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Catchment and reverse Catchment Profiles

Describe about the Health Service and Facility Planning.

Bulk admission reported from the Western NSW residents. Inpatient care data showcase the possibility of increment in the number of patients affected by chronic cardiac issues with concomitant rise in the duration of stays in the hospital. Outpatient care throbbing with the ever surging referral and emergency cases are facing the challenge of stable staff ratio to tackle the situation prudently and therefore require expansion and upgradation. The ambulatory care needs to be revamped as well. In the invasive cardiology category stable data bank to store the retrieved information utilizing the information technology tools are utterly necessary as indicated by study. With the surging population of patients requiring intensive interrogation of lesions the facilities that are rampant now is found to fall short. Among the non invasive cardiology services the paucity of space and concerned personnel has been a limitation for echocardiography facility provision. The gap in the need and access to cardiac MRI has also been identified. Further the arrhythmia centers are in dire need for introducing urgent pacemaker implementation service for the vast proportion of ageing population. Increase in the incidences of the heart failure demand the concerned facility in the SLHD to undergo more infrastructural improvement to meet the demands of the hour. The ambulatory service necessitates the documentation of the medical data in the electronically as electronic medical records capable of being accessible easily. Cardiothoracic surgery in addition to the vascular surgery units call for further modernization and technological upgradation through involvement of novel machineries and expert workforce. Thus the overall scenario in the SLHD cardiology stream unit although found to be stable and satisfactory, yet to further input and utilize newer and age suited equipments and facilities to ensure better patient recovery, a thorough remodeling and modernization is required in this sector (Northern NSW, 2013).

The catchment profile with respect to SLHD reveals that the healthcare facilities relevant to the cardiology stream are carried out in three major hospitals namely, the RPA Hospital, the Concord Hospital and the Canterbuy Hospital. The residents of these specific areas are therefore benefitted out of the services with a considerable proportion of the total bed allocation in these mentioned hospitals kept reserved for the local residents only. However, instances of reverse catchment status are evident as well with the patient inflow from the abroad nations and neighborhood localities and adjoining areas and other districts thronging these places in order to receive quality healthcare service (Northern NSW, 2013).

  • Strategic Issues

Situational Analysis

On evaluation of the situations that are in prominence in connection to the SLHD it was extracted that in order to ensure the smooth functioning of the existing services and practices with scopes for further betterment in the quality of facility available, definite strategies appropriate to the specific case scenario need to be addressed and implemented in real life as soon as possible. A holistic and partnership based strategy is recommended in this regard to assure the percolation of the assigned duties in a hierarchical manner with the positive implications being evident at every phase of the organizational framework. Associated to these, the district healthcare service plan, district communication plan, community participation plan, research strategic plan, working strategic plan and education strategic plan may be amended in this context (NSW, 2016).

  • Priorities

The immediate needs are to be segregated out of the multiple propositions to get the jobs done timely in a cost effective yet efficient manner. Deeper probe into the SLHD cardiology stream unit circumstances brought to forefront the following chief issues that need to be addressed urgently:

Introduction of imaging devices viz. cardiac MRI, hybrid labs cardiovascular CT, echocardiography.

Implementation of novel equipments with the aid of adequate funding

Supervision of newer therapeutic interventions and surveillance over models of care

Revamp of the information systems utilizing telemedicine and information technology (IT) tools and electronic databases

Enhancement of co-ordination care with minimized hospital utilization

Mutually responsive and open ended system flexible to changes and case appropriated demands of the patients

The priorities set as per the needs of the patients and on careful evaluation of the hospital setting in SLHD are to be resolved conforming to the international health facility guidelines (TAHPI, 2014).

Exploring relevant researches and published articles in the given context, generated enough evidences to support the need for implementation and follow up regarding the existing healthcare practices and facilities with proper emphasis being laid upon the multifaceted aspects of care delivery for patients particularly for those who are nearing the end of their lives along with the identified barriers that hinders the progress in such critically ill patients (O’Connell et al., 2014). Medical evaluation and research based on cohort studies are preferred to get a comprehensive overview of data pertaining to study mortality, prognostic factors and treatment outcomes among patients with specific clinical conditions in relation to the socio-demographic features and both clinical and treatment variables (Patterson eta l., 2014). Hence extrapolating the findings retrieved from pertinent studies into the health plan context in the cardiology stream unit of the SLHD, Australia the futuristic models and strategies relevant to the particular domain abiding by the role delineation of clinical services as put forward by the competent authority of the NSW, Australia. Strategic and functional planning essentially includes referring to minimum core services matrix for the suitable level of clinical practice and thereby determine the desired levels of core services. Comparison of the existing core services with the required core service in order to fulfill the requirements and improvise a plan accordingly has also been mentioned. Therefore conscious and insightful actions in devising and implementing a proper health service plan for the SLHD cardiology stream unit will pave the way for positive health outcomes among the distressed population receiving care from these facilities.

Key Goals

Objectives

Strategies

Recommendations

Retaining the echocardiography technical staff

Minimizing the workforce transfer from public to private sector hospitals

Hike in the remuneration of the concerned workforce

Scale up of the salary of the healthcare professionals through a proper budget

Accommodate large number of cardiac patients in the inpatient units

Meeting up to the demands of the ever increasing number of cardiac disease sufferers

Increase in the number of beds capacity

Escalation in the availability of the beds for admission of the cardiac patients through adequate funding

Outpatient units, ambulatory care units, cardiothoracic surgery, vascular surgery units need to be expanded and upgraded

Fulfilling the infrastructural demands, ensured well equipped facility, keeping pace with the modern emerging technologies and innovations

·         Workforce boost up

·         Electronic health record

·         Cardiac imaging facility

·         Hybrid Lab facility

Installation of modern equipments and introduction of telemedicine concept for data storage and retrieval

Invasive cardiology procedure, arrhythmia service, heart failure service are required to co-ordinate with one another

Collaborative and partnership approach culminate in better service outcomes

Co-ordination and understanding among the healthcare settings offering similar facilities

Improvisation of a consent based uniform working framework for healthcare providers with scope for referrals and admissions under special circumstances

Address the epidemiological demands with respect to increase in population density along with prevalent co-morbidities

Increase the average life expectancy of the general population with care being given to the terminally ill patients

Highly sophisticated and modernized infrastructure to help out the patients in need

Revamp of the Intensive Care Unit (ICU) facility

Future Services Profile

 

References:

Carter, R., Vos, T., Moodie, M., Haby, M., Magnus, A., & Mihalopoulos, C. (2014). Priority setting in health: origins, description and application of the Australian Assessing Cost–Effectiveness initiative. Expert review of pharmacoeconomics & outcomes research.

Grol, R., Wensing, M., Eccles, M., & Davis, D. (Eds.). (2013). Improving patient care: the implementation of change in health care. John Wiley & Sons.

Hou, X. Y., Rego, J., & Service, M. (2013). Review article: paramedic education opportunities and challenges in Australia. Emergency Medicine Australasia, 25(2), 114-119.

Jamieson, L. M., Paradies, Y. C., Eades, S., Chong, A., Maple-Brown, L., Morris, P., & Brown, A. (2012). Ten principles relevant to health research among Indigenous Australian populations. Medical Journal of Australia,197(1), 16.

Lozano, R., Naghavi, M., Foreman, K., Lim, S., Shibuya, K., Aboyans, V., & AlMazroa, M. A. (2013). Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. The Lancet, 380(9859), 2095-2128.

McInnes, E., Middleton, S., Gardner, G., Haines, M., Haertsch, M., Paul, C. L., & Castaldi, P. (2012). A qualitative study of stakeholder views of the conditions for and outcomes of successful clinical networks. BMC health services research, 12(1), 1.

Nicholson, C., Jackson, C. L., & Marley, J. E. (2014). Best-practice integrated health care governance: applying evidence to Australia’s health reform agenda. Med J Aust, 201(3 Suppl), S64-S66.

Northern NSW  Local Health District (2013). Health Care Services Plan 2013-2018. Vol. I & Vol.2. Retrieved from:https://nnswlhd.health.nsw.gov.au/about/northern-nsw-local-health-district/health-care-services-plan/

Northern Sydney Local Health District. (2016). Royal Northern Shore Hospital.  Retrieved from< https://www.nslhd.health.nsw.gov.au/Hospitals/RNSH>

NSW Ministry of Health (2016). The Guide to the Role Delineation of Clinical Services.Retrieved from:https://www.health.nsw.gov.au/services/Pages/role-delineation-of-clinical-services.aspx

O'Connell, D. L., Goldsbury, D. E., Davidson, P., Girgis, A., Phillips, J. L., Piza, M., & Ingham, J. M. (2014). Acute hospital-based services utilisation during the last year of life in New South Wales, Australia: methods for a population-based study. BMJ open, 4(3), e004455.

Patterson, S., Cescon, A., Samji, H., Cui, Z., Yip, B., Lepik, K. J., & Montaner, J. S. (2014). Cohort profile: HAART observational medical evaluation and research (HOMER) cohort. International journal of epidemiology, dyu046.

South Eastern Sydney Local Health District (2013). South Eastern Sydney Local Health District Healthcare Services Plan 2012 – 2017 (p. 24). Retrieved from: https://www.seslhd.health.nsw.gov.au/HealthPlans/documents/FinalSESLHDHCSP2012-withrevisedcover.pdf

State of Queensland (Queensland Health). (2015).Guide to health service planning (Version 3) (p.15-31). Retrieved from: https://www.health.qld.gov.au/publications/portal/health-services-planning/guideline-health-service-planning.pdf

Sydney LHD (2013). Our Population Factsheet. As retrieved from: https://www.seslhd.health.nsw.gov.au/about_us/documents/FactSheet_SESLHD_Our_Population.pdf

TAHPI (2014). International Health Facility Guidelines. Part S – Health Service Planning.Version4.1.(p.32-34).Retrieved from: https://healthdesign.com.au/ihfg/Guidelines/Index/iHFG

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