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Transcript
The Kilmore & District Hospital
Quality of care report 2011
November, 2011
PROVIDING WHOLE OF LIFE CARE FOR OUR COMMUNITY
0
Table of Contents
Introduction
Our Community
Consumer, Carer & Community
Participation
Accreditation
Credentialing and Certification of Staff
Quality of Care
Major Quality Improvement Projects
Health Promotion
Safer Systems
Patient Satisfaction
Compliments and Complaints
Services
2
2
3
6
7
7
13
14
15
19
20
21
1
Introduction
It is with pleasure that I introduce this year’s (2010/11) Quality of Care Report. The purpose
of this report is to inform our community and other interested parties about the services we
provide and highlight how we are improving the quality of those services.
We are proud of the services we provide, within the context of a Small Rural Health Service.
We recognize that we are not the provider of all services. Our vision however is to be your
“preferred provider and facilitator for whole-of-life health related services”. If we do not
provide the service, we will help you navigate the health system to attain the services you
need.
We continue to strive to improve the range of services available for our community. In May
2011, we were approved for a $20 million redevelopment which will see our hospital grow
from 30 to 60 acute beds. We will also build an outpatient facility which will accommodate a
range of community services to improve the continuum of care.
To enable wider access to this report, you may obtain a copy though your local doctor’s
surgery, pharmacies, post offices, Mitchell Community Health Service, John Taylor Library
(Kilmore) or a local real estate agency. The report may also be found on our internet site
(www.kilmoredistricthospital.org.au)
Bart Ruyter, CEO
Our community
The Kilmore & District Hospital serves the local community of Kilmore and surrounding
areas with an approximate population of 25,000.
The area is Taungurung country and was developed as a rural farming area by early Irish
and Scottish settlers with sheep and cattle as primary industry. Today, Kilmore's strengths
are in automotive, education, health, manufacturing, transport, horse racing, commerce,
farming and tourism. Several hundred, mostly professional, people travel to Melbourne to
work each day, now about an hour's drive or train ride from neighbouring Kilmore East.
(Kilmore mechanics website, accessed 2011)
Kilmore is becoming a metro/rural
‘fringe’ town as we are an easy
commute to the Northern suburbs
and Melbourne. As such there is a
growing commuter population
entering the area.
Population predictions project
significant growth in the future.
Local Artists partner with the Hospital to
add beauty and art to the ambience.
2
CONSUMER, CARER AND COMMUNITY PARTICIPATION
In 2008, the Department of Health released the Community Participation Policy “Doing it
with us not for us”.
The following table outlines our progress to date in meeting the participation indicators.
Indicator
Standard 1: The organization demonstrated a commitment to
consumer, carer and community participation appropriate to
it’s diverse communities.
%
Compliance
achieved
37%
Standard 2: Consumers and where appropriate , carers are
involved in informed decision making about their treatment,
care and wellbeing at all stages and with appropriate support.
75%
Standard 3: Consumers, and where appropriate, carers are
provided with evidence based, accessible information to
support key decision making along the continuum of care.
40%
Standard 4: Consumers, carers and community members are
active participants in the planning, improvement and
evaluation of services and programs on an ongoing basis.
66%
Standard 5
The organization actively contributes to building the capacity of
consumers, etc to participate fully and effectively
Descriptive
reporting –
target not
applicable
Table 1: Reporting against targets for doing it with us not for us
Priority areas for improving our participation indicators include the development of an Equity
of Access Action Plan. The objective of this group is to improve access to our services for
people with disability either physical or intellectual, of diverse cultures and of Aboriginal and
Torres Strait Islander background.
We are also working to meet the Key result Areas of the Improving Care for Aboriginal and
Torres Strait Islanders.
The Taungurung
occupy much of
country
between the upper
River and its
Dividing Range.
west, eastwards to
the north and south
Dividing Range.
Aboriginal tribes
accordance with
(Daung wurrung) people
central Victoria. Their
encompasses the area
reaches of the Goulburn
tributaries north of the
From Kilmore in the
Mount Beauty, Benalla in
to the top of the Great
Boundaries with other
are respected in
traditional laws.
3
The Taungurung people are closely affiliated with the neighbouring tribes, through
language, ceremonies and kinship ties. They are part of an alliance with the five adjoining
tribes to form the Kulin Nation. Other members of the Kulin Nation are the Woiwurrung,
Boonwurrung, Wathaurung, and Djadjawrung. The Kulin Nation group also shares common
dream-time ancestors and creation stories, religious beliefs, economic and social
relationships. The Taungurong people were part of nine clans.
Key Result Area
Key Result Area 1
Establish and maintain relationships
with Aboriginal communities and
services
Key Result Area 2
Provide or coordinate cross-cultural
training for hospital staff
Key Result Area 3
Set up and maintain service planning
and evaluation processes that ensure
the cultural needs of Aboriginal
people are addressed when referrals
and service needs are being
considered, particularly in regard to
discharge planning
Key Result Area 4
Establish referral arrangements to
support all hospital staff to make
effective primary care referrals and
seek the involvement of Aboriginal
workers and agencies
Progress
Participating in Lower Hume
Cultural Diversity Group which
includes representatives from
Aboriginal communities and
services.
Met with local elders at local
health service planning
meetings and groups
Regional cross cultural training
offered to staff
Attendance of staff at a
number of cross cultural
workshops
Planned cross cultural
inservice for staff
Equity of Access action
planning underway to identify
and implement improvements
in this area.
Transfer of care project
working to develop consistency
and cultural sensitivity in
discharge planning and
referrals.
Access of equity working to
address this
Transfer of Care and
supportive care project also
working to develop referral
systems to meet these needs
Table 2: Report on progress against key result areas of Improving Care for Aboriginal and
Torres Strait Islanders.
4
The table below lists our progress towards achieving the six minimum reporting
requirements of a health services cultural diversity plan as specified in the Victorian
Department of Health health service cultural diversity plan guidelines
Goal
Standard 1 A whole of organisation
approach to cultural diversity is
demonstrated
Standard 2 Leadership for cultural
diversity is demonstrated
Standard 3 Accredited interpreters
are provided to everyone who needs
one
Standard 4 Inclusive practice in care
planning is demonstrated, including
but not limited to dietary, spiritual,
family, attitudinal, and other cultural
practices
Standard 5 CALD consumer, carer
and community members are
involved in the planning,
improvement and review of programs
and services on an ongoing basis
Standard 6
Staff at all levels are provided with
professional development
opportunities to enhance their
cultural responsiveness
Progress
The Equity of Access working party
comprises members from each part of
the organisation and extensive
representation for the community and
culturally diverse groups. This group
will work on the Action plan to ensure
that there is a consistent approach to
cultural diversity issues.
Both the CEO and DON are members
of the Equity of Access working party
and there is executive representation
on the Mitchell Cultural Diversity
Committee.
Each patient admitted to the Hospital
is screened to determine the need for
an interpreter. Interpreters are
booked to be on site during days of
surgical procedures in advance and
the telephone interpreting service is
utilised for unplanned attendances.
Care planning for residents and
patients identifies cultural needs and
are addressed individually through
assessment and discussion with the
patient or resident. Identified needs
are able to be accommodated
individually due to the nature of our
small rural community approach.
Engaging with culturally diverse
members of the community in the
planning and review of programs
occurs wherever possible but is often
difficult due to the low numbers of
such people in our community. It is
however, the aim of the organisation
to do so.
Staff are afforded time and resource
to attend professional development
opportunities and such education is
encouraged. Uptake, however, is low
and reflects the low numbers of
culturally diverse members in the
community.
Table 3: Report on progress of standards for cultural diversity planning
5
ACCREDITATION
AREA
TYPE OF ACCREDITATION ACCREDITATION
PERIOD
NEXT SURVEY DUE
Acute
Hospital
areas & DNS
Australian Council of
Health Care
Standards (ACHS)
March, 2012
Aged Care
Aged Care Standards 3 years
and Accreditation
Agency (ACSAA)
4 years
2012
Assessment visits
annually.
Table 4: Organisation accreditation status
VOLUNTEERS
The Op Shop team continues very enthusiastically to manage their well-stocked shop.
Their efforts this year have raised much needed funds for hospital equipment and saw them
meet the extraordinary milestone of $200,000 since they opened 6 years ago.
Our Ladies Auxiliary serve as volunteers at Caladenia and Dianella or work to arrange the
flowers in the hospital along with fundraising has contributed towards vital equipment. They
are also strong ambassadors of our Hospital, selling cakes at fairs and fetes and being
involved members of the community.
The volunteer program for the organization has grown steadily with over 60 regular
volunteers and an additional 20-40 students from the International School and Assumption
College. They provide over 50 hours of service each week to our Hospital and Aged Care
homes.
Volunteers are overseen by the Volunteer Steering Committee (members of the volunteer
group) who determine priorities, develop systems, identify resources needed and determine
education requirements.
The group have expanded the program substantially over the past year. One of the key
new initiaitives has been the development of Community bus trips for residents. Our
volunteers drive the bus, assist the residents when they are out and help the staff. We also
have undertaken several training and education workshops to help volunteers develop and
grow their roles.
CREDENTIALING AND CERTIFICATION OF STAFF
Nursing and Midwifery Registration
This year the Health Professions Act came into force and all Nurses, Midwives and Doctors,
along with 8 other health professions, are now registered nationally. All Nurses and
Midwives must be registered with Australian Health Practitioner Regulation Agency.
Nurses and Midwives at the Kilmore & District Hospital fall into three registration
classifications: Registered Nurse of Midwife and Enrolled Nurse. Nurses may also hold
6
additional qualifications such as midwifery, emergency, critical care etc. or endorsements
such as Medication Endorsement. We currently employ:
87 Registered Nurses Division 1
36 Registered Midwives
37 Registered Enrolled Nurses (Div 2)
19 Registered Authorised Enrolled Nurse (Div 2 - Endorsed)
41 Registered Nurses with
additional post graduate
qualifications
Medical Credentialing
The credentialing of medical staff
ensures that every doctor
appointed to the hospital has
appropriate education, training,
experience and qualifications for
the position to which he/she is
appointed, and that doctors only
perform work they are competent
to do.
Local Doctors, Nurses and Paramedics updating their
resuscitation skills – an annual requirement
There is a comprehensive
application form and extensive
referee checks in place. No appointment is made unless proof of registration with the
Medical Board of Victoria and appropriate medical indemnity insurance is provided.
We have 17 general practitioners credentialed, 5 anaesthetists, 14 surgeons in the various
disciplines, and 2 other specialists.
Personal Care Attendants
All employees who work in our Aged Care Facilities undergo police checks. Our Personal
Care Attendants are required to have Certificate III or IV in Aged Care Qualification.
QUALITY OF CARE
The quality framework of an organization describes a quality system which has the
consumer as its primary focus and helps the health care team to provide services that are
safe, effective, timely and appropriate. Within this system, clinicians work together to
produce the best results and understand and are committed to their roles and
responsibilities for safety and quality.
Aged Care
Our vision is that residents will come to see the residence as their home where their
individual needs and desires are understood and met and they are treated respectfully as
an adult with a lifetime of experience and knowledge.
7
Residents will be physically comfortable and safe, in a pleasant surrounding which identify
and meet their personal space and social and wellbeing needs. They will have access to
the right care and the right time delivered by the right person.
Opportunities to continue activities undertaken in the community prior to admission will be
maintained and family and friend relationships will be optimised.
Residential aged care at Caladenia and Dianella will provide opportunities to live a
purposeful, comfortable, safe and enjoyable life.
Relatives and friends of residents will feel welcome and at home in our aged care
residences and feel that they are also part of our residential community. They will be
genuinely accepted by staff without predjudice. Relatives and friends will feel that their
family member is cared about and well looked after.
Residents of Dianella enjoyed a day at Werribee Zoo earlier this year
Acute Care
Our Acute Services patients, however they enter the service, will have their care needs
assessed appropriately, receive good information and effective communication about their
admission, in hospital care and discharge. We will ensure that patients are referred to
primary and community care supports as required and that their needs and the care they
have received at our Hospital is effectively communicated to others involved as needed.
Patients will feel free to work with the health care team to plan and manage their care
needs.
The Victorian Clinical Governance Framework was released in 2009 and is to be reported in
the Quality of Care Report. Kilmore has partially implemented each aspect of the
framework and continues to work towards full alignment with this policy.
The four domains of the framework are:
8
consumer participation
clinical effectiveness
an effective workforce
risk management (encompassing incident reporting and management).
Figure 1: Victorian Clinical Governance Framework
The Acute Ward provides inpatient services for 2,500 patients per year. Rural hospital
acute wards are very different to larger Hospital wards in that the staff will provide care for a
diverse range of patients at any given time. Patients in the ward will be receiving care for
medical conditions, post surgical recovery, cancer care palliative care or because they are
having a baby. This
means that our staff
are incredibly skilled
and experienced at
managing a variety of
health problems.
200 babies are born at
the Hospital each
year.
This year the babies of
5 of our own staff and
2 grandchildren of staff
9
Pictured is Rebecca and Mark with baby Jesse. Rebecca works as a Nurse
in the Acute Ward and Caladenia Nursing Home.
were born at the Hospital! That has to be a good endorsement of the care women and
families receive at Kilmore & District Hospital.
Around 200 chemotherapy treatments are provided to around 50 local people through our
Oncology unit.
The Operating Theatre performs approximately 1000 surgical procedures each year.
Operations range from Ear, Nose and Throat surgery for children and Adults through to
Gynaecological surgery for women.
10
The Emergency Department sees upwards of 8000 people each year and is staffed by
Nurses 24 hours per day. Our local GPs provide the necessary medical support to the
Nursing team and are an invaluable support to our Hospital.
The most important quality work the Acute Sector has been part of is the Transfer of Care
project. Working together with the Emergency Department, Operating Theatre and our
District Nursing Service the objective of this project is to ensure that our vision for quality
care is achieved and patients have a seamless journey from entry to care at home.
George’s Story
George’s story illustrates the importance of this work. George is an
elderly man who lived in a bungalow behind his son’s house. George was
not an easy man to work with and frequently challenged the community
care staff who came to help him. He no longer was able to make good
decisions about his care and his son was having difficulty understanding
his father’s decline. George would often fall and be lying on the floor for
long periods of time, was not eating properly or taking medications.
Consequently George would attend the Emergency Department at the
Hospital for care. Sometimes he would be admitted to the hospital for a
short time and then go home again. The staff at the Hospital were not
always aware of the community care providers George had in place at
home and vice versa. George would ‘bounce’ between home and hospital
with little communication or planning between the services.
People like George can slip through the cracks. Those who have difficult
and challenging behaviours and social circumstances are at risk of
missing out on the services that they really need. The transfer of care
committee used George’s case to identify the communication gaps and
look at ways to make it easier for staff to identify and communicate with
other care providers involved in his care.
11
Living in our aged care community.
We are very proud of the care provided to our residents who live in our residential aged
care community.
Caladenia Home provides complex nursing care for residents with high care needs and
Dianella Hostel cares for residents with less complex health and personal care needs. Both
residences are committed to providing an environment that helps residents live life to their
fullest capacity.
Care is underpinned by our philosophy of:
Enjoy
Contribute
Live life
Be Secure
Relax and feel good
12
Key improvements in the Aged Care area have been the expansion of the volunteer
program to help residents achieve individual quality of life goals. It has helped more
residents get out and about and to participate in activities that include them more in the
community at large.
The community bus program now runs up to twice a week to get residents to where they
want to go and we have a number of community groups who hold their meetings and
gatherings at the homes to enable residents to attend. We have enjoyed our partnerships
with U3A and the friendship circle.
Along with these lifestyle program
improvements we continue to monitor and
improve all parts of the personal and
clinical care that we provide for residents.
Val and Sharon looking at Aboriginal artefacts at the
NAIDOC week presentation
13
Scaretactics has become an annual event in which our residents are very pleased to participate – and we don’t do
too badly either with winning entry 2009, runner up 2010 and 2011.
MAJOR QUALITY IMPROVEMENT PROJECTS
We regularly participate in major projects to improve, develop and evaluate the care and
services that we offer.
Rural Medical Workforce Project
This year we have been undertaking a major scoping project, funded by the Department of
Health Medical Workforce branch, to review the medical models of care possible for small
rural health services.
The main activities for the project to date include;
Developing and administering a statewide survey. The response rate from rural health
services to the Rural Health Services Emergency Department / Urgent Care Survey
2011 was excellent, with 47 surveys returned out of 58 or 81%.
Progress on Medical Workforce Profile continues.
Progress is also being made on the designing a future medical workforce plan. A
template for “Designing a Future Medical Workforce” is being completed with a number
of key domains – demographics, models of care, workforce profile, emergency
presentations, positions profile and service environment
The Department of Health also funded a project officer position to look at ways to make the
transfer of care more seamless between agencies. We have been the lead agency for
reviewing and developing consistency for the Transfer of Care between health and
community agencies across the Lower Hume Primary Care Partnership (PCP) team.
Work continues on a number of elements in the admission and discharge process and care
planning process for the acute sector as well as community health;
Meetings have progressed onto “activities” of care planning that occur including the
complex care meetings and bedside handover
Admission and discharge policies and literature are under review
Referral codes have been identified
Referral numbers to community using a common referral tool are being collated
The main
been
the
that occur
care
the gaps in
Supportive
Cancer
Hume
Integrated
Services
outputs have
discussing
activities
alongside
planning and
the process.
care for
Clients
Regional
Cancer
funded a
14
project to introduce supportive screening using a validated screening tool for all people who
come into our service with a Cancer diagnosis. This screening meets the requirement of
the Victorian Cancer Action Plan and will ensure that people struggling with Cancer are
offered all the services at their disposal.
Consumer representative, Shirley Carrington, with crafted items called
S*$% bags – each has a notepad and bag for cancer sufferers to write
Their unhappy feelings on and tuck away.
HEALTH PROMOTION
The health promotion committee priority areas align with key health issues facing our
community. The committee aims to undertake activities which:
Minimise the impacts on health of smoking
Promote healthy eating and reduce obesity
Improve health and fitness
Promote emotional wellbeing
This year we declared the site a non smoking site and offered staff support to Quit.
Emergency Department runs staff health checks which were well supported. Healthy
breakfast week was a great success, providing our staff with healthy breakfast options and
an opportunity to catch up on a social basis.
15
Night duty nurses enjoying their healthy breakfast.....or is that dinner?
The workplace wellbeing project reviewed the social and emotional wellbeing of staff and
received feedback about organisational barriers to staff wellbeing.
SAFER SYSTEMS
Incident reporting
Incidents are events that occur that do not align with good care. Incidents might have
actually happened or very nearly did happen. This includes things such as:
Medication errors such as wrong dose, wrong medication, medication not given or
illegible orders.
Falls
Pressure ulcers
Hazards
Unexpected events
Policy and procedures not followed.
Trends from recent years show a constant reporting rate, demonstrating a culture of
willingness to report.
All incidents and risk assessments are reviewed by the Risk Coordinator, and Risk and
Quality Committee. Where possible, action is taken to reduce the risk of an adverse event
reoccurring.
Total Incidents
600
500
400
Series1
300
200
100
0
Yesr 2003 Year 2004 Year 2005 Year 2006 Year 2007 Year 2008 Year 2009 Year 2010
Graph 1: Total number of incidents (measured by financial year)
Falls Monitoring and Prevention
16
As people grow older there is increased risk of falling due to loss of muscle strength,
balance, vision and bone density. Research shows that falls seriously contribute to disability
and loss of independence and quality of life and even death for older people. For these
reasons we focus on reducing the risk of falls occurring and the seriousness of injuries
sustained.
All patients and residents are assessed to ascertain the level of risk of a fall occurring.
Appropriate falls minimisation strategies are put into place.
Some Strategies include:
Alarms that alert nursing staff to any unexpected movement of patients / residents
who are at risk of falling
Increased physiotherapy sessions
Strength training
Monitoring and supervision of patients / residents who require mobility aids.
Environmental Audits to reduce clutter etc
Strengthening and mobility exercise classes.
Review of time, place and activity when falls occur – to identify trends.
Review of injuries sustained due to fall – eg skin tears, bruises and fractures to
identify trends and develop reduction strategies eg skin protectors have been
implemented when there is poor skin integrity.
Total Falls Organisation Wide
250
200
150
Series1
100
50
0
Series1
Year 2008
Year 2009
Year 2010
138
131
207
Graph 2: Number of falls by year (financial year period)
Pressure Ulcer Prevention
Pressure ulcers impact on quality of life of patients and residents.
All patients and residents are assessed on admission and regularly throughout their stay to
reduce the incidence of a pressure ulcer developing.
Pressure Prevention strategies are put into place. These include:
pressure reducing mattresses,
skin integrity management,
provision of a nutritional diet and
proactive nursing practices
17
The Pressure Ulcer Committee reviews all pressure ulcers reported with aim of identifying
gaps and recommending improvements in the provision of care.
Our approaches to pressure ulcer management have helped to contain pressure ulcers to
stage one with few progressing further.
Medication Management
Fortunately medication incidents have been minor without adverse outcome.
Medication Related Incidents 2011
90
80
70
60
50
Series1
40
30
20
10
0
Year 2008
Year 2009
Year 2010
Year 2011
Graph 4: Mecation Incidents by year (financial period)
Infection Control
Improved health care worker hand hygiene is a vital component of reducing health care
associated infections.
The national campaign stems from the World health Organizations health alliance patient
safety campaign “clean care is safer care”.
18
The Kilmore and District Hospital’s hand hygiene compliance rates are consistently high
and have been above the Victorian average of 71.7%
Graph 5: % Hand Hygiene compliance by year (financial)
Cleaning
Anybody who has looked closely around our Hospital and Aged Care Residences can see
how impressively clean they are. External audits confirmed what we knew – our cleaners
are above average! Our scores are consistently above 95%, significantly higher than many
other health organizations. Congratulations go to our environmental services team.
Phil and Tina regularly audit our patient and resident
care areas to ensure that we keep up our high
standards of cleanliness.
PATIENT SATISFACTION
The Kilmore & District Hospital participates in the Victorian Patient Satisfaction Monitor. Each 6
months a sample of patients are sent questionnaires to complete about their experience here. Our
results show that patients are more satisfied with their overall care than those at all hospitals but
slightly less satisfied than patients of similar organisations.
19
COMPLAINTS AND COMPLIMENTS
Feedback, both good and bad, helps us to improve our service and is an important
mechanism for change. Compliments encourage our staff to continue to do great work; we
all like to be appreciated! Compliments are measured from January to December and
reflect 2010 figures.
Total Complaints
% complaints actioned
within 14 days
Average days taken to
close
Type of complaint
Lack of information
Communication
Concerns about care
Other
Environment
*U=Unavailable
2010
30
100%
2009
24
100%
2008
20
100%
2007
16
100%
2006
23
60%
9
4
5.2
3.81
11
2008
%
U
U
U
U
2007
%
6
31
37
31
2006
%
31
30
13
19
2010
%
0
20
30
26
23
2009
%
0
22
16
16
46
Feedback from patients and residents has led to a number of reviews and improvements.
The following are examples:
20
Comprehensive clinical case review leading to the identification of issues and actions
to prevent the events being repeated. Actions include review of policies, procedures
and guidelines, education of staff, changes to risk management guidelines, changes
to workforce profiles and clarifying roles and communication structures.
Regular meetings between the food services manager, residents and aged care
managers to maintain an ongoing discussion about menus and food service
provision.
Refurbishment of the ED including the provision of a television in the waiting room.
Painting of Caladenia
73 Compliments are on file for 2010. It is impressive that many people feel moved to pen
their thanks for the care received. I believe it demonstrates the efforts our staff go to to
meet the needs of our patients and residents. Compliments were spread fairly evenly
throughout the organisation with the exception of Acute which received the highest number
of compliments.
PLEASE GIVE US YOUR FEEDBACK ON THIS REPORT
Email: [email protected]
Phone: 5734 2000
Letter: The Kilmore & District Hospital, Reply Paid 185, Kilmore 3764
Website: www.kilmoredistricthospital.org.au
Services
MATERNITY SERVICES
Comprehensive Maternity
Services provided. Models of
care provided are GP led
care, public antenatal care
and Know Your Midwife care.
Referral through GP or self
referral possible
DISTRICT NURSING SERVICE
Home nursing care provided
including personal care,
specialist wound care,
administration of intravenous
medication, post surgical
follow up care.
Referral through GP, Hospital
or self referral.
URGENT CARE
Our Emergency Department
is open 24 hours per day and
staffed with experienced
Nurses who are able to
provide first line care. Local
General Practitioners support
the department on an on call
basis.
ACUTE WARD
30 bed inpatient ward –
medical, surgical, maternity
and palliative care.
OPERATING THEATRE
Types of surgery include Ear,
Nose & Throat, Orthopedic,
Gynaecology, Urology and
General surgery.
RESIDENTIAL AGED CARE
Providing residential aged
care for elderly people with
high nursing care needs and
also those who require
assistance with their activities
of daily living.
Referral through local GP to
visiting specialists.
Referral via local GP
21
Applications can be made
directly to Dianella Hostel and
Caldenia Nursing Home once
the Aged Care Assessment
Team has undertaken the
required assessments.
DIAGNOTIC SERVICES
Healthscope Pathology
undertake blood tests and
Electrocardiograph testing on
site.
CONSULTANT SPECIALISTS
Gynaecology, General
Surgery, Cardiology, Cancer,
Urology
Referral via local GP
Capital Health Radiology
provide xray, CT scanning
and Ultrasonography.
Referral via local GP
22