Hours: 8.00am – 9.00pm weekdays
9.00am – 5.30pm weekends
The role of the ED care coordination team is to ensure the safe and effective discharge of ED patients who are medically cleared for discharge, but are screened to be at risk of not managing in the community.
This screening is achieved by conducting a generic care needs assessment to identify the safety issues for discharge, including:
• Whether the patient lives alone
• Whether they are likely to have self care problems
• If they care for other people
• If they already using community services
An action plan is then implemented to address each of these issues in a timely and appropriate manner in order to ensure a safe patient outcome. This plan may include:
·Referring to other allied health professionals within the team for discipline specific intervention to ensure the patient is safe for discharge
·Negotiating arrangements with family and friends where available
·Arranging short term support services to assist patients to recover at home from their current illness or injury (personal care, homecare, meals, home nursing services, carer support/respite, allied health services, counselling, drug & alcohol services, crisis intervention)
·Referring to other community services to provide longer term assistance to patients or carers
·Referral and liaison with other hospital staff or services when patients require admission to ensure early planning for discharge
GPs are most welcome to contact the care coordination team (or highlight the need for care coordination to the admitting officer) if they are sending patients to the ED who have an acute medical problem, but who also have complex social or functional issues that need to be addressed.
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