Nick Ternes1, Scott Edwards2, Lucinda Marr3, Samantha Plumb4
1 Royal Melbourne Hospital, Grattan Street Parkville, Victoria, 3052, Nick.Ternes@mh.org.au
2 Royal Melbourne Hospital, Grattan Street Parkville, Victoria, 3052, Scott.Edwards@mh.org.au
3 Royal Melbourne Hospital, Grattan Street Parkville, Victoria, 3052, Lucinda.Marr@mh.org.au
4 Royal Melbourne Hospital, Grattan Street Parkville, Victoria, 3052, Samantha.Plumb@mh.org.au
The aims of the AHIPP -General Medicine role were to improve access to allied health intervention to improve patient outcomes and flow; provide clinical leadership and improve capacity of the allied health team; and provide an alternative career pathway for experienced allied health staff that encompasses a broad range of high level skills and capabilities, whilst maintaining hands on clinical responsibility.
The AHIPP was implemented as a feasibility pilot study with initial funding support from the Department of Health and Human Services. Two general medical units received AHIPP intervention and two control group general medical units received standard care. The AHIPP interventions included screening and early assessment of patients to establish allied health needs and ensure appropriate referrals were in place for timely intervention from each discipline. The AHIPP reviewed patients with a length of stay greater than 7 days to support allied health decision making and discharge planning.
The AHIPP was implemented and initially evaluated over a four month period from July to November 2015 with positive trends seen. The role continued throughout 2016 with further extensive analysis completed. Key findings included a 1 day decrease in median length of stay in AHIPP intervention units compared to control units (7 days (IQR 4-12) versus 8 days (IQR 5-13), p=0.016), 4.3% increase in proportion of patients discharged directly to their previous place of residence compared to control units and a 10% increase in allied health referrals being made within 48 hours of admission.
Significance of the Results to Allied Health
The AHIPP – General Medicine is an innovative model of care enabling a more responsive allied health service to better meet the challenges of a complex patient caseload.