Kristi has worked with Hall & Prior for the past six years and now holds the role of Regional Leader for the Great Southern and South West areas. She works across Hall & Prior’s homes in Albany, Donnybrook and Harvey spanning over 400km. Kristi is a Registered Nurse by background but also has a PhD which has allowed her to gain both clinical and research experience in the aged care sector. Kristi has a particular interest in accessibility to aged care in a rural setting as well as palliative care. Kristi is passionate about older Australians having access to quality aged care regardless of their proximity to regional hubs. She is also passionate about providing older and ageing Australians with choice in their care needs as they age.
A true integrated care model; home care, long term care, and specialist palliative care in an Australian regional centre
Kristi Holloway, Hall & Prior Health and Aged Care Organisation, Australia
The challenge of long term care is significant social and economic issues facing much of the world. The Australian aged care sector has traditionally been complex, often fragmented, with different funding and management strategies.
Consistent with global demographic trends, Australia has a rapidly growing older population. Services need to adapt to cater for the increase demand and evidence suggests that innovative models with greater uses of shared resources and a combined approach to workforce and care delivery will be required.
The concept of integrated care is not new. It has been highlighted as a strategy to improve care coordination, quality outcomes and efficiency across many different cohorts, particularly those with chronic conditions. However, there are few practical examples of integrated models in work targeting aged care services generally. A model combining a residential and community aged care program in regional Western Australia demonstrates the successful concept of integrated aged care.
Clarence Estate represents a best practice integrated aged care service, operating 86 long term care beds (since 2002), 200 home care clients in the community, and a further 100 clients receiving specialist, in home palliative care services. Management and clinical governance is overseen by a singular, nurse led structure, with the scale of operations providing the opportunities for education and career development. The purpose is to provide insight on the structure and working of the model and demonstrate outcomes and the lessons learnt. It will focus on what has been identified as key pillars in the development of an integrated model of care, providing a best practice model about how an integrated service can be replicated in other regional areas through
- Building on existing community based clinical services and infrastructure;
- Building and enhancing existing networks and partnerships;
- Accessing other care packages in the community, such as home care packages to support basis functions such as cooking and cleaning;
- Implementing seamless handover protocols between services; and
- Detailing a care plan between individual patients, their families, and care providers that reflects the wishes of the patient, including end of life planning.
- Becoming an employer of choice in a competitive employment market
Key lessons have been learnt from this model. Significant benefits for care recipients include familiarity and ongoing connectedness with staff. Strategic partnerships between residential and community care services offer mutual benefit to the organisation, service and client. The shared use of staff and resources enables a flexible, cost effective service that is responsive to the choices of care recipients particularly with the move towards a single standardised framework. This care model has also been able to translate policy into practice. Provision of services that are comprehensive, integrated, offer a range of services that minimise the number of providers a care recipient has to engage with, have long been recommendations of government policy, agencies and aged care advocates.
The lessons learnt from this innovative integrated model applied are transferrable to other residential facilities and have implications for future interventions, funding initiatives and programs.