Louise Stewart

1
A Nurse Practitioner Success Story

• Louise Stewart
• lstewart_at_revivegroup.com.au

2
Agenda

• Recognition at last!
• Who we are
• The Revive Clinic journey
• What has been said along the way
• Where we are at now
• What still needs to happen

3
Who we are

• Facilitate treatment interventions in a timely
  manner
• NP skills to deliver health services and care to
  fill the gaps in the health care system
• Health awareness, disease prevention, health risk
  management and case management of CDs
• Provide wider access to treatment in
• community for common medical
• conditions and preventive health
• services

4
Mark Thorton, Australian Pharmacist. March 2009
5
Our vision

• Recognised centre for delivery of patient
  focused, holistic health assessments
  interventions based on the most current
  appropriate evidence
• Positive patient experiences
• Strive 7 day a week access
• Strong commitment to working
• in multi-disciplinary teams

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Objectives

• Reduce waiting list for GPs
• Patients ability to access health services in a
  timely manner
• Reduction in numbers attending ED for non life
  threatening conditions
• NP as resource for community services,
• employer and other agencies
• Increase access to preventative health
• services for the community

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What we treat

• We can treat patients at any Revive Clinic
  location, at work or in the home
• Get well sooner Respiratory conditions, ears,
  sinus, colds/flu, monoarthropathy, headache,
  cellulitis, wounds, well women, In development
  diabetes heart disease case management
• Stay well Longer Health screenings, lifestyle
  assessments, lifestyle interventions, health
  coaching for healthy heart, weight loss, get in
  shape, smokefree, stress relief, diabetes
  fighting
• Pathology
• Referral to/by GP or allied health
• (interdisciplinary collaboration)

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Corporate Health Programs
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What Constitutes Success?
Access/Participation
Usage/Completion
Change in Readiness
Change in Behaviour
Change in BMI
Change in Risk
Satisfaction Rates
10
Health Assessment

• Identify risk factors
• Weight
• Stress
• Mental Health
• Sleep/Fatigue
• Alcohol Consumption
• Fruit Vegetable intake
• Physical Activity
• Smoking

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Lifestyle Prescriptions

• Quit Smoking
• Nutrition
• Alcohol Use
• Physical Activity
• Weight Management
• Stress Management

• Smoke Free Program
• Healthy Heart Program
• Diabetes Fighting
• Weight Loss
• Get in Shape
• Stress Management

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Telephone Coaching Support

• Coaching Programs
• Healthy Heart, Weight Loss, Stress Relief, Smoke
  Free, Get In Shape, Diabetes Fighting
• TEACH the full impact of an unhealthy lifestyles
  intervening with individuals that might be in a
  pre-disease state to prevent the progression to
  a more costly disease/diagnosis
• Initiate appropriate guidance based on
  participants risk factors
• Coaching techniques from established behavior
  change models and clinical expertise
• Social workers - Behavior coaches fitness
  professionals dietitians registered nurses
• Utilize additional tools with coaching
• Online tools and Program booklets

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Patient Access

• Search for Health providers
• Participate in community Forum
• Access special offers
• Rate health providers
• View bookings
• Manage profiles/contacts
• View health record
• Health assessment
• View coaching documents
• Receive regular e-newsletters

• Future developments
• Points based incentives
• Quarterly Health Challenges
• More education

14
What the media has to say

• Health Shop care questioned, the West
  Australian
• AMA president Dr Rosanna Capolingua's If they
  are pretending to be doctors, I invite nurse
  practitioners to go to medical school and do the
  training required, The Australian
• Well, actually they're not pretending and the
  reason they're nurses is because they want to be.
  And, more
• importantly, they're prepared to work in the
  places doctors won't.
• But the AMA should realise there's a desperate
  need for front-line health care that we all know
  doctors just can't provide.

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And the tide turns

• Nurse practitioners hail script , bill reform,
  Give equitable healthcare to more Australians
  and reduce pressure on public hospitals, and
  Doctors do U-turn over Medicare access for top
  nurses.
• But only briefly
• Pharmacy Clinics spark fears of supermarket
  medicine, August
• Medical Association condemning the plan as
  "supermarket medicine", which posed "a risk to
  the government, to the health system and to
  patients".
• Surely the Government does not believe that a
  nurse practitioner plus a pharmacist equals
  collaborative care. 
• Surely the Government does not believe that a
  nurse practitioner plus a pharmacist equals a
  doctor.
• Nurse practitioners tend to be highly trained in
  a narrow area of health care and are not skilled
  or experienced in providing holistic care,"
  association president Andrew Pesce said.
• The Revive clinics are being promoted as a
  one-stop shop for diagnosis, treatment and
  prescribing for common or minor ailments, which
  is a dangerous claim by practitioners not
  qualified or experienced to identify when
  symptoms may be due to more serious or complex
  illnesses.

16
Next Steps

• More funding and support from government for
  prevention, risk identification and interventions
• Funding for 7 days a week
• Health funds play a more proactive role in
  integrated health provider services
• Implementation of national registration and MBS
  PBS to increase equity of access
• Business and industry take more responsibility
• More focus on regional areas e.g. Port Hedland