Report re Model... · Web viewThe Division of Mental Health, Justice Health, and Alcohol and Drug Services (MHJHADS), ACT Health, is currently developing an Electronic Clinical Record

University of Canberra Public Hospital (UCPH)

Model of Service Delivery

Version ControlNo. Date Remarks

1.0 28- Jul-14 Extracts of report issued for Round 1 User Group consultation (sections 2, 3 & 4)

1.1 8- Aug-14 Updated following Round 1 User Group meetings

1.2 12-Aug-14 Extract of report for Round 2 User Group meetings

1.3 30- Sept- 14 Updated extract for Round 2 User Group meetings incorporating feedback from Linda Kohlhagen – for reference at meetings only (not for circulation)

1.4 8-Oct- 14 Updated draft following Round 2 User Group meetings

1.5 28- Nov- 14 Updated draft incorporating feedback following Round 2 User Group meetings and targeted work re ambulatory services

1.6 5-Dec-14 Updated draft incorporating feedback and outcomes of targeted work re inpatient services

1.7 19-Dec-14 Updated draft following Round 3 User Group meetings

1.8 9-Jan-15 Updated draft for Round 4 User Group meetings

1.9 23-Jan-15 Updated draft for Reference Group meeting 28/1/15. Incorporates feedback received from Round 4/5 User Group meetings including document restructure

2.0 13-Feb-15 Final incorporating outcomes of Reference Group meeting and other feedback provided

3.0 9-Mar-15 Final incorporating feedback provided

4.0 01-Oct-15 Final incorporating definitional clarification around models of care and models of service delivery and structural changes

UCPH Model of Service Delivery V4.0 3 /27

Table of Contents

1 Introduction.............................................................................................................................6

2 Model of Service Delivery.......................................................................................................7

2.1 Service Elements/Activities to support care delivery at UCPH...............................7

2.1.1 Aboriginal Liaison Service.................................................................................7

2.1.2 Access...............................................................................................................7

2.1.3 ACT Records Management...............................................................................8

2.1.4 ACT Health Revenue and Financial Services....................................................8

2.1.5 Admissions.........................................................................................................8

2.1.6 Administration....................................................................................................8

2.1.7 After-hours Management...................................................................................8

2.1.8 After-hours Medical Cover.................................................................................9

2.1.9 Automated Guided Vehicles (AGVs).................................................................9

2.1.10 Bed Management...............................................................................................9

2.1.11 Biomedical Engineering.....................................................................................9

2.1.12 Body Holding......................................................................................................9

2.1.13 Booking and Scheduling....................................................................................9

2.1.14 Café.................................................................................................................10

2.1.15 Cashier/Billing..................................................................................................10

2.1.16 Central Equipment Store.................................................................................10

2.1.17 Cleaning...........................................................................................................10

2.1.18 Clinical Records...............................................................................................10

2.1.19 Clinical Support Role.......................................................................................11

2.1.20 Consultation Liaison Services..........................................................................11

2.1.21 Consumer Engagement Team.........................................................................11

2.1.22 Design Construct Maintain (DCM) Contract....................................................11

2.1.23 Disaster Response..........................................................................................11

2.1.24 Duress Response............................................................................................12


2.1.25 Emergency Code Response............................................................................12

2.1.26 Equipment Loan Service (ELS).......................................................................12

2.1.27 Food Services..................................................................................................12

2.1.28 Front Reception...............................................................................................13

2.1.29 Hydrotherapy...................................................................................................13

2.1.30 Information and Communications Technology (ICT).......................................13

2.1.31 Linen Service...................................................................................................13

2.1.32 Mailroom..........................................................................................................13

2.1.33 Management of the Unwell Patient..................................................................13

2.1.34 Manual Handling..............................................................................................14

2.1.35 Medical Gases.................................................................................................14

2.1.36 Medical Imaging...............................................................................................14

2.1.37 Medical Supplies..............................................................................................15

2.1.38 Multi-faith Service............................................................................................15

2.1.39 Nurse Call System...........................................................................................15

2.1.40 Office Accommodation.....................................................................................15

2.1.41 Parking.............................................................................................................15

2.1.42 Pathology.........................................................................................................15

2.1.43 Patient Entertainment......................................................................................16

2.1.44 Patient Transport – Internal.............................................................................16

2.1.45 Patient Transport – External............................................................................16

2.1.46 Pharmacy.........................................................................................................16

2.1.47 Privileged Visitors............................................................................................17

2.1.48 Property Management and Maintenance.........................................................17

2.1.49 Public and Staff Only Circulation.....................................................................17

2.1.50 Referral and Intake Process............................................................................17

2.1.51 Security............................................................................................................17

2.1.52 Shared Education, Training and Research......................................................17

2.1.53 Smoke Free Environment................................................................................18


2.1.54 Staff Amenities.................................................................................................18

2.1.55 Sub-acute Services..........................................................................................18

2.1.56 Switchboard.....................................................................................................18

2.1.57 Telehealth........................................................................................................18

2.1.58 Therapy Space.................................................................................................18

2.1.59 Tissue Viability and Infection Control...............................................................18

2.1.60 Veteran’s Liaison Service................................................................................18

2.1.61 Videoconferencing/Webcam Capability...........................................................19

2.1.62 Volunteers........................................................................................................19

2.1.63 Waste Management.........................................................................................19

2.1.64 Service Pathway..............................................................................................19

2.1.65 Service Delivery Team.....................................................................................19

3 Appendices............................................................................................................................21

3.1 Outline of Consultation Process...........................................................................21

3.2 Acronyms and Glossary.......................................................................................23

3.2.1 Acronyms.........................................................................................................23

3.2.2 Glossary...........................................................................................................23

3.3 Reference Documents..........................................................................................26


1 IntroductionThe ACT Health Infrastructure Program (HIP) plans for the future health infrastructure requirements of the ACT and regional catchment areas. It focuses on service planning and delivery of major capital works. HIP has delivered a number of capital projects in recent years including developments at the Canberra Hospital and community health centres. The University of Canberra Public Hospital (UCPH) is one of the key major infrastructure projects currently being planned.

UCPH will be located on the University of Canberra campus on the corner of Aikman Drive and Ginninderra Drive. UCPH will form part of a planned network of ACT Health hospitals and facilities designed to meet the needs of our ageing and growing population.

Extensive planning has been undertaken to define the services to be provided at UCPH. This information is publicly available in the Service Delivery Plan and Functional Brief, both of which are available on the ACT Government Time to Talk website.

UCPH will deliver sub-acute care consisting of adult Mental Health inpatient rehabilitation and day services, and adult and geriatric inpatient rehabilitation, day and ambulatory services. UCPH will not have an Emergency Department and will not deliver acute services. Specialist palliative care and psychogeriatric care will not operate from the site.

The development of the new UCPH facilities will enable significant enhancement and increased capacity of adult Mental Health and Rehabilitation, Aged and Community Care (RACC) services in the ACT. It provides the opportunity to develop innovative Models of Care for the future. The proposed future Models of Care have been developed to enhance existing service strengths and address any weakness or gaps in existing service provision. The collocation of a number of services on a standalone site presents the opportunity for new collaboration and integration opportunities with a critical mass of sub-acute care provided from one location.

In order to develop the Model of Service Delivery for UCPH the following planning has been undertaken:

Development of the Adult Mental Health Rehabilitation Unit Model of Care;

Development of the Adult Mental Health Day Service Model of Care;

Development of the Rehabilitation, Aged and Community Care (RACC) UCPH Model of Care (note: this document is part of the current community consultation process);

Review, validation and confirmation of the operational principles for UCPH; and

Preparation of a Transition Roadmap which outlines the initiatives that need to be addressed in order to facilitate the transition of services to the new UCPH facilities.

A Model of Care describes how clinical services are /will be delivered, while, for the purposes of this document, a Model of Service Delivery describes the clinical and non clinical services to support the Model of Care being delivered.

Consultation on the Mental Health services that will be provided at UCPH took place in 2014. The Models of Care relating to these services have now been endorsed. They are provided in the current consultation material for information only and are not for feedback.


2 Model of Service Delivery At this stage in the planning process, clinical and non clinical support services have been identified, but operational details are still to be worked through.

The services listed on the following pages represent the agreed approach to provision of:

facility wide management (e.g. after hours management)

clinical services (e.g. after hours medical cover)

procedures (e.g. emergency code response).

Identifying and consolidating these services will enable optimised and efficient care delivery.

As UCPH will be one of a number of health settings within the Canberra Hospital and Health Services (CHHS) network, the principles underpinning provision of these services are consistent with the operation of the broader CHHS network.

2.1 Service Elements/Activities to support care delivery at UCPH

2.1.1 Aboriginal Liaison Service

Aboriginal Liaison Officers will be based at UCPH during agreed hours. This service will be coordinated through the CHHS Aboriginal Liaison Service. Aboriginal Liaison Officers will access multipurpose space (workspace, lounge and courtyard) when on-site. The model for this service is to be further developed to ensure that it is responsive to future demand.

2.1.2 Access

Public (patient, family/support people, visitors) entry points into the UCPH facilities will be minimised. Entry points will be provided as follows:

Main entrance – access point for Mental Health and RACC inpatient and ambulatory services including hydrotherapy

- The opening hours for the main entrance will be consistent with Canberra Hospital.

- The front reception will be staffed during opening hours of the main entrance.

- After-hours access for inpatients and members of the public will be via the main entrance utilising a ‘call for assistance’ button. The model for response to the after-hours call button is to be developed.

- After-hours entry for staff will be via the main entrance using swipe card access.

- Relevant access information will be provided including Tactile Ground Surface Indicators located at the main entrance (e.g. Braille).


- There may be a second entrance to improve access for persons arriving by public transport.

Dedicated hydrotherapy entry/exit point to enable after-hours access to hydrotherapy only (including access by external users).

Equipment Loan Service (ELS) – access for patients, family/carers, visitors, staff and contractors via a separate pick-up/drop-off entry point which accommodates the flow of clean and dirty equipment. This service will be a satellite service from Village Creek Centre to support UCPH and will have limited opening hours.

Loading dock access for support services (supply, linen, cleaning, pharmacy, pathology, clinical engineering, property management and maintenance).

2.1.3 ACT Records Management

A remote service will be provided by ACT Records Management with ACT Records managed at point of care. ACT Records storage will be provided off-site.

2.1.4 ACT Health Revenue and Financial Services

A remote service will be provided to UCPH with all inpatient election documents and other related files for billing and revenue scanned to a centrally managed revenue and finance service with hard copies to follow.

2.1.5 Admissions

Clinical and clerical admissions will be undertaken within the inpatient units and ambulatory/day services. There will be agreed principles for admission, however, Mental Health and RACC admissions may follow different processes e.g. Mental Health and RACC may follow different processes for finance and billing related issues.

2.1.6 Administration

A facility wide approach to administrative services will include provision of a wide range of support services throughout UCPH. Clinical services will have dedicated administration teams designed to meet the specific needs of each service whilst utilising service wide standard processes where appropriate. Administration staff will report to a professional discipline lead. The provision of administration services will be consistent with the organisation wide approach.

The future function of ward clerks, including role and hours of service, is to be further developed to inform the number of staff required for UCPH.

A centralised booking and scheduling process will be utilised to coordinate the appropriate care team and access to appropriate clinical spaces (room bookings).


2.1.7 After-hours Management

Facility wide after-hours management of UCPH will be undertaken by a clinical staff member. It is proposed that this role be undertaken by an experienced nurse who would undertake a number of roles across the facility including coordination of after-hours requests for admissions and after-hours emergency and maintenance situations. This role will also be the central coordination point for nursing services after-hours e.g. for the management of the deteriorating patient and the provision of clinical support. This model is to be further developed. It is expected that the principles for after-hours management will be consistent across the facility, however Mental Health and RACC will separately manage coordination of relief and casual nursing staff, staff requests and replacement of unplanned personal leave.

2.1.8 After-hours Medical Cover

A facility wide integrated approach to after-hours medical cover for all UCPH inpatients is proposed. This model is to be further developed to address the specific requirements of Mental Health and RACC patients (e.g. on-call psychiatry, urgent medical reviews etc.).

2.1.9 Automated Guided Vehicles (AGVs)

Planning will include space to accommodate the use of AGVs in the future.

2.1.10 Bed Management

A facility wide approach to bed management will be undertaken which is consistent with the broader organisation wide approach. The UCPH Bed Management process will allow Mental Health and RACC to coordinate the movement of patients into and out of inpatient and ambulatory/day services at UCPH. It will facilitate active uptake of patients to the UCPH facilities and will optimise continuum of care. These roles will link closely with existing bed management positions (e.g. with Mental Health Patient Flow Manager, Canberra Hospital Bed Manager). These roles are to be further developed.

2.1.11 Biomedical Engineering

Biomedical Engineering will provide an on-site service including an on-site workshop and storage. Services will be provided by visiting staff from CHHS Biomedical Engineering.

The future model for maintenance of biomedical equipment will be clearly defined and separate to other maintenance services (refer to Central Equipment Store, Equipment Loan Service and Property Management and Maintenance). Biomedical engineering services will be centrally coordinated and scheduled, and will be supported by location based services for equipment tracking.

2.1.12 Body Holding

A full mortuary service is not required. Space for temporary storage of 1 x standard and 1 x bariatric body will be provided.

2.1.13 Booking and Scheduling

A facility wide approach for scheduling patient and clinician appointments and room bookings will be developed. Booking and scheduling will be standardised, integrated and coordinated, and will enable room bookings and relevant clinician bookings to be undertaken efficiently. This system will include dedicated teams to manage Mental Health and RACC clinicians and spaces. It will also enable the booking of rooms for non-clinical functions e.g. shared teaching and learning spaces.


The booking and scheduling system will be developed to ensure the most equitable and efficient use of space and the most appropriate allocation of room bookings (i.e. the size of the room is suited to the number of people using the room; recurring bookings will require regular review to ensure currency; etc.).

The booking and scheduling system will link with a patient flow management system (e.g. integrated multimedia queue management or similar system) notifying patients of appointment times and delays on the day of intervention etc., and to the bed management system and patient transport system.

Note: all shared spaces will be bookable with the exception of the de-escalation room.

2.1.14 Café

The Territory may operate, or permit to be operated, one café or similar from a single location within the hospital to support hospital functions. Detail regarding the café service to be provided is to be developed. The café will be subject to a retail lease managed by Building and Infrastructure, ACT Health.

2.1.15 Cashier/Billing

A central cashier service will not be provided. Cashier/ billing services will be provided remotely consistent with a CHHS wide approach.

Pharmacy will include a data point for Electronic Funds Transfer only.

Secure storage for petty cash will be required, After-hours access will be limited to key individuals.

2.1.16 Central Equipment Store

This store will be separate to the Equipment Loan Scheme (ELS) store which provides loan equipment for UCPH ambulatory patients and inpatients at point of discharge who have trialled the equipment and have a valid referral. Equipment processes for ELS and the Central Equipment Store will be managed separately, however both will ensure that their equipment is monitored, cleaned, repaired, maintained and available as required. This service will be supported by location based services for equipment tracking. A responsive supply of equipment for use by patients in UCPH areas will be provided.

Equipment types will be consistent to ensure uniformity of provision and streamlined management of spare parts etc. Warehouse, cleaning and management will be incorporated into a central data system.

2.1.17 Cleaning

A coordinated facility wide cleaning service will be provided. This will include cleaning of equipment and furniture that are part of the facility. Cleaning services will be provided by an external contractor, and will adhere to the appropriate cleaning standards.

Detail regarding this service is to be developed with respect to the chosen Design Construct Maintain (DCM) contracting model (refer to DCM below).


2.1.18 Clinical Records

It is envisaged that UCPH will adopt a fully electronic clinical record in the future. The electronic record will be consolidated, shareable and patient centric. There may be some use of paper clinical records upon the opening of UCPH.

The Division of Mental Health, Justice Health, and Alcohol and Drug Services (MHJHADS), ACT Health, is currently developing an Electronic Clinical Record (ECR), a new, single, clinical record system to replace the existing Mental Health Assessment Generation Information Collection (MHAGIC) database and paper records.

RACC will also be implementing an ECR, starting with the Community Care Program. The ECR will support the patient journey from referral into the service, through provision of care, to discharge from the service. It will replace paper based clinical records, enabling clinicians to access and enter clinical information electronically in real time regardless of where the service is provided. The ECR will provide a person centred integrated view of clinical encounters and facilitate closer collaboration with other ACT Health services. The ECR implementation for the Walk-in Centres and RACC Community Care Program is occurring in 2015/16. Other RACC services to follow.

There will also be some paper records. Paper records will be digitised upon discharge and possibly at agreed intervals for patients with a longer length of stay (to be determined). Records will be digitised by staff based at the Canberra Hospital and stored on the Clinical Record Information System (CRIS). Paper records that have been digitised will be stored for 3 months (at the Canberra Hospital) for quality assurance purposes. A regular courier service between UCPH and Canberra Hospital will support this process.

2.1.19 Clinical Support Role

The role of clinical support workers/wards persons is currently being reviewed. Wards persons currently undertake the following:

Based within clinical areas – assist with clinical care and manual handling (personal care assistant)

Based external to clinical areas (24 hour service) – provide a portering service and support in response to emergency codes.

The future model for provision of these services is to be developed and may be enhanced to include an expanded range of clinical support services (e.g. pressure injury management and personal care assistance) and other assistant duties (e.g. courier service). The future model will include a facility wide approach to the provision of clinical support and may also include allied health assistant activities and assistants in nursing.

2.1.20 Consultation Liaison Services

There are a range of consultation liaison services that may be provided to patients at UCPH e.g. Consultation Liaison Psychiatry, Alcohol and Other Drug Services, and Pain Management. The model for access to these services is to be further developed.

2.1.21 Consumer Engagement Team

The CHHS Consumer Engagement Team will provide a responsive service for UCPH consumers, receiving feedback and responding to enquiries. The Consumer Engagement Team will have a presence at UCPH supported by a phone line. Detail regarding this model is to be further developed.


2.1.22 Design Construct Maintain (DCM) Contract

The procurement of UCPH will be undertaken utilising a DCM contracting model. This will involve entering into an arrangement for the design and construction of the facility as well as provision of certain longer-term facilities management services (for example this may include building maintenance, utilities management, grounds and gardens and pest control) and soft services (for example this may include cleaning and patient portering).

The delivery of services such as a linen service, property maintenance, medical supplies and other back of house services may be modified from what is described in this document, as the model will be based upon the requirements of the DCM Contractor (to be appointed at a later stage).

2.1.23 Disaster Response

The disaster management coordination and meeting room will be located on the ground floor and will provide an additional Disaster Coordination Room for ACT Health. This room will have video capability and direct links to the Disaster Coordination Room at Canberra Hospital (Building 24). It will also require a number of dedicated lines for external calls in emergency situations, a number of internet/intranet access ports provisioned for computers, and dedicated storage facilities for such a Disaster Coordination Room.

The management of disasters will be in accordance with the broader CHHS plan.

2.1.24 Duress Response

Clinical support staff will provide the first line response to mobile and fixed duress alarms. On-site security staff will also respond to alarms and provide back-up if necessary. This model is to be further developed.

2.1.25 Emergency Code Response

A facility-wide response to emergency codes, including response by an appropriately skilled team will be developed. Emergency calls will emanate from appropriately located emergency call buttons. It is anticipated that the skilled team will receive calls via mobile paging devices.

Given the nature of the UCPH facility, it is likely that the response model will include features of the existing Canberra Hospital and Community Health Centre response models.

2.1.26 Equipment Loan Service (ELS)

ELS will provide equipment services to UCPH patients only.

The existing ELS service (based at the Village Creek Centre) will provide mobility and Activities of Daily Living (ADL) equipment to eligible UCPH ambulatory patients and inpatients at point of discharge for short term loan. In order to provide this service to UCPH patients, ELS will have a satellite space at UCPH.

This store will be separate to the Central Equipment Store which provides loan equipment for use by UCPH inpatients, day and sessional patients at UCPH. Equipment tracking, cleaning and maintenance will be managed in line with current business practice ensuring that all equipment is appropriately monitored, cleaned, repaired, maintained and is available as required. This service will be supported by location based services for equipment tracking.


2.1.27 Food Services

People in the Mental Health Rehabilitation Unit will be encouraged to prepare their own meals. Where clinically indicated people who are not able to do this will be able to access meals via an electronic ordering system. Morning, afternoon tea and supper supplies will be provided to the Mental Health Rehabilitation Unit for self service.

People in the Rehabilitation and Aged Care inpatient units will order or be assisted to order meals via an electronic ordering system. Morning, afternoon tea and supper will also be provided in the dining room.

Meals will be served to patients in their bedrooms by exception.

People who attend the Mental Health and Rehabilitation and Aged Care day admission program will be offered a lunch box type meal in the ambulatory services dining room. Morning and afternoon tea will also be provided in the dining room. Water fountains will be available.

The food service will provide special and modified meals and snacks as required for inpatients and ambulatory services patients e.g. culturally appropriate food, texture modified food, thickened fluids and for special events.

2.1.28 Front Reception

There will be a single reception point at the main entrance for all people visiting UCPH. The front reception will be staffed during agreed main entrance opening hours.

2.1.29 Hydrotherapy

Hydrotherapy may be accessed by Mental Health and RACC patients at UCPH and other patients/users as detailed within the RACC UCPH Model of Care.

2.1.30 Information and Communications Technology (ICT)

ICT provisions will include a consolidated, shareable, patient centric health record as well as other health technologies to enable more efficient and effective work practices and mechanisms to efficiently manage support services e.g. use of mobile devices to access information rather than returning to a centrally based computer, and equipment and patient tracking using RFID and standardised supply chain processes.

Future ICT provisions will also include facilities for consumers enabling access to electronic health records and systems to allow completion of forms and changes to appointment times.

2.1.31 Linen Service

A facility wide linen service will be provided using a linen trolley exchange service provided by an external contractor. Linen will be delivered from the loading dock to point of use by the external contractor. On-site storage for emergency back-up linen supplies will be provided.

The facility wide linen service will not clean people’s personal items. People in the AMHRU will be encouraged to launder their personal items where appropriate. Laundry facilities will be provided within the unit.


2.1.32 Mailroom

As it is envisaged that the volume of mail will be small, a dedicated space for the mailroom will not be required. Incoming and outgoing mail will be sorted within the front reception area and collected and delivered to relevant areas within UCPH by a courier service (the details of this service are to be further developed).

2.1.33 Management of the Unwell Patient

Safe management of a deteriorating patient at UCPH will be undertaken as follows:

Medical emergency (e.g. acute coronary or cerebral event) – UCPH will not have a Medical Emergency Team (MET), however, will have a first response team for which an operational model is to be developed.

Non-urgent deterioration (e.g. increased pain, increased agitation) – assessment, intervention and monitoring by medical and nursing staff within the patient’s clinical area.

2.1.34 Manual Handling

Manual handling will be undertaken in accordance with ACT Health wide policy and procedures. This will be enabled by the inclusion of height adjustable desks and work stations in clinical and administrative areas as well as the inclusion of ceiling mounted and mobile lifters throughout clinical areas as follows:

Mental Health areas will not have ceiling mounted hoists.

RACC standard single bedrooms to have ceiling track between bed and ensuite (250kg load capacity).

RACC ‘special’ bedrooms to have ceiling track between bed and ensuite (250kg load capacity for all except 1 x 450kg).

RACC 2 bed inpatient rooms to have ceiling track between bed and bedside chair (250kg weight capacity).

Hydrotherapy area to have 1 ceiling mounted hoist (250kg weight capacity) and floor mounted (450kg weight capacity).

RACC ambulatory services to have ceiling mounted hoist in 1 x treatment room and 1 x multipurpose consult room.

Clinical Technology Workshop Space to have ceiling mounted hoist.

Mobile lifters may be used within Mental Health and RACC inpatient and ambulatory services areas.

2.1.35 Medical Gases

Reticulated medical gases (oxygen and suction) will be provided in all bedrooms in the RACC inpatient units.

Reticulated medical gases are not required in the gymnasium and ambulatory spaces or in Mental Health bedrooms. Portable oxygen may be used throughout the inpatient areas.

Portable oxygen and suction will be stored with the Automated External Defibrillator (AED) units on the inpatient units and in ambulatory areas.


The supply of portable medical gases will be managed by a support role which is to be confirmed e.g. Wards Persons (clinical support role).

Reticulated medical gases (oxygen, suction and air) will also be provided in the Biomedical Engineering workshop.

2.1.36 Medical Imaging

On-site plain X-ray and video fluoroscopy will be provided for UCPH patients during scheduled sessions. It is currently envisaged that video fluoroscopy services will operate Monday – Friday during agreed hours.

An afterhour’s plain X-Ray service may be provided via an on-call radiographer service.

Remote reporting will be undertaken from the Canberra Hospital. Timely reporting will support the continuum of care.

The transfer of patients off-site for medical imaging services (e.g. Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) or after-hours services) will be undertaken via a coordinated process and clear pathway which minimises the wait time for patients.

2.1.37 Medical Supplies

A facility wide approach to provision of supplies will be adopted. General supply services will include sterile stock. Provision of supplies will be based on an imprest system with delivery of supplies direct to the point of use.

There will be minimal on-site storage of supplies.

Detail regarding this service is to be developed with respect to the chosen DCM contracting model.

2.1.38 Multi-faith Service

A multi-faith room will be provided centrally within UCPH and be accessible for patients, staff, support people and visitors 24 hours a day, seven days a week. The multi-faith service will provide physical, social, emotional and spiritual care and support to patients, staff and visitors of UCPH.

Multi-faith staff will be based at UCPH and coordinated through the Canberra Hospital service. Visiting multi-faith staff will have access to counselling rooms, office space and change facilities. Multi-faith staff will have access to clinical records in order to record their input, however, will not be able to read the clinical record. This service will be supported by volunteers.

2.1.39 Nurse Call System

A nurse call system will be utilised within inpatient areas activated by a button at the bedside, in a toilet or shower area (in ensuite rooms) which alerts nursing staff via the nurse annunciator panel or mobile paging devices carried by nursing staff if a patient requires attendance. This system will be implemented in accordance with the AS3811 standards for Nurse Call and Healthcare Communication Systems.

Refer to section 2.1.25 for Emergency Code Response.

Out of bed sensors will be utilised and will integrate with the Nurse Call System or will issue alarms via wireless paging devices.


2.1.40 Office Accommodation

Office accommodation at UCPH will be provided based on the ACT Health Office & Facilities Accommodation Policy.

2.1.41 Parking

Staff, government vehicle, public and accessible parking will be provided by the University of Canberra, however, nominated on-site pick-up and drop-off bays will also be provided (including accessible parking, ambulance parking and bike parking).

2.1.42 Pathology

Pathology collection will be undertaken within the inpatient units (for inpatients) or in the pathology collection area located adjacent to ambulatory services (for ambulatory services patients). Pathology collection will be undertaken by ACT Pathology staff (based at Canberra Hospital) during agreed hours from Monday to Friday. A pathology courier service, transporting specimens to Canberra Hospital, will be scheduled at agreed times to ensure timely assessment of specimens.

The demand for pathology collection is expected to be relatively low. After-hours pathology collection will be undertaken by clinical staff. If clinically indicated an after-hours courier service will transport specimens to Canberra Hospital for analysis.

Point of care testing may be utilised for monitoring glucose levels and INR levels (International Normalised Ration, which provides a standardised method of reporting the effects of an oral anticoagulant such as warfarin on blood clotting).

Pathology collection will be provided for UCPH patients only.

2.1.43 Patient Entertainment

Bedside televisions with ‘free to air’ channels will be provided throughout RACC inpatient units. Televisions will also be available in patient lounges and AMHRU pod lounges.

Bedside televisions will not be provided within the Adult Mental Health Rehabilitation Unit (televisions to be provided within central living spaces only).

2.1.44 Patient Transport – Internal

A facility wide internal patient transport system will be provided to assist patients to move around UCPH. As noted previously under ‘Clinical Support Role’, the model for this service is currently being reviewed and is to be developed.

2.1.45 Patient Transport – External

A facility wide external patient transport system will be developed. External patient transport services will include:

Emergency patient transport via ACT Ambulance Service;

Non-urgent inpatient transport (e.g. for admission and for off-site appointments) – model to be developed;


Non-urgent transport for ambulatory services patients attending the facility – this service will be provided through external providers (e.g. volunteer transport, ACTION buses and Territory and Municipal Services).

2.1.46 Pharmacy

On-site pharmacy services will be comprised of:

Pharmacy staff embedded within the Mental Health and RACC multi-disciplinary teams including participation in ward rounds (clinical service);

Integrated support services for UCPH patients including supply of medication to inpatient units (to automated dispensing machines and to patient bedside lockers) via a regular courier service and supply of discharge medications (supply service).

When clinically indicated, self management of medication will be encouraged as part of each patient’s rehabilitation program. Pharmacy supply may include the provision of some medication in Webster packs as well as original packaging to support self-management of medication. This will be enabled through the storage of individual patient medication in locked bedside lockers. Each Unit will store S8 medication via each unit’s medication storage area according to legislative requirements.

The clinical and supply components of the pharmacy service will incorporate pharmacists and support staff e.g. technicians will assist in undertaking medication reconciliation (review of medication changes along a care pathway) and review of medications for inpatients and the home medicine review program.

A seven day pharmacy service is proposed to support efficient care provision for patients including weekend admissions and discharges. After-hours medication may be accessed from the after-hours medicine automated dispensing machine and an after-hours on-call service will be provided by arrangement with the CHHS Pharmacy service.

2.1.47 Privileged Visitors

Privileged visitors include Official Visitors, the Public Advocate and the Health Services Commissioner. Privileged visitors may visit the AMHRU and AMHDS at UCPH at a time of their choosing to discharge their legislative functions.

2.1.48 Property Management and Maintenance

Detail regarding this service is to be developed with respect to the chosen DCM contracting model. Maintenance services will be centralised, coordinated, and scheduled.

2.1.49 Public and Staff Only Circulation

There will be clear separation of public and staff only circulation areas (vertical and horizontal).

2.1.50 Referral and Intake Process

A seamless facility wide process for acceptance of referrals and intake will be established, consistent with the ACT wide approach. Mental Health and RACC will manage their referral and intake through separate processes. This function is to be developed and will include administrative and clinical functions. The referral and intake process will be supported through ICT infrastructure and will be linked to the booking and scheduling system.


2.1.51 Security

A facility wide approach to security services will be provided at UCPH and include the following:

Security Operations – contracted service, providing 24 hour surveillance, incident response and staff escorts to car park; and

Security Administration – ACT Health service providing access control, security passes, drop safe for patient valuables, management of lost property etc. in partnership with front reception.

The response to security related emergency codes will be a dual response with Wards Persons (clinical support role). This response will be coordinated with clear delineation of roles and responsibilities.

2.1.52 Shared Education, Training and Research

The shared Education, Research and Meeting Facilities will consist of formal and informal teaching and learning space (commons), including simulation space and research space. These areas will be accessible by UCPH staff and students and staff and students from other ACT Health facilities, University of Canberra Faculty of Health staff and students as well as external institutions as agreed (e.g. other service providers and universities).

2.1.53 Smoke Free Environment

The UCPH campus will be a smoke free environment.

2.1.54 Staff Amenities

Staff amenities will be provided as per the Australasian Health Facility Guidelines (a combination of centralised and decentralised facilities).

2.1.55 Sub-acute Services

UCPH as a sub-acute facility will accommodate patients that are of a lower medical acuity. The provision of some acute care may be provided where clinically indicated e.g. intravenous antibiotics and blood transfusion.

2.1.56 Switchboard

The switchboard function for UCPH will be provided by a desktop PABX. The UCPH switchboard will have the capacity to accept Canberra Hospital main telephone number calls, and the Canberra Hospital switchboard will be able to accept UCPH main telephone number calls in the event of telephony failure at either site.

2.1.57 Telehealth

Telehealth will be used for a range of functions including the provision of care for patients at UCPH as well as the provision of care for patients who are off-site. Telehealth will also be used for a range of teaching and training activities.


2.1.58 Therapy Space

Mental Health and RACC services will have dedicated therapy space for inpatient and ambulatory services. There may be some sharing of the ambulatory services including the gymnasium, therapeutic outdoor space and hydrotherapy pool as clinically appropriate.

2.1.59 Tissue Viability and Infection Control

It is proposed that a range of specialist skills (e.g. tissue viability and infection control) be provided at UCPH through structured training programs such as the existing tissue viability training program i.e. UCPH staff would be invited to indicate an expression of interest to participate in a CHHS training program and would return to their clinical role at UCPH with specialist skills. This model is to be developed.

The future Infection Prevention and Control service at UCPH would likely be supported by the Canberra Hospital Infection Prevention and Control Unit e.g. in the event of an outbreak at UCPH. Infection control services will be consistent with the ACT Health wide approach.

2.1.60 Veteran’s Liaison Service

The CHHS Veteran’s Liaison Service, based at Canberra Hospital, will provide a visiting service to eligible UCPH inpatients. The visiting Veteran’s Liaison Officer will access shared bookable workspace and meeting space. The volunteer service will support this function e.g. visits to Veterans.

2.1.61 Videoconferencing/Webcam Capability

Videoconferencing/webcam capability will be utilised for a number of functions including:

Mental Health Tribunal and Guardianship Board Hearings (for consumers at UCPH to attend hearing remotely); and

Simulation learning sessions into and out of UCPH General meetings.

2.1.62 Volunteers

It is envisaged that UCPH will be supported by an extensive group of volunteers providing a range of services including a volunteer concierge/way finding service. Volunteers will also undertake a range of activities throughout the facility including within clinical areas.

Volunteers will be based within the main entrance and operate a shop-front service. Detail regarding this service is to be developed.

2.1.63 Waste Management

Detail regarding this service is to be developed with respect to the chosen DCM contracting model.

2.1.64 Service Pathway

The facility wide services described in this document will be provided as routine aspects of running the facility e.g. food services, cleaning and waste management.

Other services will be provided to patients as clinically indicated and directed by the multi-disciplinary care team or requested by the patient and their family/support people e.g. pathology, medical imaging, patient transport, Veteran’s Liaison Service, multi-faith services. Mechanisms for


requesting these services will be coordinated, integrated and supported by an ICT system to enable efficient delivery of services.

2.1.65 Service Delivery Team

The service delivery team for these services and procedures will include a wide range of clinical, clinical support and non-clinical support staff including:

Aboriginal Liaison Service;

Administration/reception (including booking and scheduling, mail room and switchboard);

Allied health;

Allied health assistants;

Biomedical engineering;

Cleaning, waste management, supply, food services and maintenance;

Clinical records;

Clinical Support Worker/Wards Persons;

Consumer Engagement Team;

ICT;

Medical;

Multi-faith;

Nursing;

Peer workers;

Pharmacy;

Pathology;

Radiography (present during scheduled sessions);

Recovery support officers;

Security;

Students;

Veteran’s Liaison Service; and

Volunteers.


3 Appendices3.1 Outline of Consultation ProcessThe UCPH Model of Service Delivery has been developed in consultation with key ACT Health representatives through the following consultation process:

Three Reference Group (RG) meetings (30 July 2014, 13 October 2014, 28 January 2015).

Four rounds of User Group (UG) meetings

- 30-31 July 2014 to profile the current RACC activities;

- 1 October 2014 to develop the RACC UCPH Model of Care;

- 10-11 December 2014 to develop the RACC UCPH Model of Care; and

- 14-15 January 2015 to develop the Model of Service Delivery and Transition Roadmap for UCPH.

Targeted consultation undertaken by ACT Health to develop the future RACC Model of Care for UCPH inpatients and ambulatory services (27 October 2014 – 21 November 2014).

Out of session feedback/clarification.

Note: the above consultation process have informed both the development of the UCPH Model of Service Delivery, the Roadmap for Transition of Services to UCPH and the RACC UCPH Model of Care. A separate consultation process has been undertaken to inform development of the Adult Mental Health Rehabilitation Unit and Adult Mental Health Day Service Models of Care.

Membership of the RG and UGs included:

Executive Director, RACC, CHHS;

Executive Director, Clinical Support Services, CHHS;

Director of Nursing, Clinical Support Services, CHHS;

Senior Manager Security Operations, Business and Infrastructure, Strategy and Corporate;

Director Logistic Support, Business and Infrastructure, Strategy and Corporate;

Executive Director, Mental Health, Justice Health and Alcohol and Drug Services, CHHS;

Director Geriatric Medicine, RACC, CHHS;

Director Rehabilitation Medicine, RACC, CHHS;

Director of Nursing and Assistant Director of Nursing RACC, CHHS;

Director Acute Support, Clinical Support Services, CHHS;

Director Allied Health, RACC, CHHS;

Director Client Support Services, RACC, CHHS;

Director Community Care Program, RACC, CHHS;

Assistant Director Client Services, Security and Emergency, Business and Infrastructure, Strategy and Corporate;


Clinical Nurse Consultant, 12B, RACC, CHHS;

Clinical Nurse Consultant Rehabilitation Independent Living Unit, RACC, CHHS;

Clinical Nurse Consultant Acute Care of the Elderly, RACC, CHHS;

Rehabilitation Nurse Practitioner, RACC, CHHS;

Physiotherapy Clinical Educator, RACC, CHHS;

Manager Speech Pathology, RACC, CHHS;

Manager Occupational Therapy, RACC, CHHS;

Manager Physiotherapy, RACC, CHHS;

Manager Community Care Physiotherapy, RACC, CHHS;

Manager Psychology and Counselling, RACC, CHHS;

Manager Social Work, RACC, CHHS;

Manager Exercise Physiology, RACC, CHHS;

Manager Aboriginal Liaison Officer Service, Clinical Support Services, CHHS;

Manager Pathology Collections; Pathology, CHHS;

Rehabilitation Care Coordinator, RACC, CHHS;

Manager Transitional Therapy and Care Program, RACC, CHHS;

Manager and other nominees, Clinical Support Services, CHHS;

Volunteer Manager Client Services, Security and Emergency, Business and Infrastructure, Strategy and Corporate;

Manager E-Health and Clinical Records, E-Health and Clinical Records, Strategy and Corporate;

Operational Director ACT-Wide Mental Health Service, Mental Health, Justice Health and Alcohol and Drug Services, CHHS;

Clinical Nurse Consultant, Brian Hennessy Rehabilitation Centre, Mental Health, Justice Health and Alcohol and Drug Services, CHHS;

Consumer representatives, ACT Mental Health Consumer Network;

Program Manager, ACT Mental Health Consumers Network

Clinical Director ACT-Wide Mental Health Service, Mental Health, Justice Health and Alcohol and Drug Services, CHHS;

Team Leader Adult Mental Health Day Service, Mental Health, Justice Health and Alcohol and Drug Services, CHHS;

Representatives, Carers ACT;

Project Officer, Mental Health, Justice Health and Alcohol and Drug Services, CHHS;

Project Officers, Healthcare Consumers Association;

Consumer representatives, Healthcare Consumers Association; and

Project Officers and Manager, Health Services Planning Unit, HIP.

In addition to the above consultation, a literature review was undertaken to inform targeted consultation and development of the RACC UCPH Model of Care. The literature review included review of a number of relevant Australian and international model of care documents.


Reference documents utilised in developing this document are outlined in Section 4.3.

3.2 Acronyms and Glossary

3.2.1 Acronyms

Acronym Meaning

ACTPAS ACT Patient Administration System

ADL Activities of Daily Living

AED Automate External Defibrillator

AMHDS Adult Mental Health Day Service

AMHRU Adult Mental Health Rehabilitation Unit

CHHS Canberra Hospital and Health Services

CRIS Clinical Record Information System

CSP Clinical Services Plan

CT Computed Tomography

ECR Electronic Clinical Record

EP Exercise Physiology

ELS Equipment Loan Service

GEM Geriatric Evaluation and Management

MHJHADS Mental Health Justice Health and Alcohol and Drug Service

MoC Model of Care

MoSD Model of Service Delivery

MRI Magnetic Resonance Imaging

RACC Rehabilitation, Aged and Community Care

RG Reference Group

SDP Services Delivery Plan

UCPH University of Canberra Public Hospital

UG User Group

3.2.2 Glossary

Key terms relevant to the Model of Service Delivery for UCPH are defined below.

Acute Care

An episode of acute care for an admitted patient is one in which the principal clinical intent is to do one or more of the following:

Cure illness or provide definitive treatment of injury;


Perform surgery;

Relieve symptoms of illness or injury (excluding palliative care);

Reduce severity of illness or injury;

Protect against exacerbation and/or complication of an illness and/or injury which could threaten life or normal functions;

Perform diagnostic or therapeutic procedures; and

Manage labour (obstetric).

Admitted Services

Admitted services are those which are provided to patients who require formal admission to hospital and care within a hospital bed. Care provision may be overnight or day only.

Ambulatory Services

Ambulatory services are health services provided on an outpatient basis to patients who attend a hospital or health care facility and depart after treatment on the same day.

Ambulatory services at UCPH will include Mental Health day services and RACC day programs and sessional therapy.

Care Plan

A care plan is a patient-centred plan agreed to with the patient and their family/support people with the clinicians. It will identify care/treatment goals and timeframes, intensity of therapy required and the multi-disciplinary team members or inreach services required.

Community Based Services

A range of community-based health services for people of any age including a range of technical nursing services, allied health services, health promotion and self management of chronic conditions. Service provision may be health centre based or provided within a range of community settings e.g. patient homes, workplaces and public spaces.

Consultation Liaison Services

Consultation liaison services provide consultation services to RACC or Mental Health Justice Health and Alcohol and Drug Service (MHJHADS) patients when necessary.

Geriatric Services

The provision of care for patients who have conditions associated with ageing. Care provision is typically provided for patients over the age of 65 years or over the age of 50 years for Aboriginal and Torres Strait Islander peoples, however, younger patients may be seen if they have a condition which is associated with the ageing process. Patients aged above 65 years or 50 years for Aboriginal and Torres Strait Islander peoples may access a range of clinical services of which geriatric services are one.


Inpatient Services

Inpatient overnight services are provided to patients whose condition requires formal admission to hospital. Patients receiving inpatient care require care within the hospital overnight in order to treat their condition and/or safely undertake activities of daily living.

Note: there are some inpatient services with the patient does not reside in the hospital e.g. Hospital in the Home (HITH).

Model of Care

The Model of Care describes how clinical services are/will be delivered to a patient or client.

The focus of the Model of Care description is on direct clinical service provision, however, aspects of support services which are integral to care provision (e.g. information and communications technology and administration/booking/scheduling) are also described as part of the Model of Care.

Model of Service Delivery

For the purposes of this document a Model of Service Delivery describes the clinical and non clinical support services to support the Model of Care being delivered.

This document outlines the Model of Service Delivery for services to be provided at UCPH broadly.

Non-admitted Services

Non-admitted services are those provided to patients who do not undergo a formal admission process and do not occupy a hospital bed. For example, services provided by hospitals:

In hospital outpatient clinics;

In community based clinics; and

In patients’ homes.

Rehabilitation

Rehabilitation is the provision of care that aims to:

Restore functional ability for a person following a period of illness or injury

Enable restoration of function consistent with pre-injury/illness status and the constraints of the medical prognosis; and

Develop compensatory functional skills to address deficits that cannot be reversed

Sub-acute Care

Sub-acute care for RACC patients is the provision of specialised multi-disciplinary care in which the primary need for care is optimisation of patient functioning and quality of life. A person’s functioning may relate to their whole body or a body part, the whole person, or the whole person in a social context, and to impairment of a body function or structure, activity limitation and/or participation restriction.

Sub-acute care for Mental Health is the provision of care for people with moderate to severe mental illness not requiring ongoing acute services. It has a focus on the enhancement of a person’s quality of life and or improvement in their functional status through the engagement in a


variety of rehabilitation services. Sub-acute care will assist people to develop their capacity to live successfully in the community and provide foundations for continued recovery.

UCPH will be a sub-acute facility providing adult rehabilitation and Geriatric Evaluation and Management (GEM). Palliative care and psychogeriatric care will not be provided. Emergency Department and other acute services will not operate from the site.

3.3 Reference DocumentsReference documents that have informed the development of this report include:

ACT Health Strategy and Corporate, eHealth & Clinical Records, 6/2/13, V1.1.

ACT Health Clinical Services Plan 2014-2018 Draft March 2014.

ACT Health Ambulatory Care Framework 2012.

Directions Paper – A Professional Approach to Administration Support to Ambulatory Care Services, April 2014.

Service Models and Projected Service Demand for Adult Rehabilitation and Aged Care Services 9/10/12, Christopher Poulos.

Subacute Planning Workshop 9/11/12 (dated 4/1/13), Christopher Poulos.

ACT Health Community Health Centres Model of Care Part 1 October 2009, V3.1.

ACT Health Community Health Centres Model of Care Part 2 September 2009, V4.

Towards Culturally Appropriate and Inclusive Services – a Co-ordinating Framework for ACT Health 2014-2018.

Health Directorate Reconciliation Action Plan 2012 – 2015.

University of Canberra Public Hospital Services Delivery Plan, 28 August 2013.

ACT Health Workforce innovation in sub-acute care speciality services: a literature review, November 2013.

ACT Health University of Canberra Public Hospital (UCPH) Workforce Innovation Forum 13 December 2013, Record of Discussion.

University of Canberra Public Hospital (UCPH) workforce planning workshop overview: Rehabilitation and Aged Care, 6 June 2014, Record of Meeting.

NSW Health Guide to Role Delineation of Health Services, Third Edition 2002, available at http://www.health.nsw.gov.au/services/Publications/guide-role-delineation-health-services.pdf).


http://www.health.nsw.gov.au/services/Publications/guide-role-delineation-health-services.pdf

http://www.health.nsw.gov.au/services/Publications/guide-role-delineation-health-services.pdf