home-‐based services not seen as intrusive and respect the client who may not want ‘an outsider’ telling them what to do and how to live.
Picture (photo or graphic) of an Aboriginal person over background Aboriginal Artwork
EXAMPLE. LOCAL INDIGENOUS
ARTWORK MAY BE USED HERE AND THROUGHOUT DOCUMENT→
TEMPLATE [NAME] Local Health District
Promoting Transition Care services in rural and remote locations
• Address discrete access barriers include non-‐availability of experOse locally, distances involved, and lack of available transport.
• Discuss issues up front with prospecOve client and their family.
• Tailor services to local circumstances and avoid unrealisOc expectaOons.
Where have we come from? Where are we at? • Since 2002, 4,000 TransiOon Care places now operaOng naOonally
• Reduced numbers of paOents experiencing extended length of stay in hospital – only 1,197 in 2012-‐13
BUT
• NaOonal occupancy rates have only improved from 82% in 2009-‐2010 to 85% in 2012-‐13
• And variaOons in rates across jurisdicOons and locaOons range from 55% to 91%
Why a 2nd national evaluation needed
• To assess the factors affecOng current occupancy rates • To gain a more accurate picture of whether the TransiOon Care program is meeOng demand and being accessed appropriately by all older people potenOally able to benefit following a period of hospitalisaOon
• To idenOfy what acOon can be taken to improve access and equity, including whether and where more places are needed
Transition Care Program Guidelines State and Territory governments required to collaborate with the Australian Government in the na4onal evalua4on of the Transi4on Care Programme (draX Guidelines 2014).
…. to ensure the Program remains current and consistent with new developments in health and aged care and to facilitate changes iden4fied through growing experience with the Program (Guidelines 2011).