In part 1, we learnt:

Part of the comprehensive care we provide at PartridgeGP includes visiting Residential Aged Care Facilities

It is a pleasure and a privilege to serve our older patients

We MUST remember certain rules

You MUST see your patient (face to face or via telephone/telehealth) for them to claim a Medicare Rebate

There is NO such thing as a QUICK LOOK

Older patients are frail – do not prescribe powerful medications (opioids, benzodiazepines, anti-hypertensives) without careful consideration and review.

In part 2:

The Swiss Cheese model of accident causation, originally proposed by James Reason, likens human system defences to a series of slices of randomly-holed Swiss Cheese arranged vertically and parallel to each other with gaps in-between each slice.

We spend time developing a relationship with the facilities as well as our patients. This builds trust and all parties know more about the capabilities, needs, and limitations of the other. This is not just a residential aged care issue – this is an issue with hospitals as well. I have mentioned this here and here.

“PASSING the baton” describes what health care professionals try to achieve as care of patients is transferred between providers in our complex health care systems. The safety concerns related to poor clinical handover are not new: it’s a problem the health care industry and doctors as a profession have been grappling with for decades. Poor clinical handovers are wasteful of limited resources. How can we improve patient outcomes and “drop the baton” less often?

In addition to these, we believe fewer medications, less often can be a boon. To paraphrase Christian Ryan (writing about Shane Warne of all things!), we aim to be: Like the great classical painters, we stumble upon the art of simplicity. Our prescribing was never simpler, nor more effective, nor lovelier to look at. Medication reviews and keeping up to date help a lot with this. Telehealth can also help.

There is not a pill for every ill. Recent studies have shown what we have long thought – many medications are just not that useful for our elders. We can, will, and do support our fantastic residential aged care facilities and their staff in looking after our patients/residents without multiple excess medications. Facilities are labouring under the imposts of paperwork and bureaucracy. We will help!

Let’s continue with this!

There is not a pill for every ill and pills do not substitute for great nursing care. We will support our patients to live their best lives and we will support our Residential Aged Care Facilities and their staff in helping them do that as well. After all, some of these medications just don’t work as well as they say they do…

Calling after hours doctors (often NOT GPs) during the after hours period, when regular staff are not on, and expecting them to do great work, speaks to a failure during the in hours period, in my opinion. Clear communication, documentation, and direction based on regular in hours reviews with patients, staff, and families, should reduce inappropriate prescribing of sedative hypnotics – and reduce falls, improve quality use of medicines, and potentially, add life to years rather than years to (sedated) life.

Urine. It’s not the window to the soul. Urine samples should only be sent to the lab when the clinical decision has been made to use antibiotics. A urine dipstick (a plastic strip with colour coded boxes that turn different colours in the setting of infection or abnormalities) is more than enough to make clinical decisions with. Don’t waste money looking at urine for no reason.

Don’t just leave medications on a drug chart without thinking about whether they are still needed. A drug chart full of entries is time nursing staff have to spend with pills and charts rather than with patients. Pills aren’t care…in fact they eat away at the time and attention allocated to care. Less is very often more.

Sometimes, people need to be restrained, chemically or physically, for their own benefit. This should be safe, legal, and rare. This is always a case where some calm talking with patients, staff, and families, can produce better outcomes.

PartridgeGP works with all involved with aged care to help make better health decisions, and we won’t just ‘have a quick look’. We pride ourselves on great communication and we’re ready to share our professional skills and knowledge with you. 

Let us be the missing piece in your puzzle! This is only MORE important now, in the time of a global pandemic with a new vaccine on the horizon. The way forward is clear: make your appointment with us conveniently online right here – or call our friendly reception team on 82953200.

Better, for you.

Want more?

Photo by Miguel u00c1. Padriu00f1u00e1n on Pexels.com

For everyone, we believe that having a usual GP or General Practice is central to each person’s care and recommend that people with any health issues that come to the attention of other health professionals should be advised to attend their usual GP or General Practice rather than a specialised service (ie a place not providing the holistic care a specialist GP would).   If  they say that they don’t have a usual GP or general practice, they should be helped to find one and to actually attend it. Call PartridgeGP on 82953200 or make an appointment online here.

(Hat tip: Dr Oliver Frank)

Photo by Miguel u00c1. Padriu00f1u00e1n on Pexels.com

If you’re employed, get a side hustle and get into business. If you’ve already got a business, get a network. Want to get started? Find your tribe here!

If you are a great GP or a great Allied Health Professional, and you want to serve your clients or patients to the best of your ability, without worrying about all the non clinical things that get in your way, lets talk. Call Mrs Hayley Roberts on 8295 3200 and have a coffee and chat with us as to how PartridgeGP can help you to help others.

In yesterday’s part 1, we learnt:

Part of the comprehensive care we provide at PartridgeGP includes visiting Residential Aged Care Facilities

It is a pleasure and a privilege to serve our older patients

We MUST remember certain rules

You MUST see your patient (face to face or via telephone/telehealth) for them to claim a Medicare Rebate

There is NO such thing as a QUICK LOOK

Older patients are frail – do not prescribe powerful medications (opioids, benzodiazepines, anti-hypertensives) without careful consideration and review.

This appears to be a Swiss Cheese problem. The Swiss Cheese model of accident causation, originally proposed by James Reason, likens human system defences to a series of slices of randomly-holed Swiss Cheese arranged vertically and parallel to each other with gaps in-between each slice.

Reason hypothesizes that most accidents can be traced to one or more of four levels of failure:

• Organisational influences,
• Unsafe supervision,
• Preconditions for unsafe acts, and
• The unsafe acts themselves.

In the Swiss Cheese model, an organisation’s defences against failure are modelled as a series of barriers, represented as slices of the cheese. The holes in the cheese slices represent individual weaknesses in individual parts of the system, and are continually varying in size and position in all slices. The system as a whole produces failures when holes in all of the slices momentarily align, permitting “a trajectory of accident opportunity”, so that a hazard passes through holes in all of the defences, leading to an accident.

So what does PartridgeGP do a little differently?

We spend time developing a relationship with the facilities as well as our patients. This builds trust and all parties know more about the capabilities, needs, and limitations of the other. This is not just a residential aged care issue – this is an issue with hospitals as well. I have mentioned this here and here.

“PASSING the baton” describes what health care professionals try to achieve as care of patients is transferred between providers in our complex health care systems. The safety concerns related to poor clinical handover are not new: it’s a problem the health care industry and doctors as a profession have been grappling with for decades. Poor clinical handovers are wasteful of limited resources. How can we improve patient outcomes and “drop the baton” less often?

Communication is key – better communication equals better outcomes. Documentation of communication is the secret sauce.

Of course, our fundamental ethos of time and care for our patients and their families doesn’t stop as they progress to residential care – Advance Care Directives allow THEIR wishes to take centre stage at all times. In addition to these, we believe fewer medications, less often can be a boon. To paraphrase Christian Ryan (writing about Shane Warne of all things!), we aim to be: Like the great classical painters, we stumble upon the art of simplicity. Our prescribing was never simpler, nor more effective, nor lovelier to look at. Medication reviews and keeping up to date help a lot with this. Telehealth can also help.

There is not a pill for every ill. Recent studies have shown what we have long thought – many medications are just not that useful for our elders. We can, will, and do support our fantastic residential aged care facilities and their staff in looking after our patients/residents without multiple excess medications. Facilities are labouring under the imposts of paperwork and bureaucracy. We will help!

PartridgeGP works with all involved with aged care to help make better health decisions, and we won’t just ‘have a quick look’. We pride ourselves on great communication and we’re ready to share our professional skills and knowledge with you. 

Let us be the missing piece in your puzzle! This is only MORE important now, in the time of a global pandemic with a new vaccine on the horizon. The way forward is clear: make your appointment with us conveniently online right here – or call our friendly reception team on 82953200.

Better, for you.

Want more?

Photo by Miguel u00c1. Padriu00f1u00e1n on Pexels.com

For everyone, we believe that having a usual GP or General Practice is central to each person’s care and recommend that people with any health issues that come to the attention of other health professionals should be advised to attend their usual GP or General Practice rather than a specialised service (ie a place not providing the holistic care a specialist GP would).   If  they say that they don’t have a usual GP or general practice, they should be helped to find one and to actually attend it. Call PartridgeGP on 82953200 or make an appointment online here.

(Hat tip: Dr Oliver Frank)

Photo by Miguel u00c1. Padriu00f1u00e1n on Pexels.com

If you’re employed, get a side hustle and get into business. If you’ve already got a business, get a network. Want to get started? Find your tribe here!

If you are a great GP or a great Allied Health Professional, and you want to serve your clients or patients to the best of your ability, without worrying about all the non clinical things that get in your way, lets talk. Call Mrs Hayley Roberts on 8295 3200 and have a coffee and chat with us as to how PartridgeGP can help you to help others.