A National Forum on Safety and Quality in Healthcare will be held in Canberra next week, with the theme, Society, Regulators and Health Providers: a clash of expectations?

The forum is hosted by the Australian Council on Healthcare Standards, ACT Health and the Australian Commission on Safety and Quality in Healthcare.

One question I will be asking when I drop by the conference is: whatever happened to the planned myhospitals website? It was mooted for launch in August; understandably those plans had to be put on hold once the election was called (esp as a Coalition Government would have canned the site).

But surely sufficient time has now passed since the election. Surely someone, somewhere must have an inkling of a launch date?

Meanwhile, thanks to the forum organisers for rounding up some of the presenters to provide you with some reading on quality and safety matters.

First off the hustings is Brenda Ainsworth, Executive Director – Health Performance Improvement Innovation & Redesign, ACT Health,  who gives an overview below of the ACT’s nurse-led walk in centre, which aims to relieve pressure on emergency departments. (And isn’t this always a timely issue, particularly as we heard from a federal health department officer at Senate estimates hearings this week that in 2007-08, 1.5 million patients with what would be categorised as GP-type needs attended an emergency department in evenings and on weekends, ie during the times when most GPs are not available).

Reducing pressures on emergency departments

Brenda Ainsworth writes:

The pressure on public emergency departments (EDs) is no secret and one of the greatest challenges has been an increase in the number of people seeking treatment for minor injuries and minor illness.

In the ACT alone, our two public EDs had almost 100,000 people present in the year 2007-08 and of these people, 60% sought treatment for minor or semi-urgent conditions.

Access to GPs is also a challenge in the ACT where there is an estimated shortfall of 60 GPs and it’s reported that about 50% of our GP practices no longer accept new patients.

Such challenges have a significant impact on the safety and quality of our healthcare system and there is much time and effort being dedicated to finding new ways of doing things.

One innovative model of care is the concept of a nurse-led, Walk in Centre (WiC) which provides consumers with an alternative to attending an ED or your GP for treatment of minor injuries or illnesses.

On May 18 this year we turned this concept into bricks and mortar, when Australia’s first public nurse-led WiC was opened on the grounds of the Canberra Hospital campus.

A former Chief Executive of ACT Health first came across this model on a visit to the UK in 2008 and and charged ACT Health’s Innovation and ReDesign Unit with the task of establishing the model here.

A major challenge though was that we were testing the traditional boundaries of clinical groups within the ACT, indeed the national, health system.

It also challenged traditional thinking with regards to who can deliver safe and efficient clinical care autonomously.

However, the opportunities were also significant.

WiCs can provide healthcare choice while also extending the capacity of the health system by optimising the skills of nurses.

Our goal is that by offering nurses an innovative new role that provides job satisfaction and professional autonomy, we can take one step in addressing the nursing workforce shortage and reducing the rate of attrition.

We have put a lot of work into ensuring care and treatment are provided in a safe and consistent model.

This model means all advice and treatment is provided under the guidance of strict treatment protocols and standing orders for a defined group of medications such as antibiotics, anti-emetics and anti-histamines.

Staff use a clinical software product to support all their clinical decisions and patients seeking treatment are first assessed against the clinical scope of the service. If their condition falls outside that scope, they are redirected to an appropriate healthcare provider.

While there has been some anxiety from stakeholders about the political and economic implications of a significant change in health care policy direction, ACT Health has had cautious support in forging this brave new world.

The centre is now operating with a full staff of Nurse Practitioners, Transitional Nurse Practitioners and advanced practice nurses. In its first 12 weeks of operation, staff saw more than 3,000 patients.

Through innovation, we are trying to make things a bit better for everyone.

• Stay tuned…part two in our series of posts from the forum will discuss how Chernobyl and the Concorde crash could have lessons for patient safety.

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