Methods
The first of 10 RAC pilot programs has been completed at Sunshine Coast University Hospital (SCUH), following the announcement of funding to 10 Hospital and Health Services (HHSs) to reduce ED pressure.
At SCUH, rapid access to clinical care is enabled for known or existing patients with emergent conditions likely to necessitate an emergency department (ED) presentation.
Historically at SCUH, patients known to the hospital system were managed for exacerbations of their illness after discharge in exactly the same way as patients who were unknown to the health service. This resulted in patients well known to specialists and units presenting to the ED to be seen, assessed, and treated by a team of doctors who have never seen that patient before.
The SCUH RAC service piloted a one-stop access point for respiratory patients known to the health service, connecting them via approved pathways to respiratory specialist advice and/or urgent medical care during periods of clinical exacerbations that would otherwise initiate an ED presentation and readmission.
Pathways included phone advice, telehealth review, or referral into RAC as a planned admission (within 24-48hrs).
The RAC service was accessible to patients, GPs and other medical specialties via a direct phone number monitored by the hospital Respiratory Nurse Practitioner or Respiratory Clinical Nurse Consultant, who were responsible for assessing and triaging calls, and initiating the most appropriate pathway.
