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Older Persons and Rehabilitation is entering an exciting period of expansion and service re-development.
Looking to the future – expansion into the new facilityWe are expanding our service and building a major new assessment, treatment and rehabilitation facility, the Older Persons and Rehabilitation Building, right across the road from the main Waiora Waikato Hospital campus.
This purpose-built space for assessment and rehabilitation teams will allow for seamless provision of:
The new facility will have 113 beds. Significant outdoor areas and courtyard space are also part of the plans.
- services for older adults: inpatients, assessment-treatment-rehabilitation, and outpatients
- mental health services for older people
- organised stroke services including acute stroke service
- rehabilitation services for <65 year olds.
Construction also includes a bridge over Pembroke Street to link the building with Waikato Hospital.
Visit the photo gallery to see construction progress images.
VIDEO: Older Persons and Rehabilitation Building - construction
||Construction began in December 2011, and is due for completion June 2013.|
The building will allow more cooperation among the contributing specialties of psychiatry, orthopaedics, adult medicine/neurology (stroke), and surgery.
While these are separate and distinct specialties, there are clear points of shared interest and service interface.
The ‘rubbing of shoulders’ in the workplace and the culture of rehabilitation is associated with better outcomes and shorter lengths of stay.
Photo: Architect's impression of the new Older Persons and Rehabilitation Building.
Looking to the future - service redevelopment
The new facility will be fantastic, but service development is just as important as the bricks and mortar. Service redevelopment will be very important for improving patient outcomes, enhancing throughput and gaining efficiencies across the organisation. Both services are excited about and committed to:
- service collaboration, ensuring service delivery is seamless and appropriate across the care continuum
- integrated service delivery, achieving a value that the constituent services cannot achieve in isolation
- greater efficiency and efficacy of services
- collocation, improving communication in the interests of patients and staff development.
We will endorse seamless care through staff engagement, clinical and service integration, and working together with our patients, their families and whanau.
Redesigned service delivery models will be mindful of the need to provide a greater range of convenient services closer to our patients’ home to promote and protect good health, self management and independence in the community. Our admission avoidance scheme (START) will help us ease the pressure on the hospital.
Implementation of the InterRAI tools will ensure needs assessment and care planning focuses on how to best meet our patient’s needs and optimise individual function and potential. The various components of a patient’s care plan will be well integrated to ensure better, sooner more convenient service delivery.
We are also working hard on building a flexible, sustainable, fit for purpose workforce who will be well positioned to deliver healthcare services for older people. Service developments already happening include:
New services are planned, such as
- Comprehensive Stroke Unit
- Orthogeriatrics Rehabilitation Service
- Supported transfer and accelerated rehabilitation teams for Hamilton, Tokoroa, Thames and Hauraki areas
- further roll out of supported transfer and accelerated rehabilitation teams and home-based therapies
- improved collaboration for outpatient services, such as falls and ‘funny turns’ clinics
- and making the most of the existing outpatient facilities such as the Memory Service.
There are exciting new opportunities to research and develop, such as community-based support teams (clusters) of staff nestled in primary practice.
Research and training options for all members of staff will be encouraged, including unique training opportunities focussing on, for example, adult rehabilitation and comprehensive stroke services.Implementation of the interRAI assessment tools in Waikato DHB and throughout New Zealand
The Acute Stroke
More than 650 patients are admitted to Waikato Hospital every year with strokes or transient ischaemic attacks and another 250 in the Midland region. Best practice, evidence and expertise in stroke management and rehabilitation guide the development and direction of the Waikato stroke service.
Rehabilitation is an essential part of stroke recovery for the majority of patients, however in those cases where recovery is no longer possible the rehabilitation team aims to facilitate adjustment by providing support to individuals and families in managing to live with stroke related problems.
The establishment of the Acute Stroke brings together the interdisciplinary team philosophy, which offers a comprehensive, holistic, patient-centred approach to care. The Stroke Foundation field officer plays an integral part in the team offering support to patients and families.
Primary and community health care providers activate referrals to the Acute Stroke by a single point of entry referral.
Overview of current services and facilities
||Older Person and Rehabilitation provides interdisciplinary assessment, treatment and rehabilitation (AT&R) services for adults. |
Physicians lead interdisciplinary teams consisting of medical, nursing and allied health staff, in both geriatric medicine and rehabilitation.
Our inpatient, outpatient and community-based services, include:
- Waikato Hospital - Inpatient AT&R including Ward 54 (Orthopaedic Rehabilitation Service), Ward 55 (Comprehensive Stroke Unit and Neuro Rehabilitation), Ward 58 (general AT&R) - see details below
- Thames Hospital – 10 AT&R beds
- Matariki and Rhoda Read
- Disability Support Link (DSL) – community-based service coordination for people with disabilities and a need for long term supports.
Inpatient AT&R (Assessment, Treatment and Rehabilitation)
Our purpose is to provide assessment, treatment and rehabilitation for people over the aged of 65. Specialised rehabilitation is also provided for younger people over the age of 16.
We aim to restore, maintain and promote their cognitive and functional ability.
Assessment, treatment and rehabilitation consists of a cluster of areas providing specialist intensive assessment, treatment and rehabilitation.
Excellence in patient care and outcome is paramount and this is achieved by providing effective and evidence based care.
All units have been refurbished and new equipment provided. Each area features comfortable lounge areas specific to patients and their families/whanau. Therapy areas are available with opportunities for group work, education and recreation.
WARD 54 - Orthopaedic Rehabilitation
Ward 54 is a 22-bed orthopaedic rehabilitation ward.
We work in collaboration with acute orthopaedics to ensure a seamless approach between post operative or acute care and active and intensive rehabilitation.
Although patients present with an orthopaedic event, they commonly have co-morbidities requiring complex planning, treatment and evaluation. We strive for an interdisciplinary approach. Care planning includes nursing, allied health and medical in the first instance. The extended team members are accessed as required and join the team to consult and advice on individual patient requirements.
WARD 55 - Comprehensive Stroke Unit and Neuro Rehabilitation
Ward 55 is a 23-bed stroke and neuro rehabilitation ward.
Ward 55 provides acute care for patients with stroke and those requiring assessment, treatment and rehabilitation.
This is a newly refurbished ward with collocation of acute and rehabilitation stroke. Our model of care will focus on the acute needs and assessment, treatment and rehabilitation across the continuum.
Care is provided by a ‘core team’ and each patient is allocated a core clinician to ensure continuity of care is provided to patients, family and whanau members.
WARD 58 - Assessment, treatment and rehabilitation (AT&R)
Ward 58 is a 28 bed unit providing generalised assessment, treatment and rehabilitation to people from 16 years of age and over.
Patients are under the care of either a geriatrician or rehabilitation physician.
Principles of best practice in older persons care underpin the care delivery to our older patients. A team nursing approach is the key to this cluster. Two teams work across the ward and nurses are joined by allocated allied health members. Learning opportunities are available in the clinical environment with regular ‘nursing rounds’ lead by clinical nurse specialists and nurse educators.
The Ward 58 team is friendly with multicultural diversity.
Disability Support Link (DSL)Disability Support Link (DSL)
– community-based service coordination for people with disabilities and a need for long term supports.
In September 2012 DSL won an award for a person or organisation who has made a significant contribution to the Health and Disability Sector within the Waikato Region within the past 12 months.
The award was part of the 2012 Health and Disability Expo held at Claudelands, and was presented at the Life Unlimited Awards breakfast.
"We were delighted to receive the award for the organisation who has made a significant contribution to the sector. We were nominated by a national provider, who identified that DSL was a great NASC to work with, as we were not bureaucratic, had a holistic view of the client needs, and addressed the client support needs promptly. They also identified that we had excellent relationship skills," says Kim Holt, manager DSL.Implementation of interRAI brochure
Opportunities for resident medical officers (RMOs)
Resident medical officers gain experience in dealing with a broad range of conditions and are important members of interdisciplinary team.
We provide excellent opportunity for resident medical officers to practise medicine in the Older Persons and Rehabilitation's community-based and home-based settings.
Resident medical officers also have the opportunity of seeing new GP referred patients to outpatient clinics and do this work under the supervision of consultant physicians.
Resident medical officers work in the Older Persons and Rehabilitaton for a period of three months and rotate with other sub-specialities of medicine. For those who are interested, longer periods of appointment will be available. This area of medicine is as an excellent training ground for those wishing to pursue GP training.
Teaching programmes include weekly rehabilitation education meetings, grand rounds, medical unit case presentations, trainee lectures and radiology sessions.
Clinical leadership partnership
Clinical Services Leader
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