- For Health Professionals
- For Community
- About
- News & Resources
- Events
- Jobs
The Australian Institute of Health and Welfare studies potentially preventable hospitalisations as a measure of primary care effectiveness. Patients diagnosed with chronic conditions, such as asthma, chronic obstructive pulmonary disease, congestive cardiac failure, diabetes, and hypertension, are at higher risk of deterioration and hospitalisation over the winter period.
We have implemented successful Winter Strategy programs over the past three years.
Our Winter Strategy has two significant components:
Winter Strategy aims to support general practice in improving the management of patients with chronic conditions by implementing important preventative care measures to minimise their risk of hospitalisation. Patients are encouraged to be equal partners with their care team to better manage their chronic conditions, avoid hospitalisation and stay as well as possible during the winter months.
During the Preparation Phase of the program, practices recruit and maintain a register of at least 20 eligible patients to participate in the program. Patients eligible for the program need to:
Once the register of patients is established in the Preparation Phase, practices enter the Implementation Phase of the program and complete the measures for each enrolled patient:
“Like other practices within our region we have many patients with chronic and complex health problems and this program offered the opportunity to be really proactive in their care and management. The aims of the program were really well defined and we found it easy to identify patients that were at high risk of hospital admission or major sickness throughout the winter months. Using Top Bar with our practice software then helped identify the patients that we enrolled in the program and complete the necessary criteria. We have found that the additional time spent with the patient has been invaluable in updating medical notes, ensuring medications are reviewed, immunisations are up-to-date and care plans are given to patients to use in case of hospital admission. We are hoping that we will see a significant reduction in presentation to the Emergency Department from these patients over the winter months due to our proactive and multidisciplinary approach to managing their healthcare needs.” - Dr Kate Brunton - McGraths Hill Medical Centre
If you are interested in joining our winter strategy program, complete the expression of interest form below: