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Jess Rojas, Christina Antonas & Sinead Tierney, St George Hospital - Bright Eyes - A Collaborative Approach to Caring for Mothers and Children
Jess Rojas, Christina Antonas & Sinead Tierney, St George Hospital - Bright Eyes - A Collaborative Approach to Caring for Mothers and Children
Jess Rojas, Christina Antonas & Sinead Tierney, St George Hospital - Bright Eyes - A Collaborative Approach to Caring for Mothers and Children
Jess Rojas, Christina Antonas & Sinead Tierney, St George Hospital - Bright Eyes - A Collaborative Approach to Caring for Mothers and Children
Jess Rojas, Christina Antonas & Sinead Tierney, St George Hospital - Bright Eyes - A Collaborative Approach to Caring for Mothers and Children
Jess Rojas, Christina Antonas & Sinead Tierney, St George Hospital - Bright Eyes - A Collaborative Approach to Caring for Mothers and Children
Jess Rojas, Christina Antonas & Sinead Tierney, St George Hospital - Bright Eyes - A Collaborative Approach to Caring for Mothers and Children
Jess Rojas, Christina Antonas & Sinead Tierney, St George Hospital - Bright Eyes - A Collaborative Approach to Caring for Mothers and Children
Jess Rojas, Christina Antonas & Sinead Tierney, St George Hospital - Bright Eyes - A Collaborative Approach to Caring for Mothers and Children
Jess Rojas, Christina Antonas & Sinead Tierney, St George Hospital - Bright Eyes - A Collaborative Approach to Caring for Mothers and Children
Jess Rojas, Christina Antonas & Sinead Tierney, St George Hospital - Bright Eyes - A Collaborative Approach to Caring for Mothers and Children
Jess Rojas, Christina Antonas & Sinead Tierney, St George Hospital - Bright Eyes - A Collaborative Approach to Caring for Mothers and Children
Jess Rojas, Christina Antonas & Sinead Tierney, St George Hospital - Bright Eyes - A Collaborative Approach to Caring for Mothers and Children
Jess Rojas, Christina Antonas & Sinead Tierney, St George Hospital - Bright Eyes - A Collaborative Approach to Caring for Mothers and Children
Jess Rojas, Christina Antonas & Sinead Tierney, St George Hospital - Bright Eyes - A Collaborative Approach to Caring for Mothers and Children
Jess Rojas, Christina Antonas & Sinead Tierney, St George Hospital - Bright Eyes - A Collaborative Approach to Caring for Mothers and Children
Jess Rojas, Christina Antonas & Sinead Tierney, St George Hospital - Bright Eyes - A Collaborative Approach to Caring for Mothers and Children
Jess Rojas, Christina Antonas & Sinead Tierney, St George Hospital - Bright Eyes - A Collaborative Approach to Caring for Mothers and Children
Jess Rojas, Christina Antonas & Sinead Tierney, St George Hospital - Bright Eyes - A Collaborative Approach to Caring for Mothers and Children
Jess Rojas, Christina Antonas & Sinead Tierney, St George Hospital - Bright Eyes - A Collaborative Approach to Caring for Mothers and Children
Jess Rojas, Christina Antonas & Sinead Tierney, St George Hospital - Bright Eyes - A Collaborative Approach to Caring for Mothers and Children
Jess Rojas, Christina Antonas & Sinead Tierney, St George Hospital - Bright Eyes - A Collaborative Approach to Caring for Mothers and Children
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Jess Rojas, Christina Antonas & Sinead Tierney, St George Hospital - Bright Eyes - A Collaborative Approach to Caring for Mothers and Children

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Jess Rojas, Christina Antonas & Sinead Tierney, St George Hospital delivered the presentation at the 2014 Discharge Planning Conference. …

Jess Rojas, Christina Antonas & Sinead Tierney, St George Hospital delivered the presentation at the 2014 Discharge Planning Conference.

The 2014 Discharge Planning Conference - Assisting health services to adopt an integrated and consumer directed approach to discharge planning.

For more information about the event, please visit: http://bit.ly/dischargeplan14

Published in: Health & Medicine
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  • 1. Jess Rojas Project Manager Women’s and Children’s Health Model of Care Project “Bright Eyes - A Collaborative Approach to Caring for Mothers and Children” Project Manager Sinead Tierney and Christina Antonas Team Leaders Women’s and Children’s Health Social Work St George Hospital July 2014 Jess Rojas Project Manager – Social Worker Women’s and Children’s Health Model of Care Project A Collaborative Approach to Caring for Mothers and Children” Project Manager – Social Worker Sinead Tierney and Christina Antonas Team Leaders Women’s and Children’s Health Social Work St George Hospital July 2014
  • 2. Bright Eyes - A Collaborative Approach to Caring for Mothers and Children COLLABORATION OPENNESS RESPECT EMPOWERMENT A Collaborative Approach to Caring for Mothers and Children COLLABORATION OPENNESS RESPECT EMPOWERMENT
  • 3. St George Hospital NSW  St George Hospital (SGH) - Health District, Southern Sector  A major trauma and teaching hospital in NSW  2nd busiest Emergency Department in NSW  44 full time social work positions  The St George Area of Sydney is one of the most culturally diverse areas in NSW St George Hospital NSW South East Sydney Local Health District, Southern Sector A major trauma and teaching hospital in NSW busiest Emergency Department in NSW 44 full time social work positions The St George Area of Sydney is one of the most culturally
  • 4. Social Work in Women’s and Children’s Health  2500 births in 2013  SGH is a high risk birthing unit  Team of 3 full time Social Work positions Team of 3 full time Social Work positions  Paediatric ward, Antenatal clinics, Postnatal ward, Gynaecology ward, Special Care Nursery Social Work in Women’s and Children’s Health SGH is a high risk birthing unit Team of 3 full time Social Work positionsTeam of 3 full time Social Work positions Paediatric ward, Antenatal clinics, Postnatal ward, Special Care Nursery
  • 5. Reasons for referral to Women’s and Children’s Social Work Team  Child protection – drug and alcohol, mental health, domestic violence (DV)  Domestic violence  Young parents  Adoption  Sexual assault /trauma/refugees  Significant anxiety and adjustment issues regarding pregnancy and parenthood Reasons for referral to Women’s and Children’s Social Work Team drug and alcohol, mental health, /trauma/refugees anxiety and adjustment issues regarding
  • 6. Reasons for referral to Women’s and Children’s Social Work Team  Recent bereavement  Stillbirth/miscarriage /foetal abnormality  Poor prognosis/new diagnosis/disability Poor prognosis/new diagnosis/disability  Relationship breakdown  Significant social isolation, limited supports  Homelessness Reasons for referral to Women’s and Children’s Social Work Team Stillbirth/miscarriage /foetal abnormality Poor prognosis/new diagnosis/disabilityPoor prognosis/new diagnosis/disability Significant social isolation, limited supports
  • 7. Background  An increase in birth rate (approximately 25% over 10 years) at SGH and NSW Government policy protection and domestic violence significantly the Social Work role in Women’s and Children’s Health.  Social Work staff needed to be enhanced to the increasing antenatal outpatient caseload  Statutory requirements were unable to be met due to the high volume of inpatient and outpatient referrals. Background rate (approximately 25% over 10 years) at SGH and NSW Government policy changes for child protection and domestic violence significantly increased Women’s and Children’s Health. staff needed to be enhanced to keep up with antenatal outpatient caseload. Statutory requirements were unable to be met due to the high volume of inpatient and outpatient referrals.
  • 8. Background  Antenatal outpatients were left on a wait list of up to 3 months before they received Social Work intervention  The average response to referrals was 2 - 8 weeks  56% of waitlist cases had Statutory requirements Background
  • 9. How could we demonstrate the need for enhancement in this current budgetary climate?  Difficult to secure any additional funding for enhancements  Model of Care Project Model of Care Project I. Evidence based practice II. Keeping accurate stats III. Business plan How could we demonstrate the need for enhancement in this current budgetary climate? Difficult to secure any additional funding for enhancements
  • 10. Outline of Project  The 6 month Model of Care (MOC) project reviewed activity and demand in this clinical area.  It has informed service delivery priorities so patients have greater access to high quality antenatal and inpatient care.  This innovative MOC enabled a new exclusive Antenatal Project Manager position to be trialled, offering specialised intervention to high risk women, in collaboration with midwifery staff and other hospital and community partners.  A new weekend Social Work service was also piloted as part of this MOC project, exclusively for Women’s and Children’s Health patients. Outline of Project 6 month Model of Care (MOC) project reviewed activity and demand in this clinical area. has informed service delivery priorities so patients have to high quality antenatal and inpatient care. This innovative MOC enabled a new exclusive Antenatal Project Manager position to be trialled, offering specialised intervention to high risk women, in collaboration with midwifery staff and other hospital and community partners. A new weekend Social Work service was also piloted as part of this MOC project, exclusively for Women’s and
  • 11. Goals of the Project  Create a 7 day week service ensuring continuity of care for patients  Positive impact on patient care and safety  Patients have greater access to high quality antenatal and inpatient careinpatient care  Reduce unnecessary length of stay  Safer and quicker discharge for Midwifery Support Program  Increase weekend and Monday discharges  Positive impact on patient flow in meeting NEAT & NEST targets Goals of the Project Create a 7 day week service ensuring continuity of care for Positive impact on patient care and safety access to high quality antenatal and Reduce unnecessary length of stay Safer and quicker discharge for patients eligible for Increase weekend and Monday discharges Positive impact on patient flow in & NEST targets
  • 12. Goals of the project  Decrease wait list for Antenatal women requiring Social Work services  Meet all Statutory requirements in accordance with NSW Health, Child Protection and Domestic Violence Policies  Improve multidisciplinary team work Improve multidisciplinary team work  Formalise partnerships with various community agencies  Creation and implementation of innovative ideas  Collect & analyse data on social work referrals, interventions and typology Goals of the project Decrease wait list for Antenatal women requiring Social all Statutory requirements in accordance with NSW Health, Child Protection and Domestic Violence Policies Improve multidisciplinary team workImprove multidisciplinary team work Formalise partnerships with Child Protection Services and community agencies Creation and implementation of innovative ideas Collect & analyse data on social work referrals,
  • 13. Outcomes of Weekend Service  Weekend referrals to SW increased by 56.4%  We demonstrated that this service facilitated the discharge of 67 patients on a weekend or Monday morning, over the 6 month trial period.  There was a total potential saving of $46,854 There was a total potential saving of $46,854  Cost for the weekend service for the 6 month period was $17,649  The safety benefits and cost effectiveness of the 7 day/week service were recognised by the Hospital Executive and the Weekend service built into 2014 budget Outcomes of Weekend Service Weekend referrals to SW increased by 56.4% We demonstrated that this service facilitated the discharge of 67 patients on a weekend or Monday morning, over the potential saving of $46,854potential saving of $46,854 Cost for the weekend service for the 6 month period was The safety benefits and cost effectiveness of the 7 day/week service were recognised by the Hospital Executive and the Weekend service built into 2014 -15
  • 14. Outcomes for Antenatal position  Early intervention  Improved care coordination  Equity and access to services Equity and access to services  Improved patient and staff experience  Continuity of social work care for antenatal patients when they birth in the hospital Outcomes for Antenatal position and integration of services servicesservices Improved patient and staff experience Continuity of social work care for antenatal patients when
  • 15. Outcomes of Antenatal position  100% of Statutory requirements are now being met in accordance with priority guidelines of 72 hours72 hours  100% of cases are assessed prior to the 36 week review  Increase in referrals of 54.8% since commencement of MOC project Outcomes of Antenatal position
  • 16. Innovation – Management Developed to ensure that all high risk antenatal cases have a step by step plan in place prior to delivery  case management which is streamlined and coordinated  improved access to relevant information  more effective partnerships with other  implemented across the Sector at St George and Sutherland Hospitals. Management Plans all high risk antenatal cases have a step by step plan in place prior to delivery case management which is streamlined and coordinated access to relevant information effective partnerships with other disciplines implemented across the Sector at St George and
  • 17. Patient Journey Antenatal booking in visit Referral to MCDReferral to MCD Allocated to Social Work Management plan Disclosed DV at 32 weeks Psychosocial and Child Protection AX Information gathering - Federal Police, FACS, solicitor Frequent SW Intervention and DV counselling Patient Journey - Rebecca Management plan completed in collaboration with Complex Care CMC Postnatal Assessment done in delivery suite Discharged to safe house on MSP from delivery suite SW Antenatal Case Management Ongoing liaison with FACS
  • 18. Innovation- Staff Survey “Since the commencement of the new Social Work Antenatal role, I have noticed a significant improvement in the identification and support process of the women. I feel it is a vital aspect of women centred care “It is comforting to know that we have social workers over the weekend who know the area and problems faced by our clients and ourselves…Whereas before we had to consult emergency social workers” (Nurse) Staff Survey the commencement of the new Social Work Antenatal role, I have noticed a significant improvement in the identification and support process of the women. I feel it is a vital aspect of women centred care” (Midwife) It is comforting to know that we have social workers over the weekend who know the area and problems faced by our clients and ourselves…Whereas before we had to consult ” (Nurse)
  • 19. What we achieved  Through evidence based practice we were able to demonstrate the benefits to patients, staff and cost effectiveness of the 7 day/week service and increases to antenatal service.  We were given the opportunity to showcase the project to hospital executives and submitted a business plan. What we achieved Through evidence based practice we were able to demonstrate the benefits to patients, staff and cost effectiveness of the 7 day/week service and increases to We were given the opportunity to showcase the project to hospital executives and submitted a business plan.
  • 20. What we achieved  We were successful in securing funding of a weekend service which now continues to generate a high level of referrals and facilitates patient flow.  An Allied Health review has been conducted across St An Allied Health review has been conducted across St George Social Work Department. Clinical allowed for 2 days permanent to be allocated to the antenatal caseload. What we achieved We were successful in securing funding of a weekend service which now continues to generate a high level of and facilitates patient flow. review has been conducted across Streview has been conducted across St epartment. Clinical redesign has allowed for 2 days permanent to be allocated to the

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