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Monash Minute is a collection of short articles and headlines about Monash Health which may be useful for primary health providers. 
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April/May 2022 Update from Monash Health GP Liaison

Please forward this newsletter to GPs in your practice or email us at GPLiaison@monashhealth.org to subscribe to this newsletter.
COVID Positive Pathways at Monash Health 


The COVID Positive Pathway has been evolving to keep pace with the changing clinical presentation of more recent COVID-19 variants. 


Recent changes to the program include:

Expansion of the Self-Care pathway to include adult patients <65 years of age who:
  • are up to date with COVID vaccinations, 
  • have nil or mild symptoms and 
  • no high-risk comorbidities.
Expansion of the Self-Care pathway to include paediatric patients > 1 month old regardless of vaccination status but 
  • with nil or mild symptoms and 
  • no high-risk comorbidities.
Alteration of the criteria for low and medium severity pathways to ensure that health service pathway resources (i.e. Complex Care at Monash Health) are reserved only for the patients who require this level of care.

COVID information for patients and further details on the individual pathways can be found here.

Early COVID-19 Treatments 
Early treatments for COVID-19 are proving to be effective for eligible patients, with more treatments becoming available. Information about early COVID-19 treatments available at Monash Health can be found here, including an online referral form

For queries about the COVID Positive Pathway at Monash Health, please email : 
E: covidcare@monashhealth.org

 

Virtual Emergency Department Service
 (Virtual ED Service)


Monash Health, Alfred Health and Peninsula Health, working in partnership with Ambulance Victoria (AV) and supported by the Victorian Department of Health, have launched a virtual Emergency Department (ED) servicing Melbourne’s southeast.

In this initial phase, the Virtual ED is a dedicated pathway for AV employees to access ED teams across the three health networks. The Virtual ED allows AV teams to identify patients that can potentially bypass ED and be directed to suitable alternative pathways for ongoing investigation and management. In time, we plan to expand the service to other health care professionals, which could potentially include GPs  

The Virtual ED Service will be provided via telehealth (video and audio) and be offered seven days per week, from 12.00pm – 9.00pm for COVID and non-COVID patients. It will:
 
  • Allow AV paramedics to consult directly with ED clinicians when determining the most appropriate care for a patient.
  • Allow medications to be prescribed and forwarded to the patient’s pharmacy from the Virtual ED.
  • Be able to refer patients to other services within the south east, such as GPs, Hospital in the Home, COVID Pathways and other community health services as appropriate.
We will continue to keep you informed, particularly as the Virtual ED Service becomes available to other health care professionals.

Thank you in anticipation of your support of the Virtual ED as we seek to extend the high levels of care provided to our community.

 
 If you have any further questions, please do not hesitate to contact

Electronic referrals (eReferrals) replacing faxes
Monash Health is moving towards an all-electronic referral process for GPs to refer to Specialist Consulting Clinics

eReferrals are proving to be the safest, most secure and most reliable method to send a referral successfully to Monash Health, with GPs reporting a much higher level of confidence in eReferrals than fax as they receive immediate electronic confirmation of successful delivery. As a result, eReferrals will shortly replace fax which is typically fraught with transmission failures such as missing pages, incomplete transmissions. GPs can access a HealthLink eReferral form for each Specialist Consulting clinic through most clinical software including Medical Director, Best Practice, Genie and MedTech Evolution. Referral guidelines are built into most eReferral forms, making it easier for GPs meet specific clinic intake requirements and resulting in fewer declined referrals. A quick guide to sending eReferrals to Monash Health is available at GP-eReferrals-Simple-Referral-Guide eReferrals significantly reduce unnecessary delays in arranging appointments for patients, for instance when a Specialist Consulting clinic is waiting for the GP to resubmit a referral after receiving an incomplete or illegible document due to fax failure.  GPs who use ZedMed, Stat and other software not mentioned above can still access HealthLink SmartForms through a web-based MyHealthLink portal. 

If you need support using HealthLink eReferral forms to send a referral to Monash Health, please contact Christopher Daniel - eReferral Project Lead, Monash Health

E:  Christopher.Daniel@monashhealth.org M: 0400 449 922  Alternatively, you can contact your local Primary Health Care network (PHN) –  Eastern Melbourne PHN: P:9046 0300    E:digitalhealth@emphn.org.au    South Eastern Melbourne PHN: P: 1300 331 981 (option 3)     E: providersupport@semphn.org.au   

 
Hospital Outreach Post Suicidal Engagement (HOPE)
Monash Medical Centre Clayton.  


HOPE was developed as part of the Victorian Suicide Prevention Framework. It is an initiative that provides psychosocial support for people who are identified as having presented with suicidal or self-harm attempts or suicidal or self-harm ideation.

The HOPE initiative aims to provide follow up care and support to people who would not traditionally have received such intervention immediately after hospital discharge. The initiative has broader referral pathways and targeted psychosocial support which is delivered through an evidence-based model of care developed by Beyond Blue known as The Way Back Model of Care.

The Way Back Model of Care

How to refer:
  • The service is delivered in an assertive manner in the community.
  • Service is provided for up to 3 months from the time of hospital discharge. 
  • The service is provided by clinical and non-clinical staff.
Eligibility Criteria
  • People who are identified as having presented with suicide attempt, actual attempt, interrupted attempt, aborted attempt OR
  • Serious suicidal ideation with intent /plan/preparatory behaviours (not exclusively self-harm).
  • 18 years plus
  • Patient is willing and consents to involvement with HOPE Clayton.
  • HOPE Clayton has available capacity to support patient.
Referral Pathway
Psych triage for referrals - 1300 369012 requesting the HOPE program.  

For further information please contact
E: Caroline.LeBrun@monashhealth.org
Monash Health
Antenatal Infectious Diseases Clinic


Pre-existing or newly diagnosed infectious disease conditions and maternal immunisation concerns.

Monash Health offers a specialist Infections in Pregnancy Clinic, led by two Infectious Diseases physicians embedded within antenatal services. GPs can refer pregnant women, regardless of the hospital they are booked at for delivery, for expert advice related to infections in pregnancy. We advise on all infectious diseases which present additional considerations for the health of the pregnant woman, her family and her baby. This includes (but is not limited to) hepatitis B,hepatitis C, cytomegalovirus, toxoplasmosis, syphilis, and HIV.

Key points:
  • Specialist clinic runs fortnightly at Monash Health Clayton Campus Maternity Clinic.
  • We prioritise review during pregnancy (the average wait is 2-6 weeks for an appointment)
  • The woman does not have to be booked to deliver her baby at Monash Health
  • Referral is required
Referral 
  • The current process for referral is to the Department of Infectious Diseases, Monash Health. 
  • Please ensure it is clear on the referral that the woman is pregnant and this will be referred to our team for triage.
For more information please contact the Department of Infectious Diseases
P: 9594 4564
Monash Children’s ONE-SIM PROGRAM 
OBSTETRICS & NEONATAL EMERGENCY SIMULATION

Monash Children's Hospital (MCH) Simulation Centre

The ONE-Sim (Obstetrics and Neonatal Emergency Simulation) workshop is an inter-professional simulation workshop run by the educational simulation leadership teams of Monash Health and Monash Children’s Hospital in conjunction with MCH Sim.

The workshop provides opportunities doctors,midwives and nurses from different specialties (including GP, maternity, paediatrics, ED and anaesthetics) to practice the technical and teamwork skills which are known to have a positive impact on the management of obstetric and neonatal emergencies.

During the COVID-19 pandemic, these are being delivered in an innovative online fashion with limited places available for in person training.

The program is a 3 hr course offered online or in person, focusing on obstetric and neonatal emergencies encompassing both term and preterm births through immersive simulation scenarios. These are followed by structured debriefs.

Details:
  • Date : Wednesday 22 June 2022 1pm – 4pm
  • Venue : Monash Children's Hospital Clayton
  • Online Option available
  • Limited to 24 participants (12 online & 12 in person)
More details and signups are available on Monash Shop.

For further information contact:  Monash Children's Simulation
P:    +61 3 8527 3820
e:  iris.pilares@monashhealth.org       
Advance Care Planning (ACP) 

GPs play an important role in assisting people to plan for their future medical care.  ACP provides patients with the opportunity to make their care preferences known in the event they are unable to make decisions for themselves.


ACPs ensure those close to the person, and those caring for them, know:
  • what is important to them
  • what preferences they have regarding medical care and 
  • who is appointed to make decisions for them if they are unable to do this for themselves 
Documents available for completion include:
  • Appoint a Medical Treatment Decision Maker (MTDM) (previously called a Medical Power of Attorney)
  • Document Preferences, Values, Consent or Refuse Treatment
  • Prepare an Advance Care Directive (ACD)
  • Appoint a Support Person
ACP documents need to be discussed with and witnessed by, the person’s medical practitioner (GP). 

The role of GPs in witnessing an Advance Care Directive (ACD) is to:
  • not make judgments about the reasonableness of a person’s decision
  • ensure the person understands the nature and effect of the statements in their ACD and the possible implications of including these statements in their ACD
  • help ensure that the ACD is consistent and practically applicable
Witnessing requirements:

An ACD must be witnessed in the presence of the person completing the document by two people, with one being a registered medical practitioner. Each witness* must certify that the person:
  • appeared to have decision-making capacity at the time of signing
  • appeared to freely and voluntarily sign the document
*The witness is not an appointed Medical Treatment Decision Maker

Referral:

For further information or to refer a patient to Monash Health Advance Care Planning Program contact via:

E: acp@monashhealth.org 
P: 9594 3475
Web: Advance Care Planning (ACP) | Monash Health
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