build knowledge about various service options including optimum skill-mixes, client focus and cost effectiveness;

Transcription

1 INTRODUCTION The Coordinated Primary Options (CPO) project recognises that people may often be admitted to hospital because of financial and/or other barriers in gaining access to services in the community. Therefore, CPO s purpose is to: enable Primary Care teams to access community based services, offering alternatives to acute hospital admission; build knowledge about various service options including optimum skill-mixes, client focus and cost effectiveness; identify and where appropriate, address communication and service gaps that contribute to hospital admissions; encourage general practice insights into issues and general practice support for reducing hospital admission; support practice changes required to achieve the goals of reducing the level of acute admissions and achieving integrated services. A range of community diagnostic, therapeutic and logistic services are available at no cost (excluding the initial GP consultation) to the patient. Examples of these include: Diagnostic tests X rays, ultrasound Home visits by GP and/or practice nurse; Follow up and return visits to GP locations; Transportation; Rest Homes Community IV therapy Coordinated Primary Options is flexible and easy to use accessing the services requires forwarding completed referral and invoice forms, either electronically through Medtech or manually through paper based forms.

2 CPO PATHWAY Patient presents and pays for Initial Consultation with GP Would you normally refer this patient to hospital? NO Manage patient in usual way. Yes Can you safely manage this patient with $300 funding for up to 5 days? Yes Can you take clinical responsibility for this patient s care? Yes NO NO Refer patient to hospital. NO Can a colleague or A&M doctor take clinical responsibility for this episode? Contact CPO coordinator on , if required Provide services within your own practice or refer to another GP provider as required (for certain pathways) Yes Complete Referral Form and submit or fax to Attach CPO number to all correspondence relating to patients episode of care including prescriptions, X-ray requests etc. Submit electronically or Fax a referral form to the Service Coordinator After Completion of Care: 1. Complete Outcome/Invoice Form-electronic or manual 2. Submit or Post forms to CPO Coordinator: P O Box Hastings or Fax to

3 REFERRING A PATIENT TO CPO FREQUENTLY ASKED QUESTIONS Which patients are eligible to access CPO services? Any patient who resides in Hawkes Bay (including Wairoa, Waipukurau, Waipawa), and would have otherwise been referred acutely to hospital. How are services accessed for the patient? Complete an electronic referral form and submit, OR fax a manual form to If the Service Coordinator assistance is required, phone (027) Electronic referrals are installed on MedTech and My Practice as advanced forms Who has clinical responsibility for the patient while receiving CPO services? By accessing CPO, the referring GP agrees to take clinical responsibility and ongoing care for the patient in the community. What happens if a patient requires admission after all? Refer to hospital services in the usual way. It is essential that patients receive the safest and clinically appropriate treatment and be admitted when necessary risks should never be taken to avoid an admission. CPO will pay for services already provided within primary care. How much is allocated per patient per episode of care? $300 (incl GST) is allocated per episode (GP visits, scans, medications, etc included). Discuss with the Service Coordinator if the episode of care may exceed $300. How much can be charged for services? A schedule of fees is on the outcome/ invoice form. How many days can a patient be under CPO? The episode of care should be likely to have completely resolved in five days. Can the Practice team provide CPO services? Yes. Some examples of practice based services are: Practice nurse consultation or observation; IV therapy GP/PN home visits When should the Referral form be faxed to CPO? The referral form should be received by the Service Coordinator within 24 hours of the patient s initial consultation or the next normal working day. How are Practice-based services claimed back? Complete an Outcome form and submit electronically. Or Post the manual outcome form to the Service Coordinator when the episode of care is complete. For manual forms send the original referral form as well.

4 You will receive payment for your care by the 20 th of the month if all documentation is in order. Does the patient have to pay for CPO? No. Their initial GP consultation incurs the usual practice charge and thereafter, all services are provided at no cost to the patient. Can CPO services be accessed for the same patient for more than one episode of care? Yes, funding is allocated per patient, per episode of care. Are there any conditions or situations where patients should be admitted straight to hospital rather than CPO? The clinical judgment rests with the GP. Examples include: Patients with chest pain of cardiac origin; Patients who suffer a stroke; Older, frail adult with multiple medical problems. Are there some conditions not covered by CPO? Only conditions specified as pathways are funded under CPO Who can help with medical advice? Dr Alan Wright CPO Medical Advisor Telephone: Mobile Appropriate Registrar Physician of the Day How can further information be obtained if the need arises? Contact the Service Coordinator on (027) , or (06)

5 SERVICE PROVIDERS Radiology Address Telephone Fax Hawkes Bay Radiology Prospect Road HASTINGS Hawkes Bay Radiology Kennedy Road Greenmeadows NAPIER Onsite Ultrasound Unit 3 62 Munroe Street NAPIER Onsite Ultrasound Canning Road Hastings Send patient by taxi if necessary (using Hastings Taxis). Please ensure the taxi driver knows not to wait while the procedure is performed. All referrals must have a completed referral form with the CPO reference number included.

6 Pharmacy Provider Contact Phone/Fax The Pharmacy The Hasting Health Centre 101 Queen Street East HASTINGS Radius Care Pharmacy 32 Munroe Street NAPIER Paul Messerschmidt Phone Fax: Fraser Smith Phone Fax: Taradale Medical Pharmacy Taradale Medical Centre Puketapu Road Taradale Richard Barley Rachael McNeil Phone Fax: All medications that are prescribed under CPO can only be supplied by the above pharmacies. These are IV cefazolin, moxifloxicin, gentamycin, clexane. 2. This does not include those medications available on the MPSO or prescriptions given at the completion of the episode of care ie: oral antiobiotics, dexamethasone, intravenous saline (1L). 3. All prescriptions MUST have the CPO reference number included.

7 Transport The Coordinated Primary Options taxi service may be used to transport patients to and from any of the CPO Service Providers. Provider Contact Phone/Fax Hastings Taxis 303 Railway Road HASTINGS Phone When ordering a taxi you must: 1. State that it is a Coordinated Primary Options pick-up and should be charged to the CPO account. Also give the reference number and name of the patient. 2. Transport is unable to be provided from rural areas.

8 Community IV Therapy Provider For patients requiring IV therapy, who are unable to come into the surgery and are suitable to receive IV Cefazolin in their home or rest home. The responsibility of care remains with the referring General Practitioner Provider Contact Phone/Fax Health Care NZ Hawkes Bay P O Box Browning Street NAPIER Dianne Sharplin Phone Fax: For this service to commence, please contact Dianne Sharplin on The GP needs to complete the Community IV Referral Form (found in outbox in Medtech, or paper based) and fax to before 2pm. The original referral form must be posted to: IV Community Nurse, PO Box 953, Napier. Key points for Referral Form: The prescription component of the form must be written in legible writing and signed by the prescribing doctor The first dose of the drug must be given within the general practice/ Afterhours Medical Centre The referral form must be faxed to before 2pm Monday to Friday, if you wish the nurse to commence IV therapy on that day. For queries regarding this referral contact IV Community Nurse on The practice will be contacted via phone to confirm acceptance The GP is able to utilise the nurses am, pm or both. (You need to specify this on the referral form.) A contact number of the prescribing GP must be available for the nurse, including an afterhours number. GP s will be contacted if the patient s condition deteriorates; the IV tissues or the nurse has concerns with the patient s condition.

9 Patients are advised to visit their GP at the completion of treatment There is weekend and public holiday cover if the patient has commenced treatment prior to the weekend or public holiday. No new referrals are able to be accepted over a weekend or a public holiday. NB: The cost for this service will be included as part of the package of care with an anticipated value of $300. Any queries please contact Sonya Harwood, CPO Coordinator on