Mental health post-discharge care
The NSW Acting Auditor-General, Tony Whitfield, today released a report on the care that is provided to mental health patients in the first seven days after they are discharged from acute mental health units.
The audit examined models of care provided by five Local Health Districts: Northern NSW, Sydney, Western Sydney, Central Coast, and Murrumbidgee. The audit looked at how well these Local Health Districts implemented the Ministry of Health’s policy directive on the transfer of mental health patients from hospitals to the community.
'Overall, mental health patients receive good follow-up care after they are discharged', said the Acting Auditor-General. 'However, there are still good practices that should be more widely adopted', he added.
Increasing proportion of patients receiving follow-up care
The proportion of patients receiving follow-up contact within seven days of discharge has increased in NSW over recent years. Local Health Districts have made this a priority, and many clinicians go to great lengths to ensure that patients are not lost to care. In some cases, clinicians make exhaustive attempts to contact discharged patients.
However, not all Local Health Districts have achieved the benchmark of 70 per cent of patients receiving follow-up care within seven days of discharge.
'While the efforts of clinicians must be applauded, some patients still do not receive follow-up care and further improvement is needed to ensure individuals don’t fall through the cracks', Mr Whitfield said.
Greater patient, family and carer involvement needed in planning
More attention is required to ensure that patients and their carers are involved in preparing the care plans that accompany their transfer from hospital to the community.
'The policy directive talks about putting consumers, their carers and families at the centre of care, though very rarely were they involved in planning or even given a copy of a transfer of care plan', said the Acting Auditor-General.
Good discharge practices help to promote good post-discharge care
We found that discharge planning varies considerably across Local Health Districts, although there was a strong consensus that good discharge planning plays a crucial role in good post-discharge care.
'There is substantial opportunity for greater sharing of good discharge planning', said the Acting Auditor-General. 'Some Local Health Districts ensure that their community mental health teams are involved with inpatients, while others wait until the patient has already been discharged to the community', he added.
There was consensus among clinicians that post-discharge care can be hampered when patients have a rushed or poorly planned discharge from hospital. Planning for discharge needs to begin as soon as possible after a patient is admitted, and community mental health services need to be brought into the hospital to be part of these discussions. This helps to ensure a good understanding of the patient’s physical, psychosocial and practical needs in the community.
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