RDNSVAC Partnership agreement A successful and innovative model

1
RDNS/VAC Partnership agreement A successful and
innovative model

• Liz Crock (Clinical Nurse Consultant HIV/AIDS
  Royal District Nursing Service and John Hall,
  Manager HIV Services Victorian AIDS Council)

2
Introduction

• RDNS employs 1,336 people across Melbourne.
• VAC employs 47 people (many P/T or casual)

3
The Partnership Agreement

• Informal partnership began in 1985 to develop a
  strong community-based home care scheme
• Pilot project began in 1987 which was evaluated
  in 1989-90 arrangement was then formalised in a
  Memorandum of Understanding
• Revised and renewed in 2006

4
RDNS catchment area

• Nurses work out of 23 centres across Greater
  Melbourne.
• VAC covers similar catchment area

5
Target population

• People living with HIV/AIDS at home requiring
  district nursing support and additional community
  supports

6
Target population- 50 mutual clients

• RDNS clients 120
• 63 have mental health problems and/or drug and
  alcohol
• Up to 22 CALD background
• 47.5 live alone
• Most on DSP and live in public housing
• 2/3 referred from hospital, some self-referred, 7
  from VAC

• VAC clients 89
• 25 significant others
• 46 mental health issue
• 6 CALD background
• 52 live alone
• most on DSP and in public housing
• 20 self referred, 10 referred by RDNS.

7
Objectives of the Partnership agreement

• Ensure philosophies of VAC/RDNS upheld
• Ensure access to RDNS and VAC services
• Ensure provision of 24 hour nursing care home
  based trained volunteer support if needed
• Facilitate access to other specialist services
• Mutual input into educational programs of each
  service
• Provide advocacy on behalf of clients of each
  service
• Response to current and future changes in the
  epidemic

8
Services available

• Nursing care
• Allied health support
• Volunteer support
• Other VAC services
• Training and education
• Pastoral care/spiritual linkages
• Debriefing

9
How integration is done

• Collaborative approach for referral/assessment/car
  e planning
• Monthly team meetings
• RDNS attendance at key CSP meetings and functions
• Representatives of CSP and RDNS on interview
  panels
• Documentation in home accessible
• RDNS invited to VAC debriefing
• RDNS facilitating education and training as
  needed

10
Challenges

• Challenge for RDNS working with volunteers
• Communication
• Blurring roles
• Acute sector often doesnt value what already
  exists
• Ongoing education for workforce
• Recruitment and maintenance
• Chronic understaffing

11
Resource requirements

• RDNS 3 CNCs cross regional. 2003 2 fulltime
  HIV Resource Nurses at 2 high case load centres.
  Liaison nurse. Other RDNS staff as needed.
• RDNS - new role Mental Health D and A CNC
  pilot project
• VAC - 3 Client Support Officers, Team Leader and
  85 volunteers
• Both organisations have Educator roles

12
Resource requirements - training

• Education for CNCs
• Education for CSOs have access to RDNS education

13
Outcomes

• Social determinants of health i.e. people
  resourced, linked in, translates to better health
• Client satisfaction high trust and confidence
• 468 transport to medical appointments not
  counting other transport
• Lack of joint data on outcomes need project

14
Why the program is successful/innovative

• Integrated service ensures better care
  coordination, quick response
• Join representation on committees
• Joint submissions
• Regular meetings
• After hours phone support
• Timely feedback to clinical staff
• Includes In Home Support Program

15
(continued)

• Interventions such as formal case conferences for
  at risk clients to plan consistent and
  responsive care
• Improves access to both services for marginalised
  clients
• Can work collectively according to VAC charter
  around broad purposes such as social justice,
  social change we are strategic partners in
  community based response
• Together we have a stronger voice.

16
Translatability

• Would readily translate to other states/regions
  who have dedicated HIV team within a nursing
  service, and who have similar volunteer service
  for PLWHA
• Some states have similar but informal
  arrangements
• Makes sense to formalise arrangements RDNS as
  VAC clinical arm working collaboratively across
  a range of services