Menu
Menu
Aug
22
2017
Dr Hilton Koppe
Senior Clinical Editor, HealthPathways
“Paid thinking time.” That’s what I used to call my work as a medical educator with North Coast GP Training (NCGPT). Of course, it was much more than that. It was an opportunity to assist the next generation of general practitioners launch their journey in our region. There were benefits that came from teaching – they say, “If you can’t do it, teach it … and then you’ll know how to do it.”
So it was a great loss when NCGPT lost the contract for delivering GP training in our region at the end of 2015. Fortunately NCPHN opened a different door for me, and I joined the HealthPathways team as a clinical editor.
Once again, I have a job which involves “paid thinking time.” Working on HealthPathways has been a revelation. There are opportunities to ensure that patients get the right treatment at the right time in the right place. On a personal level, I have learnt so much medicine. I definitely feel that I am a better doctor for my patients as a result.
The other day I saw Jim, a patient who complained of calf tenderness after his plaster was removed for treatment of an ankle fracture. I had reviewed the DVT HealthPathway a few weeks earlier, and learned about the Revised Wells Score Clinical Risk Assessment Calculator for DVT. Using this calculator, I was able to assess Jim as being of low risk of DVT, thus avoiding him needing to take time off work to have Doppler.
The other week I saw Muriel, a 75-year-old woman who was complaining of vague lower abdominal discomfort and bloating. She had mild tenderness in lower abdominal region, so I arranged for her to have an ultrasound. This showed a 3cm right ovarian cystic structure. The radiologist did not report any sinister findings, but – due to my involvement in a workgroup developing HealthPathways for ovarian cancer – I was aware of the Risk of Malignancy Index (RMI) for assessing risk for ovarian cancer. Muriel agreed to have CA125 done to further quantify her risk. When this came back raised, with associated elevation in RMI score, I knew from my work on the relevant HealthPathway that I needed to refer her directly to a gynaecological oncologist. Plus, I knew that HealthPathways had up-to-date contact details for these specialists. It’s possible that most other GPs already knew this information, but I didn’t. Without my work on HealthPathways, I am not sure that Muriel would have received optimal treatment in an appropriate time frame.
And then there was last Monday. One of those days in general practice we all dread. Three new patients with suicidal thoughts! None of them required immediate mental health team assessment, but they all needed assistance with keeping them safe. Once again, HealthPathways came to my rescue. I had been involved in developing our new Suicide Risk pathway earlier this year, so I was aware of the resource in that pathway called “Keeping me safe plan”. Just what the doctor ordered for these three disturbed patients. They were all delighted that I was quickly able to print out a personalised action plan with local and national contact numbers to help keep them safe during this challenging time.
These are just three examples of how working on HealthPathways has helped me be a better doctor for my patients. Every pathway I work on results in better care for my patients. This paid thinking time is paying dividends!
There are often opportunities to be involved in the development of new pathways, either as a member of a workgroup, or in reviewing pathways before they are published. If you are interested, please contact Kerrie Keyte at [email protected] or myself at [email protected].
For a list of all localised pathways see:
Mid and North Coast Localised Pathways
Username: manchealth
Password: conn3ct3d
For further information about HealthPathways email [email protected] or [email protected].
The RACGP Green Book Needs Your Input
Cancer Genetics for GPs
Healthy North Coast acknowledges the Traditional Custodians of the lands across our region, and pay our respect to Elders past, present and on their journey. We recognise these lands were never ceded and acknowledge the continuation of culture and connection to the land, sky and sea. We acknowledge Aboriginal and Torres Strait Islander peoples as the Land’s First Peoples and honour the rich diversity of the oldest living cultures.
We acknowledge the traditional custodians of the land we live and work, the Bundjalung, Arakwal, Yaegl, Gumbaynggirr, Githabul, Dunghutti and Birpai Nations, and their continuing connection to land, sea and community. We pay our respects to elders past, present and future.
Strategic Priority Area: One team
North Coast is identified as the region most likely to be impacted by climate change in Australia and also forecasted greatest growth in those 65+.
Healthy North Coast takes a lead role in ensuring the older population and the sector that supports them are prepared for, can respond to and recover from disasters and other emergencies.
We have led eight regional disaster management capacity building workshops, bringing together SES, community organisations and the aged care sector.
We have also developed disaster preparedness tip sheets for both residential and community aged care providers.
Strategic Priority Area: One team
In May 2022, the NSW Parliament passed the Voluntary Assisted Dying Act 2022. Effective from Tuesday, 28 November 2023, eligible people have the choice to access voluntary assisted dying.
Healthy North Coast has developed a webpage for both health professionals and consumers, with links to available information and resources.
Strategic Priority Area: No one is left behind
Healthy North Coast has worked with people living with dementia, their families and local service providers to develop an information booklet that will help them connect with local and national supports along their journey.
Highly regarded by a range of professional supporting those on or starting the dementia journey, the booklet includes commonly asked questions for people to ask their GP and/or specialist.
“It’s a fantastic resource and I give it to everyone on their first diagnosis. Its easy to read, so well planned and thought through and has lots of really useful information, tailored to the region.
I also find it very helpful when educating clinical staff.”
−Geropsychiatric Nurse Practitioner, Mid North Coast.
The resource is available in digital and printed copies, with more than 5,000 distributed across the region. An e-version is available to clinicians via the Dementia and Cognitive Impairment HealthPathway.
Strategic Priority Area: One team
The Deteriorating Resident Response Tool (DRRT) has been developed to guide RN’s in Residential Aged Care homes (RACHs) to better understand, anticipate and make clinical decisions responding to the deteriorating health of residents.
The objective of the DRRT is to give RACH staff clear information to triage and provide appropriate care for a range of residents’ health conditions, and, in turn, prevent unnecessary presentations to ED.
The tool has been designed together with a specialist geriatrician, consulting with stakeholders such as Residential Aged Care Managers, NSW Ambulance, GPs, and experts from Mid and North Coast LHDs.
The pilot commences in March with four participating RACHs. Evaluation measures will include effectiveness in building RN confidence and reported reduction in unnecessary hospitalisations. Findings will inform a future planned, region-wide implementation.
Strategic Priority Area: No one is left behind
The Care Finders program is a free region-wide service to support vulnerable older people who have no-one else to help them, to learn about, apply for and set up support services.
Care finders can help people understand what aged care services are available, set up an assessment, and find and choose services. They also help people with access to other supports in the community, both accessing services for the first time and changing or finding new services and supports.
On the North Coast, Healthy North Coast has commissioned four organisations to provide this important service: EACH, Carexcell, Lifetime Connect and Footprints.
Strategic Priority Area: Improving Lives Now
Healthy North Coast commissions two service providers to deliver psychological therapies and supports for older people with, or at risk of developing, a mental illness and who are living in residential aged care homes (RACHs).
The aim of the program is to both provide direct support to residents and their families and carers, as well as upskill the RACH workforce to respond to the needs of residents presenting with mental health concerns.
Strategic Priority Area: Securing a Healthier Future
Delivered by Feros Care, the Healthy Me, Healthy Community program aims to build individual and community connections to reduce loneliness and improve wellbeing in Port Macquarie.
The program helps people to connect with community, activities, supports and services that address their broader social determinants of health, as an alternative or supplement to a clinical approach.
Strategic Priority Area: Improving Lives Now
The Royal Commission into Aged Care Quality and Safety identified several critical areas affecting aged care residents and our health system. Key challenges include:
Telehealth offers valuable opportunities to enhance support for residents living in aged care homes. Funded by the Commonwealth Department of Health and Aged Care, this initiative provides telehealth equipment and staff training as part of the response to the Royal Commission’s findings.
By improving access to primary care clinicians, specialist services, and other service providers through telehealth, we can significantly enhance health outcomes for residents, reducing unnecessary hospital transfers and emergency department visits.
The selection of telehealth equipment was guided by our Healthy Ageing Strategy (HAS), a comprehensive digital discovery questionnaire, and consultation workshops with various stakeholders. These efforts included interviews with residents to understand their attitudes toward telehealth, ensuring the initiative meets their needs and preferences.
Strategic Priority Area: Improving Lives Now
Aims to provide people who have life limiting conditions the opportunity to exercise choice and receive high quality care at home, harnessing improved and better coordinated supports and services that meet their individual needs.
Program objectives:
These objectives will contribute to achieving the following intended overarching outcomes of:
Funding is open to all primary care providers within disaster affected communities across the Healthy North Coast footprint.
Workforce Locum support and R&R funding criteria
Wellbeing Flexible Funding Criteria & Eligibility
| *Team Size (Total staff and contractors) | Funding Available |
| Small (1-5) | $500-$1500 |
| Medium (6-20) | $1500-$4000 |
| Large (>20) | $4000-$5000 |
