Post Discharge Care from Hospital Emergency Departments

1. Project Profile

Project Name(s)	Post Discharge Care from Hospital Emergency Departments Full title: Post Discharge Care for Patients Presenting to Emergency Departments with Deliberate Self Harm or Suicide Attempt
Funded Organisation	General Practice QLD
Geographical Area	Local
State/Territory	Queensland
Approach(es)	Indicated
Individual/Group	Individual and Group
LIFE Action Areas	Improving the evidence base and understanding of suicide prevention Taking a coordinated approach to suicide prevention Providing targeted suicide prevention activities Implementing standards and quality in suicide prevention
Target Groups	People who have previously attempted suicide People who have self harmed Workforce

2. Project Description

The project was developed in response to research highlighting the lack of support provided to low risk clients upon discharge from emergency departments (EDs) following self harm or suicide attempt. The project aimed to prevent suicide by addressing the need for improved discharge planning, referral and support of people at risk of deliberate self harm or suicide, who present at the Royal Brisbane and Women's Hospital (RBWH) and Princess Alexandra Hospital (PAH) emergency departments. The project aimed to achieve this by establishing and enhancing clear and effective linkages between divisions of general practice, general practice, specific clinical staff within hospital EDs and relevant community based services. NSPP funding for this project did not continue beyond June 2012.

3. Activities

• Provision of appropriate assertive follow up with primary and community care services to support eligible patients who present at the RBWH and PAH EDs with deliberate self harm / suicidal thoughts / behaviours, i.e.:
  • Clear referral pathways developed and documented at both sites
  • Ensure patients are followed up by a suitable practitioner within 24-72 hours following referral from the RBWH or PAH
  • Increase the capacity of Metro North Brisbane Medicare Local and Accoras to assist GPs and ATAPS providers to provide effective follow up to at risk patients, particularly on discharge from the ED
  • Improved discharge planning, clear referral pathways and follow up services developed and reviewed on a regular basis
  • Establish effective liaison with Primary Care (PC) service members, and other referring agents to shape referrals, pathways and support local care
  • Develop linkages with and provide information and education to GPs, psychologists and other mental health care service providers.
• Establishment and implementation of agreed written protocols, procedures, communication and governance processes for management of this patient group between emergency departments and divisions of general practice (now Medicare Locals), i.e.:
  • Develop a shared clinical governance framework which encompasses patient care, Medicare Locals, and QLD Heath roles and responsibilities, complaints processes and appropriate systems
  • Ongoing revision of protocols, procedures, communication and governance processes.
• Establishment and implementation of clear and effective linkages between Medicare Locals, general practice, specific clinical staff within hospital EDs and relevant community based services, i.e.:
  • Source any educational programs relating to suicide prevention including detection, assessment and treatment, particularly suited to the PC and non-government organisations (NGO)
  • Support the roll out of education particularly joint training between sectors
  • Build and strengthen connections between Mental Health Services, PC and NGOs. Top of page

4. Funding

• Round 1
  • NSPP funding
    • 2006/07 - not applicable
    • 2007/08 - not applicable
    • 2008/09 - $296,000
  • % project funding - not applicable
• Round 2
  • NSPP funding
    • 2009/10 - $214,545
    • 2010/11 - $240,713
  • % project funding - 100%
• Round 3
  • NSPP funding
    • 2011/12 - $267,585
    • 2012/13 - not applicable
  • % project funding - 100%

5. Staffing

• Round 1 (2006/07, 2007/08, 2008/09)
  • Number staff positions funded (FTE) - not applicable
  • Number staff positions filled (FTE) - not applicable
• Round 2 (2009/10, 2010/11)
  • Number staff positions funded (FTE) - 2.5
  • Number staff positions filled (FTE) - 2.5
• Round 3 (2011/12, 2012/13)
  • Number staff positions funded (FTE) - 2.5
  • Number staff positions filled (FTE) - 2.5