HARP: A Vehicle for Change

1
HARP A Vehicle for Change

• A view from the middle

2
Better Care Of Older people A recap

• The successful HARP project for Bayside Health
  and its Partners was a multifaceted integrated
  model
• Components of the model included
• Identified register, shared electronic health
  care record, targeted strategies, extra resources

3
Means to an End

• Better Care of Older People ( also a Bayside
  Strategic Direction) saw the project as no end in
  of itself
• It was a way of promoting alternate care models
  which emphasised community interventions
• Resources to be shifted into the community
  provider sector

4
Resultant Model

• There is a Joint Steering Committee chaired by
  the Bayside Health CEO

5
Membership

• CEOs of two community health services
• 2 LGA representatives at a senior level
• 2 other Bayside Health Representatives from The
  Alfred and CGMC
• ISEPHIC
• Jewish Care
• RDNS
• GP Division

6
Leverage Existing Relationships

• Would we had to invent the PCPs?
• Strong commitment to the PCP
• Primary Care Sector had long history of
  engagement (Primary Care Alliance)

7
Other Key Players

• Strong Involvement from a range of key staff such
  as CHS CEOs
• Bayside Health involvement across a number of
  areas
• Bayside Health Representative had cross sector
  interests both in Primary Care sector and other
  sectors.

8
Proposed Model Components

• Identified client group of over 70 years multiple
  admissions or presentations, now 65
• Shared Electronic Health Care Record
• Specialist Team
• Provider Resourcing Funds( not brokerage)
• 5 sub-programs
• 24 hour call centre

9
Build on Complementary Initiatives

• There was a strong desire to ensure that multiple
  initiatives added to the total changes desired
  rather than doing so independently
• So, we envisaged structures which had common
  membership I.e. NDHP, Other Electronic Work, PCP
  Co-ordinated Care

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Components

• 12 case managers
• Pharmacy project
• Psychologist
• HARP central, project support staff
• IM component going
• Brokerage provision
• Seeding grants

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Next Parts

• Specialist team
• Disease sub-programs, especially mental health
• Consumer/community involvement

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Whats Going Well

• Relationships of Senior established players
• Got many of the components on the ground
• Range of protocols established
• Sandringham project

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Maybe not so well

• Originally treated local government sector as one
• HARP, but one program amongst many in agencies
• Identified wrong client group? Too sick?
• Insufficient attention to cultural divide at
  different levels of agencies
• need to connect better with acute

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HACC/HARP/Other Interface

• Do you cease to be HACC eligible if you get HARP
  services
• Are we developing a new HACC constituency?
• Is there continuity of service?
• Does HARP pay for the lot?
• Is HARP just a brokerage service?

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What would the retrospective Scope Say?

• Perhaps reduce initial group of agencies?
• Or work on different issues with different groups
• Work out multiple level change management
  process. Do they really want to do Hospital
  Business!
• De-emphasize virtual team. Work on KPIs.
• Work out how to divide the money!
• Support process. Under expenditure in first year
  created wrong vision, for DHS and others

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Now?

• Looking at the model
• Increasing use of KPI information
• Refining criteria
• Working on multiple component specification

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Relevant Links

• www.baysidehealth.org.au ( Bayside Health)
• www.portphillip.vic.gov.au/primary_care_partnershi
  ps.html I (ISEPHIC lead PCP)
• http//www.baysidehealth.org.au/uploads/general/Ba
  yside20Health20Strategic20Plan.pdf ( Bside
  Health trategic Plan)