Service Coordination

Service Coordination

The SCPCP Supports member agencies to embed service coordination principles, tools and pathways to improve service delivery, reduce duplication and improve the client journey through the healthcare system.

There are many different types of services available across Victoria’s health and human services system. No common system automatically links services to allow people with multiple needs to access coordinated care.

Service coordination helps health service providers to work together to align practices, processes and systems so:

  • people access the health services they need, no matter what service they go to first
  • providers exchange the right information so consumers receive good care from the right providers at the right time
  • people have their health and social needs identified early, preventing deterioration in health
  • Service Coordination places consumers at the centre of service delivery. The idea is to maximise consumers’ likelihood of accessing the services that they need.

Service Coordination Principles

  • A central focus on consumers
  • Partnerships and collaboration
  • The social model of health
  • Competent staff
  • Duty of care
  • Protection of consumer information
  • Inter-sector and engagement

Operational Elements of Service Coordination

  • Initial contact
  • Initial needs identification
  • Assessment
  • Care Planning

Service Coordination Resources

There are a number of resources developed to assist in the implementation of Service Coordination

Victorian Service Coordination Practice Manual

The purpose of the Victorian Service Coordination Practice Manual is to assist service providers across sectors to consistently implement service coordination.

Secure Messaging and eHealth

Client/patient information needs to be transmitted securely in order to meet the Privacy Legislation and agency accreditation requirements. Encryption, a system to secretly code the message, is a way to make an email secure and meet national standards for secure messaging. Unencryped emails and faxes and not secure; transmitting client/patient information in this way is a high risk practice.

South Coast PCP promotes communication of client/patient information via Service to Service (S2S) is a comprehensive web based directory of health and community services integrated with a secure messaging and referral system.

S2S Argus Project (Information to come…)

Service Coordination On-line Learning Module

Introduction This course has been developed by the Victorian Department of Health and Human Services (DHHS) and the Victoria Primary Care Partnerships to support the practice of Service Coordination in Victoria Staff new the Service Coordination may either complete part or all of this course. If you’re relatively new to Service Coordination, it’s envisaged that you’ll use this course in conjunction with guidance from your manager to identify areas of focus and priority directly relevant to your role and responsibility. Adopting this blended learning approach will facilitate a clear understanding of effective Service Coordination practice within your organisation.

Service Coordination Template Tools (SCTT)

The Service Coordination Tool Templates (SCTT) Online Module is an e-learning tool to support the use of SCTT. Organisations are encouraged to include this module into their staff orientation. Experienced SCTT users may use this e-learning tool as a means of refreshing their knowledge, or as a mechanism to keep updated with the changes to the SCTT 2012.

National Human Services Directory

The National Human Service Directory (NHSD) is a national directory providing practitioners and service providers with information about health, social and disability services Australia-wide. NHSD data supports other directories e.g the Better Health Channel, Nurse-on-call, GP on-call and Disability On-Line.

Better Health Channel

Members of the general public can go to the Better Health Channel (BHC) for a consumer focussed version of the NHSD service directory. The BHC provides health and medical information that is quality assured, reliable, up to date, easy to understand, regularly reviewed and locally relevant. the BHC provides health and medical information to help individuals and their communities improve their health and well-being.

Service Coordination and Chronic Disease Management:

  • Planned and proactive care intended on keeping people as well as possible rather than responding to an illness.
  • Empowering, systematic and coordinated care that includes regular screening, support for self management, assistance to make lifestyle and behaviour changes.
  • Care that is provided by a range of health services and practitioners (eg. GPs, podiatrist, physiotherapist, counsellor, dietitian, nurse, specialist, dentist).
  • Care that is provided over time through the stages of disease progression.

The Wagner Chronic Care Model, with its six interdependent elements, provides the framework for Primary Care Partnerships to develop a service system for improving the care of clients with chronic and complex care needs.

An online Wagner Chronic Care toolkit provides step-by-step descriptions of the specific changes involved in Chronic Care Model implementation, including more than tools, strategies to address financial and operational barriers to quality improvement and case studies of successful quality improvements and service system developments to improve chronic care.

A number of case studies from PCP’s around Victoria outlining examples of good practice in EI & IC, and fact sheets providing specific information and guidance related to particular EI & IC topics have been developed. They have been designed to respond to common issues encountered by PCPs and agencies in planning and implementing EI & IC initiatives.

For information about our current Early Intervention and Integrated Care projects, please click the ‘projects’ tab above.