A new Patient Care Facilitator Service in General Practice Program is piloted in Logan
Brisbane South PHN, in collaboration with Metro South Hospital and Health Service, is pleased to pilot the Patient Care Facilitator Service in General Practice Program. This initiative, funded by the Queensland Government, aims to strengthen care coordination for patients in Logan and Ipswich after being discharged from hospital.
The Logan pilot model builds on the strong partnership between Brisbane South PHN and our Hospital and Health Service partner, Metro South Health, to deliver coordinated care for the people in our region. By improving communication between hospital discharge coordinators and local general practices, we aim to enhance follow-up care for patients who require ongoing management of complex or chronic conditions.
"Primary care providers, like GPs and Practice Nurses, play a critical role in supporting patients once they leave the hospital," said Angela How, Program Manager for Brisbane South PHN.
"Our goal is for hospitals to communicate discharge information to GPs more easily, helping GPs connect with their patients so they receive the necessary follow-up care to maintain their health and avoid complications."
How the Logan pilot model works
As of July 2024, 10 general practices in our region are participating in the pilot. These general practices receive notifications from the Logan Hospital discharge coordinator once their patients are discharged after an unplanned hospital admission for a respiratory illness.
This program aims to support patients by ensuring they remain connected to their primary healthcare provider, enabling ongoing monitoring and management of their health needs.
Wellcare, a Kingston general practice involved in the pilot, explains how it is working closely with Logan Hospital to ensure its patients receive the care they need after returning home from the hospital.
"Being part of this pilot program allows us to proactively support our patients' recovery after a hospital stay," explained Vyapti Patel, Lead Practice Nurse at Wellcare. "Our role is to be there for our patients, help them manage their health, and prevent avoidable complications."
While the Patient Care Facilitator Pilot Program is still in its early stages, Brisbane South PHN is optimistic about its potential to improve tertiary and primary care coordination, helping to make a real difference in patient outcomes.
Said Angela, “We’re committed to supporting general practices to deliver quality healthcare to their patients. We know that patients benefit most when they have timely access to their trusted GP and primary healthcare team after being discharged from the hospital.”
Angela added, “This program is one of the many ways we work with our Hospital and Health Services partner, Metro South Health, and our local primary healthcare providers to support seamless, coordinated care in our community.”
More information
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