The Hospital Independence Program (HIP) incorporates a range of specialist care services that provide:
- specialist assessment
- diagnosis
- intervention
- management
- education
- support to clients with specific medical conditions.
These clinics treat:
- continence
- cognitive, dementia and memory services (CDAMS)
- falls and balance
- movement disorders
- chronic pain management
- chronic wound management
- young adults with complex medical needs
- Poliomyelitis (polio).
HIP clients with complex care needs or who are in residential care have access to specialist assessment and intervention based on their care needs.
Continence clinics
HIP continence clinics provide:
- specialist assessment
- diagnosis
- time-limited goal-orientated management
- education and support for clients with bladder and/or bowel dysfunction.
They assess the need for continence products and then prescribe and assist people to access them through funding schemes.
The clinics also provide consultancy, education and advice to health professionals as well as support to carers and relatives.
Cognitive, dementia and memory services (CDAMS)
The HIP service provides early diagnosis, advice, support and referral for people with cognitive difficulties that cause confusion, memory loss or thinking problems.
CDAMS also aim to support family and carers of those with cognitive issues.
Cognitive Dementia and Memory Service Best Practice Guidelines
Falls and balance clinics
These clinics focus on the assessment and management of clients with falls and balance problems. Clinics aim to provide a diagnosis and referral to other services for ongoing client management. They may provide time-limited specialist intervention.
Clinics also provide education to clients, carers and health professionals.
Movement disorder clinics
These clinics are for people with movement disorders, particularly Parkinson’s Disease or other progressive neurological disorders. Movement disorder clinics provide assessment, education, medication review and development of management strategies.
Chronic pain management clinics
These clinics focus on reducing the risk of long-term disability through clinical assessment. They provide treatment on a time-limited basis for people presenting with moderate to severe levels of chronic non-malignant pain.
Integral to the service model is a focus on enabling clients to gain an improved ability to self-manage their condition, and on developing strong links with the patients’ primary carer. This is to support continuing management in a primary care setting, following discharge from a specialist service.
Chronic wound management clinics
Wound clinics provide specialist assessment, diagnosis, management and support to clients with chronic, complex, reoccurring or non-healing wounds.
Young adults with complex medical needs
There are clinics is for young adults with complex disabilities when they are transitioning from paediatric to adult health services.
The focus of these clinics is to provide case management for young adults, assisting them to access the most appropriate adult services for their needs.
These clinics are currently based at Barwon Health, Bendigo Health, Melbourne Health, Monash Health, and St Vincent’s Hospital Melbourne.
Different health services have different diagnostic focuses. Diagnoses seen so far include:
- spina bifida
- cerebral palsy
- other congenital neurological conditions resulting in ongoing physical disability.
Polio Services Victoria
Polio Services Victoria provides assessment, care planning and long-term review of clients with post-polio syndrome. This statewide service is based at St Vincent’s Hospital Melbourne, with regular rural and regional clinics held throughout the state.
Polio Services Victoria provides consultation, education, training and support to health professionals and services working with clients who have post-polio syndrome.
Residential aged care clients
Specialist assessment services for people living in residential aged care homes provides short-term care coordination, outreach and specialist assessment of aged care residents.
More specifically, these services provide assessment and management (in appropriate circumstances) of acute medical conditions that would otherwise result in a resident unnecessarily going to hospital.
Some services may also be able to provide specialist geriatric medical assessment regarding a resident’s other conditions.
These services have been commonly referred to as residential in-reach, for more information on locations of these services, see Residential In-Reach Pilot Program Evaluation 2009 Report on our Better Health Channel website.
Chronic and complex needs
People with complex needs and/or chronic conditions, including human immunodeficiency virus (HIV), have access to specialist assessment and chronic disease management interventions based on their care needs and condition.
People with progressive neurological diseases (PNDS) can access a statewide model provided by Calvary Health Care Bethlehem (CHCB).
The role of CHCB is to build the capacity of providers across the state to deliver appropriate, integrated services to this group of people (those who are experiencing high levels of complex needs), through:
- regional PND services, supported by CHCB
- outreach tools to support patients, families, new PND services and the general workforce; for example, shared care plans, secondary consultation and education.
Osteoarthritis Hip and Knee Service
Osteoarthritis Hip and Knee Services (OAHKS) are specialist care services that coordinate the management and treatment of people with hip or knee osteoarthritis. OAHKS helps people manage their osteoarthritis by developing and coordinating a management plan that suits their needs it can also include assessment for surgery and helping patients while waiting for their planned surgery.
The service incorporates a multidisciplinary musculoskeletal team which can include allied health professionals such as physiotherapists, nurses and doctors, such as rheumatologists or orthopaedic surgeons. OAHKS aims to provide coordinated communication between referring General Practitioners (GPs), allied health services, preparation list (waitlist) managers and surgeons.
OAHKS has shown to provide the following benefits:
- Early comprehensive assessments resulting in fast-tracked surgical assessments as appropriate and/or early referral for conservative management
- Active management of the planned surgery preparation list
- Improved patient satisfaction
- Better use of limited specialist orthopaedic services.
How the service helps people with osteoarthritis
OAHKS helps people to manage their osteoarthritis by developing and coordinating a functional management plan that matches their needs.
The service provides information and guidance on the best way to manage osteoarthritis. It can assist in detecting deterioration and escalating patients to appropriate services based on their change in health, supporting access to surgery where appropriate.
How the service helps GPs
OAHKS works collaboratively with patients and their GPs to optimise best possible outcomes in the management of osteoarthritis.
The findings of any assessment and proposed treatment plan will be sent to GPs for information or feedback.
The service will advise of any significant variation from the proposed treatment plan.
The hip and knee questionnaire
The Hip and knee questionnaire is a validated tool consisting of eleven questions and takes approximately five to ten minutes to complete. It collects information about:
- severity of pain
- enjoyment of life
- ability to care for themselves and care for others
- ability to undertake paid employment
- variations in the severity of disease overtime.
A score is calculated based on the answers given in the questionnaire.
That score is then used in conjunction with clinical assessment to prioritise access to specialist care and planned surgery.
Patients can request help to complete the questionnaire.
The questionnaire can be reused at regular intervals to identify clinically and socially relevant changes in disease burden and to reprioritise access to services.
Hip and Knee Questionnaire
The questionnaire is available in 12 community languages.
Updated