Wednesday, July 22, 2009

Melton Health

Staff from HCCA were very impressed following a tour of the Melton Health Centre on the north west fringe of Melbourne last Wednesday (15 July). Melton Health is one of the sites of Djerriwarrh Health Services.

Melton Health represents a new benchmark for Integrated Primary Health Centres that are proposed in the ACT and also provides excellent ideas for consumer-centred design and refurbishment of Village Creek Centre for the Aged Care and Rehabilitation Services (Read FAQ online 55kb Pdf).

Melton Health is a SuperClinic and was established 3 years ago. Melton Health offers an extensive range of same day medical services, specialist clinics, pathology and radiology services to cater for the health and well being of a rapidly expanding community. It provides around 50,000 occasions of service per year and has greater capacity to provide up to 90,000 service provisions in the future. The figures have shown growth each year but whilst there has been an 8% growth in population, there has been a far greater growth is users of the Centre.

Services were decided on by using population, Emergency Dept, and Health Dept statistics. The highest demand services were chosen and other services were not provided if there was not a critical mass to support them. A Community Advisory Group provided input into what services were provided and the structure of these services. Community consultations were held. The Community was also involved in creating artworks for the Centre, including a large mural at the entrance.

The Centre provides a vast array of services within the one highly functional and attractive environment.

The services provided include:

Urgent Care, Renal Dialysis, Oncology, Haematology, Gastroenterology, Chronic Disease Management, Day Rehabilitation, Orthopaedic Clinic, Endocrinology and Diabetes Clinic, Chest Pain Clinic, Respiratory Clinic, Nephrology Clinic, Dermatology Program, Stomal Therapy, antenatal clinic and classes, Infant Settling and Feeding Clinic, Paediatric Clinic, and an Audiology Clinic.

The centre is open from 9am – 10.30 pm, 7 days a week. Most services are by referral, a few are self- referral.

Particularly noticeable was the absence of consumers waiting to be seen which according to the Executive Officer, David Grace, is due in part to the innovative electronic queueing system by Q-matic. The system allows nine out of ten consumers to be seen straight away by a Clinician, who is prompted upon their arrival by the system. They kiosk can scan the bar code on the consumer’s referral letter which then notifies the clinician that that consumer has arrived. David Grace believed that at first they had underestimated just how effective the queueing system would be. We think this has great potential in assisting consumers in our ongoing quest to tell our stories once and get to the right place and will be raising this for consideration in the Capital Asset Development Program and design and refurbishment of Village Creek.

The Urgent Care Stream is a walk- in service with no appointment required. It’s provided on a non on-going, one off basis where consumers are referred back to their GP for further treatment when required. Interestingly, the local area is similar to the ACT, in that there is a shortage of GP’s. Typically, consumers wait 3- 4 days to see their GP. Since the opening of the Melton Health Clinic, there has been a statistically significant reduction in Emergency Department presentations. The Urgent Care service is both Nurse Practitioner and GP led, with lots of part- time staff working side by side. Discharge summaries are provided in a written format whilst all other medical records are electronic. They are working toward discharge summaries being electronic but at present encrypting taking too long. David reported that they would have two or three code blue emergencies a month and 20% of patients referred to hospital go by ambulance.

The Ambulatory Care Stream is similar to an outpatient clinic except with a Multidisciplinary approach. At a planned appointment, consumers can get back to back appointments with a number of staff. Some staff work across the multidisciplinary team whilst others are part of a specific team. Most doctors are contracted but some are salaried or casual. 5% of doctors rent a room and have their own practice. Recruitment of staff had not been a problem as many professionals wanted to be part of the new and effective system.

The Reception area used glass surfaces and fixtures so as consumers could see the activity going on beyond the waiting area. Each module was secure with Clinicians using swipe cards to let consumers in and out. The secure doors are glass and add to the sense that you are in a welcoming environment rather than an institution.

Electronic records were kept using an electronic system which allowed for both handwritten and computer generated documents to be captured. Eyesoft is the electronic patient master system that sits above all others across the Djerriwarrh community to allow all clinicians to access all records. David Grace mentioned that no consumers have had an issue with privacy and confidentiality of records and so far all have consented to electronic records.

Some other features were pathology, ultrasound and x-ray, and dermatology facilities on site. Group meeting rooms were also provided for educational purposes. The paediatric consultation rooms were of a generous size to allow for the whole family to fit comfortably including an activity table for children.

We were very impressed with building and the sense of being built around consumer needs and also taking into account the needs of staff. HCCA would like to thank David Grace for his time in showing us the Melton Health facility.

No comments: