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Department of Rural Health

University Department of Rural Health Excellence and equity in Rural Health through education, research and engagement Rural Health Academic Network Building capacity in small rural health services

Who: Rural Health Academic Network (RHAN) - University of , UDRH How: Jointly funded academics are embedded in rural health services to provide expertise in research capacity building, research governance, translation to practice and student support. Why: A strong research culture generates new career pathways, improves staff satisfaction and retention, organisational performance and evidence based practice. Where: , , , -, Impacts: Enhanced capacity of our rural populations to access timely and effective care. for the community; reduced burden on staff and service; improved patient care.

The Rural Health Academic Network “The organisation is complimented on its primary health networks and community (RHAN), an initiative of the University of accommodation and approach to research. groups, RHAN has seen a sustained Melbourne, UDRH, has been collaborating The systems and processes in place are as impact most particularly in the area of with local health services since 2006. At comprehensive as any metropolitan health workforce role development. Signature present a team of jointly-funded academics service. The partnership in research is work has included Nurse Practitioner is based in five rural Victorian health comprehensive. The systems and processes education programs in mental health, services: Northeast Health Wangaratta, in place were consistent, robust and aged care, critical care, palliative care and Numurkah District Health Service, Cobram sustainable.” emergency care; development of rural District Health Service, Albury Wodonga (Auditors report of the ACHS EQuIPN and isolated practice endorsed registered Health and Echuca District Health Service. organisation wide survey of Cobram District nurses (RIPERNs) to support after hours Health 2016) urgent care and research informing clinical As a network, this team works to support practice using telehealth technology. Each education and build research capacity Working with nursing, medicine, allied of these initiatives enhances the capacity of in these services, undertaking a range of health and health administration our rural populations to access timely and evaluations, service development projects disciplines in addition to local councils, effective care. and supporting the rural health workforce in research and professional development. Team members are interested in allied health workforce, maternity care, chronic conditions, aged care and the prevalence of obesity in rural areas. The RHAN team supports their partner health services, students and practicing clinicians with research project design, ethics review, data analysis and dissemination of findings in diverse topics relevant to rural health. To date in 2018 we have supported 22 local research projects.

RHAN provides crucial research leadership and governance to our small rural health partners as noted by this comment: Outcome ■■ A detailed analysis of the 2017 ED The outcome from this work is a presentations to new model of care informed by local Health in (triage category evidence in Wangaratta and . 3, 4, and 5) from patients who live in The model includes a dedicated COPD four nearby locations all with UCCs transition officer position, a specific to better understand patterns of COPD cycle of care, a patient held ‘My presentation and potential gaps in Lung Health booklet’ and a number the UCC service provision. of workforce development initiatives ■■ Academic support was provided to including professional development and 3 local nurses to complete the rural an ongoing community of practice to isolated practice endorsed registered enhance the skills of health professionals nurses (RIPERN) education. within the region. There is further ■■ Data collection, analysis and monitoring of hospital and GP data and evaluation reports on Telehealth a follow-up survey of patients and health services from Northeast Health professionals to continuously evaluate Wangaratta and Albury Wodonga the impact of this project on patient Health EDs to outlying UCCs. experiences and unplanned hospital Crucial to success is the admissions. Outcomes translation of education and RIPERN qualifications have enabled This project has recently been nominated afterhours and weekend staffing of UCCs research into practice: for a Victorian Public Health award. in Cobram and Numurkah.

Case Studies Improving access to afterhours Over 900 after-hours telehealth urgent care through upskilling consultations to UCCs have now been Improving care for rural people registered nurses and use of provided & evaluated. with Chronic Obstructive Airways Telehealth in Rural Urgent Care Disease (COPD) Centres (UCCs) More than half of all patients presenting after hours to UCCs in the The Problem The Problem Telehealth service have avoided travel Sub-optimal coordination of care for has 67 rural urgent care to a regional ED. chronic disease is associated with centres which see more than 140,000 poorer patient outcomes and reduced presentations per year (9% of Victoria’s For further quality of life. Rural health services total). Maintaining these UCCs is information or to can be challenged to provide optimal challenged by overall workforce coordination of care due to workforce shortages, GP burnout and potentially discuss a potential constraints and restricted access to unnecessary low acuity presentations specialist care. to the larger regional Emergency collaboration Departments(ED). This has had contact: The Response serious service implications across The RHAN team is supporting Northeast the Moira shire. Health Wangaratta, Albury Wodonga T: 57 220 17 03 Health and Numurkah District Health The Response E: [email protected] in partnership with the Murray Primary RHAN is working with Numurkah and Health Network to improve the service Cobram District Health services to provide experience of people suffering from data for education of local communities COPD. One project has identified barriers on best use of the UCC and to assist local and enablers for coordination of COPD nurse’s upskilling to provide urgent care. care within the Wangaratta and Benalla Across the region more broadly region from the perspective of health RHAN provides ongoing evaluation professionals and patients through support in the use of ED/UCC telehealth surveys, interviews and analysis of technologies. Work has included: hospital data.

Contact Details:

medicine.unimelb.edu.au/school- +61 3 5823 4500 [email protected] structure/rural-health

Shepparton, Wangaratta and The UDRH acknowledge the Australian Government Department of Health for funding through the Rural Health Multidisciplinary Training programme. July 2018

CRICOS 00116K