May 18, 2020

Residential In-Reach Program

Residential In-Reach is a program, operating through Northern Hospital, that works with local residential care facilities to try and prevent admissions into hospital and treat more residents within their homes.

The program started in 2002 and provides clinical, specialist nursing, geriatric medicine and palliative care support as requested once a GP or a nursing home refers a patient to the program.

“We can go out and provide clinical assessment and some level of support together with Hospital in the Home service, to facilitate patient stay in the facility. We know this can be the preference of patients and their families, but it also reduces distress and risk of transferring a person to a hospital,” explained Dr Daniel Ong, Registrar.

For the COVID-19 response, the team has redeployed an extra Aged Care Registrar and a HMO to assist with dealing with the increased demand generated by anxiety over the new virus. The increase in medical staffing has meant that the team are now able to provide a seven-day-a-week full service.

“It’s an ongoing, evolving situation. The original setup was one registrar and four nurses. We are now the primary responders for any resident in those facilities in our catchment area to respond to a suspected case of COVID-19. When it all started, we didn’t know how many people we would end up seeing, but we did know that the virus can spread very rapidly,” Dr Ong said.

Furthermore, the team also assist nursing homes in terms of isolation practises and correct use of PPE, and so far haven’t had any diagnosed cases.

“The team has swabbed over 100 people. We get a phone call and we would go out as we have been trained to do COVID-19 swabs and bring specimens back. That is why we had to increase our staff numbers, both nursing and medical, with two registrars on board,” explained Kylie Muntz, Clinical Nurse Consultant.

Offering this service now seven days a week to support our community has led to a lot of positive feedback, as often the physical assessment is needed and telehealth in some cases is not a feasible option.

The team agree that what they enjoy most is supporting families, residents and staff, as well as getting a sense of relief from families that someone is looking after their elderly.

“We have a very lucky role as we are not in a hospital environment, but we are able to practice in the community. We are doing everything we know, and we are doing it out there in the community. It’s the best of both worlds, as we help patients in their own homes,” Kylie said.

The efforts of the team are showing fantastic results – in April there were over 600 face-to-face contacts compared to the usual of around 400, and the team have prevented 106 potential presentations to the Emergency Department, compared to the usual number of 30-35.

“This program is unique because it fills the service gap that exists between the GPs, nursing homes and our hospital services,” Dr Ong added.

Featured image (left to right): Kylie Muntz, Dr Daniel Ong, Anne Rutherford, Dr Bec Tai, Anne Dewey.