Maryborough District Health Service (MDHS) delivers quality healthcare to more than 15,000 residents from its three campuses in Maryborough, Dunolly and Avoca. Located in Victoria’s geographical heart, halfway between Ballarat and Bendigo, its 460 staff are dedicated to providing the best in acute, surgical and residential care, mental health, obstetrics and gynaecology, nursing education and more – every day, and for every stage of life.
Resourcing care – and caregivers
MDHS has a long history of filling the healthcare gaps for the rural communities it serves, with varied services to meet diverse local needs. In its ambitious four-year strategic plan to empower health, strengthen services, develop staff and nurture partnerships, the organisation identified its Maryborough-based 24-hour Urgent Care Centre as a high priority for transformation.
During business hours, registered nurses are supported by Visiting Medical Officers and surgical consultants. But between 10pm and 6am, nursing staff relied on a small but dedicated pool of local GPs for on-call support for acute and emergency presentations. With the nearest hospital 60 kilometres away, overnight nurses had little choice but to call in a GP for assessment and diagnosis.
“Our GPs were on call 24 hours a day, seven days a week; they were exhausted, there was no work-life balance,” recalls MDHS Chief Executive Officer, Nickola Allan.
“There were significant difficulties in attracting and retaining GPs, and in not having adequate support for our nurses to deliver acute and emergency care overnight.”
Seeking out the right solution
MDHS began exploring alternatives to support nursing staff while relieving the pressure on doctors. Trialling a Nurse Practitioner model, whereby nurses were responsible for investigating, diagnosing, treating and referring patients with acute and chronic conditions, proved unsustainable and costly. It was also placing additional stress on nursing staff while providing little relief for overstretched GPs.
When Murray Primary Health Network called for participants for a My Emergency Doctor pilot program in August 2019, MDHS welcomed the opportunity.
“We’re very cognisant of the enormous work our local GPs have put in to support the organisation, and if we could help reduce the burden of on-call for them, then we would absolutely do that,” Allan says.
My Emergency Doctor places patients and nurses in direct contact with its Australian-trained senior emergency specialists – all Fellows of the Australasian College for Emergency Medicine(FACEMs) – within minutes, 24/7, via a smart device or phone. The FACEM provides a comprehensive video consultation and facilitates local delivery of the best course of treatment and follow-up, including referrals, imaging and pathology and providing written summaries to the patient’s regular GP.
The organisation placed the telehealth partnership at the frontline of its workflow, enabling it to fully harness My Emergency Doctor’s support to provide high quality, around-the-clock emergency and acute care.
Trusted advice, exceptional outcomes
My Emergency Doctor has become the ideal long-term solution for MDHS, with significant benefits experienced right from the pilot program’s inception. In the first nine months of the partnership, MDHS nurses utilised My Emergency Doctor consults for 245 patients; of those, 13.5 per cent were admitted for ongoing care, and just 8.2 per cent were transferred to another health service for a higher level of care. The team also received zero complaints or negative feedback.
According to Allan, GPs have gained assurance that they won’t be called in unless absolutely necessary. It has also been a considerable boon for nursing staff morale.
“Being able to dial into a skilled FACEM who can provide the appropriate support and management plans for patients as they present is an enormous positive, particularly for nurses staffing urgent care at night,” she explains.
Nurses report a high level of trust in the service, and the organisation is fully invested in leveraging every benefit of My Emergency Doctor’s offerings. The local community, too, have enthusiastically embraced the emergency telehealth support model.
“We can say to patients: ‘we don’t have to wait for a GP. We’re going to call a highly skilled and qualified clinician already on-site in an emergency department, and they’ll conduct your review and set out the best treatment’. It’s a very easy sell. And the positive patient outcomes are there to support that it works,” Allan adds.
“Even if the pilot funding ends, we won’t stop using My Emergency Doctor; it’s embedded in our urgent care practice moving forward. I would like to explore how we can expand our usage, particularly in after-hours in-patient care, and perhaps in better managing referral to acute services as well.”
- Nickola Allan, Chief Executive Officer, Maryborough District Health Service
Between October 2019 and June 2020z, following My Emergency Doctor consults
- 9% of patients treated in situ
- Of those treated in situ, 5% were admitted for ongoing care and management while 78.4% were discharged home after assessment and management
My Emergency Doctor has helped Maryborough District Health Service to:
- Minimise after-hours calls to GPs
- Increase nursing staff confidence and reduce stress
- Reduce waiting and treatment times
- Prevent unnecessary admissions and transfers
- Create more efficient and effective workflows
- Grow community confidence
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