Formerly: Out of Hospital Strategies (OOHS)
“Keeping people, living with chronic disease, well and out of Hospital”
This is a project of partnership between Country Health SA and the Adelaide Hills Division of General Practice
The Adelaide Hills Division of General Practice (AHDGP) has been fortunate to gain funding to work with Country Health SA on the current ‘Better Care in the Community; Out of Hospital Strategy’.
The foundation site of Mount Barker Health Services and across the Hills region, is one of thirteen sites across the state that is currently working on this project.
The AHDGP is excited to be part of this primary care focused project, that has an emphasis on health service integration, across General Practice, Community Health Services, Hospital Services, the SA Ambulance Service and non-government organizations to better coordinate care.
The project has objectives around country hospital avoidance and shorten lengths of stay (LOS), exploring potentially avoidable presentations to metropolitan hospitals and the processes of these, all with a focus on wellness through chronic disease management (particular focus on Cardio-vascular, Endocrine and Respiratory conditions) and linkage of services.
General Practice is a key to sustainable chronic disease mangement. Linkages across General Practice and health services in the Adelaide Hills are strategies of this project.
Patient Liaison Officer positions (RNs) at local Hospitals have shown evidence-based improvement that well coordinated care of patients can reduce LOS and even avoid hospital admissions.
Transitional Care Packages and Country Home Link Packages, and more recently the Rapid Intensive Brokerage Support (RIBS) services are initiatives that form part of the state wide project.
Contact the Adelaide Hills Community Health Service for more information on the early discharge and hospital avoidance services through the RIBS Program. Phone 8393 1833.
The AHDGP is working closely with local health services to plan and implement initiatives of the OOHS around CDM and integration processes across the Adelaide Hills area.