Mental Health Services

Providing vital links to the many programs that exist within Australia.

Outcome Health is dedicated to the individual patient journey and outcome. We are committed to improving the quality of health service delivery and better access to essential community patient services.

Outcome Health’s Mental Health Care Program provides Credentialed Mental Health nurses for GPs, Private Psychiatrists, Headspace clinics Covid care clinics and Universities where they engage in the provision of coordinated clinical care for people with a range of predominately severe and persistent, (complex and chronic) mental health disorders.

Mental Health Ambulance Response - Ambulance Victoria

Outcome Health has a team of qualified, Senior Mental Health Nurses embedded at Ambulance Victoria Referral Triage Service. This initiative is said to be one of the only programs of its kind in the world, supporting ambulance despatch decision-making processes for callers with Mental Health concerns.

Our embedded clinicians provide:

- - Clinical mental health triage services to 000 callers across Victoria
  - Clinical risk assessment of callers
  - Video call back services
  - Field referrals from onsite paramedics
  - Care planning support

This service operates 24/7 providing Mental Health triage across the lifespan ensuring all callers receive the most appropriate care.

Mental Health Nurse Stepped Care Program (Gippsland)

Outcome Health’s Credentialed Mental Health Nurses work collaboratively with psychiatrists and general practitioners providing services such as:

- - assisting in the development and review of Mental Health Treatment Plans
  - helping to establish a therapeutic relationship with a patient
  - reviewing a patient’s mental state and level of risk
  - liaising with a patient’s family and/or careers
  - psycho-education
  - a range of psychological therapies, such as CBT, DBT, ACT, AOD, Family Therapy, Mindfulness
  - administrating and monitoring of a patient’s adherence to prescribed medications
  - providing patients with information about their physical health and linking back to the GP
  - providing patients with information about other support agencies and programs

Nurse Coordinated Clinics

Designed to provide patients with chronic disease with additional support and strategies.

A nurse-coordinated clinic is designed to provide patients who have a chronic disease with additional support and strategies to self-manage their illness. A clinic usually runs in a set and dedicated time during a practice’s usual business hours, so that patients can access both nursing and GP support for their chronic disease.

Outcome Health’s comprehensive range of clinical support services improve the efficiency and viability of general practices and contribute to better health outcomes for patients.

A clinic can focus on a specific chronic disease such as diabetes or asthma, or have a general focus on caring for people with chronic diseases and facilitating preventative health assessments and care planning.

Our nurse coordinated clinics include:

Asthma/respiratory clinics

Outcome Health respiratory nurse educators provide self-management skills, patient education and support, spirometry, medication education and correct device use, as well as preparing Chronic Disease Management (CDM) plans in conjunction with the GP, and following asthma cycle of care guidelines, enabling access to the Asthma SIP.

Complex care clinics

These clinics provide an opportunity for patients with chronic and complex medical conditions to have a GP management plan (GPMP) and or a team care arrangement (TCA) developed. The information in the plans then gives the patient and all health care providers involved in their care a comprehensive summary of the health issues and management. Clinics can operate as frequently as required by the practice. The nurse will work with the patient and GP to document a comprehensive GPMP/TCA and complete all relevant communication with the team members.

Coordinated Veterans' Care program

The Coordinated Veterans’ Care (CVC) Program is for eligible DVA Gold Card holders living in the community and focuses on improving wellbeing and quality of care for veterans who have chronic conditions such as congestive heart failure, coronary artery disease, pneumonia, chronic obstructive pulmonary disease, diabetes and other complex care needs, who are most at risk of an unplanned hospital admission.

This program requires GPs to prepare for the program, enroll participants in the program and provide ongoing care. Whilst GPs can run this program without nursing support, additional DVA funding is available to GPs whose CVC programs are supported by nurses.

Outcome Health can provide practices with a clinic nurse to manage the day to day care coordination for CVC patients, including completing a comprehensive needs assessment, assisting in preparation of their care plan, care coordination, regular calls and visits to the participant and providing feedback to the GP.

Diabetes clinics

Outcome Health’s qualified diabetes nurse educators provide self-management skills, patient education and support, medication education including insulin initiation and home blood glucose monitoring, as well as preparing Chronic Disease Management (CDM) plans in conjunction with the GP, and following diabetes cycle of care guidelines, enabling access to the diabetes SIP.

Option of Credentialed Diabetes Educator – Allied Health Clinic Model

Where the diabetes clinic is run by a Credentialed Diabetes Educator, the practice may choose to run the diabetes clinic as an Allied Health service. Under an Enhanced Primary Care (EPC) plan, allied health referrals can be made to this position by the GP, and Allied Health MBS items claimed from Medicare. *Please note that if the clinic is run as an Allied Health Service, the nursing hours do not contribute to Practice Nurse Incentive Payments (PNIP).

Health assessment clinics

Outcome Health can provide a nurse with the necessary skills, expertise and training to assist GPs perform health assessments in a four hour clinic session.

Practice Based Assessments

Outcome Health can provide a nurse with the necessary skills, expertise and training to assist GPs perform health assessments in a dedicated clinic session. This is one of Outcome Health’s most lucrative clinic models for practices.

Home Based Assessments

If you have patients that would benefit from a home based assessment, Outcome Health can also arrange Home Health Assessments, either on an ad hoc basis, or in a regular clinic booking. Outcome Health’s nurse will complete the assessment in the comfort of the patient’s home, and return the patient information back to the practice. The GP must then see the patient for a follow up visit to claim the relevant MBS item number. Outcome Health home-based health assessments are invoiced to the practice on a ‘per assessment’ basis.

Comprehensive Medical Assessment (CMA) for those in Aged Care Facilities

This service offers GPs an experienced practice nurse to assist with the documentation associated with completing a CMA for eligible patients. The GP completes a referral slip with relevant information. A Outcome Health nurse will visit the aged care facility to initiate the assessment process, collecting relevant information and returning it to the practice. The GP will then see the patient for a follow up visit to complete the assessment and claim the appropriate item number.

We welcome expressions of interest in our established clinics as well as suggestions for new/pilot programs, projects and support services

Benefits of Nurse Coordinated Clinics in General Practice

A well managed and efficient nurse coordinated clinic can provide increased income and profit, contributing to the long term viability of your practice. Sharing the management of chronic disease patients across multiple disciplines means the GP’s time is used more efficiently, increasing their capacity to see more patients.

By using Outcome Health’s nurse coordinated clinics practices have greater access to diabetes and asthma Service Incentive Payments (SIP) as well as Practice Nurse Incentive Payments (PNIP). Most importantly, nurse coordinated clinics help practices achieve better health outcomes for their patients by increasing the efficiency of practice resources and the range of services available to their patients. Patients appreciate that the nurse is on site with their GP and they can attend their usual practice for this additional service. Patients also appreciate that services are bulk billed, review appointments are easily available and nurses are able to spend more time on education aspects with them if required.

Health outcomes are reflective of improved management and quality of care for patients with a chronic disease, as well as screening, prevention, assessment, patient self management education, care planning and review activities.