This update has been provided by Mid North Coast Local Health District.
The Mid North Coast Admission Discharge Notification (ADN) pilot is completing the evaluation phase of the project. If you haven’t already, share your feedback today.
To date, around 102,000 ADNs have been successfully delivered to general practitioners.
The benefits of receiving these notifications are being reported in a number of ways. Through the ADN pilot evaluation feedback, Aboriginal Medical Services (AMS) have said they are now able:
- Recall high risk patients for health management and safe transition of care
- This primary care recall has reduced the re-presentation in hospital
- Make appointment immediately for patients if necessary
- Monitor Discharge Summary received
1. High-risk patients identified through hospital ADNs
In January this year, Werin Aboriginal Corporation Medical Centre received 123 notifications.
Staff were able to identify 13 high-risk patients that were recalled back to the practice. Management of these patients through primary care has been successful, with only two recalled patients re-presenting in hospital.
2. Monitoring of a patient’s journey through hospital and practice
Another identified benefit has been through the monitoring of a patient’s journey through hospital and practice.
The story below indicates the number of presentations of a single patient.
By transitioning care, it has been evidenced that the patient did not represent for February and March of 2021.
Dr Ryan Partridge has shared this story of the patient’s journey below:
Mr. X. is a young Aboriginal patient of mine at Bowraville GP with a long history of pancreatitis secondary to alcohol abuse. He had many presentations to Macksville ED with subsequent transfer to CHHC for acute abdominal pain secondary to his condition. The number of ED presentations between the 2018-2021 periods was well over 20. He was under the care of a General Surgeon and had appropriately been referred to the CHHC Pain Service. One of his admissions to CHHC was quite prolonged and required ICU admission.
As a result of these frequent presentations and subsequent admissions the CHHC/MDH ED Team and I developed a management plan for others to follow for future presentations. If the only issue at the time of presentation was uncomplicated abdominal pain then treatment with pain relief while in ED was the course of action. However for any pain complicated by examination findings or investigations then further discussion with the General Surgical team would be pursued. This plan essentially ceased the reflexive course of action for transferring him to CHHC.
Late last year (2020) we began receiving admission notifications via NSW Health for ED presentations. During this time it was noted Mr X. was still presenting to MDH ED however he was treated for presumed uncomplicated abdominal pain and discharged back to community. He had also been referred for dietary support and is currently under the additional care of the CHHC Chronic Pain Team.
Essentially we were able to see from these admission notifications that the plan we had put in place for his management was working. This enabled us to maintain our focus on his chronic needs with the assistance of our local Aboriginal Health Worker.
Please click here to provide us with more feedback about the ADN pilot.
The pilot evaluation will be closing soon. Share your thoughts about ADNs today to help make the case for their continuation or provide feedback otherwise.
Please contact the Mid North Coast LHD if you have any questions.
