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Why single specialty networked care?

Case study 5: Royal Eye and Ear Hospital, Australia

The Royal Eye and Ear Hospital in Melbourne provides an ophthalmology service to a local health service, Eastern Health, which serves a population of 900,000.

The hospital supplies the medical staff and orthoptists and advises on clinical standards and protocols and equipment purchase. The local health service supplies all other staff and is responsible for managing the service.

A partnership agreement was developed outlining the role of each organisation. The primary aim was to provide ophthalmology services and to ensure that clinical quality standards were met. The agreement is reviewed regularly and has changed to reflect evolving requirements.

Benefits include providing care closer to patients’ homes, reducing demand on the hospital and reducing waiting times.

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Key features of the partnership:

  • To address difficulties recruiting to suburban areas, the hospital tries to employ local staff or relocate them from the hospital’s main site if they live in that area.
  • Junior consultants joining the organisation are expected to undertake some of their rostered sessions (in surgery and outpatient clinics) in non-subspecialist clinics including the spoke or partnership clinics.
  • Efforts are made to ensure that outreach staff have access to training at the central site so that they do not become isolated.
  • To ensure standardisation in care delivery, all clinical hospital staff who work in the community maintain clinical sessions at the main site.
  • Some variation in existing clinical standards and protocols is recognised and work is being done to address this.
  • The hospital produces evidence-based, best practice clinical guidelines to streamline processes and audits adherence.
  • Specialist nurse training is routinely offered to graduate nurses who are given supernumerary time with senior staff to receive hands-on training.
  • Patients are involved in the designing of services.