3.2.7 Chronic Disease Management Measure impact of existing funded chronic disease HSE CCP’s Immediate Implement and evaluate Service Plan 2015 HSE, Acute Q4 2015 programmes to date in terms of reducing LOS requirements for Integrated Care pathways and Hospitals Quantify reduction in length of stay for chronic Frail Elderly. Examine opportunity to develop Division and diseases (e.g. COPD, Heart Failure) where speciality community based ANPs which can provide an CCP ambulatory care services have been developed under effective model and pathway of care specific for the clinical programmes. Maximise the national older patients to expedite their care and effect on length of stay reduction by filling treatment both inward and outward. This would geographical gaps in these services in the 2016 NSP extend the current proposal on geriatrician led services to include ANP delivered services in collaboration. Development of ANP model of care for low acuity CNO DOH and Q4 2015 Increase coverage of Clinical Nurse Specialist (CNS) Primary Care 2016 chronic illness, both in the ED and AMAU to assess, HSE and AHPs for chronic disease support to General treat and discharge low acuity chronic illness, with Practice in the 2016 Service Plan (commenced in the option for return clinics at the ED & AMAU for 2015) ongoing assessment and treatment similar to the current ED Minor Injuries model of care Commence implementation of the chronic disease Primary Care / 2016 self management support strategy in 2016 NSP CCP 3.3. CONTROL - Leadership, Governance, Planning and Oversight 3.3.1 Leadership and Governance
3.2.7 Chronic Disease Management Measure impact of existing funded chronic disease programmes to date in terms of reducing LOS Quantify reduction in length of stay for chronic diseases (e.g. COPD, Heart Failure) where speciality ambulatory care services have been developed under the clinical programmes. Maximise the national effect on length of stay reduction by filling geographical gaps in these services in the 2016 NSP HSE CCP’s Immediate Implement and evaluate Service Plan 2015 requirements for Integrated Care pathways and Frail Elderly. Examine opportunity to develop community based ANPs which can provide an effective model and pathway of care specific for older patients to expedite their care and treatment both inward and outward. This would extend the current proposal on geriatrician led services to include ANP delivered services in collaboration. HSE, Acute Hospitals Division and CCP Q4 2015 Development of ANP model of care for low acuity chronic illness, both in the ED and AMAU to assess, treat and discharge low acuity chronic illness, with the option for return clinics at the ED & AMAU for ongoing assessment and treatment similar to the current ED Minor Injuries model of care CNO DOH and HSE Q4 2015 Increase coverage of Clinical Nurse Specialist (CNS) and AHPs for chronic disease support to General Practice in the 2016 Service Plan (commenced in 2015) Primary Care 2016 Commence implementation of the chronic disease self management support strategy in 2016 NSP Primary Care / CCP 2016 3.3. CONTROL - Leadership, Governance, Planning and Oversight 3.3.1 Leadership and Governance
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