The second stage of the Improving Care for Older People (ICOP) program operated in Victoria from 2010 to 2013. Across Victoria, 35 public health services participated in the initiative, including all metropolitan health services. As part of the program, they were required to undertake initiatives to minimise the risk of functional decline in older patients and improve the provision of care in four areas:

  • Evidence-based environmental improvements
  • Organisation-wide policy development that provides a framework for improving care for older people across the organisation
  • Embedding the evidence base contained within The Toolkit to inform models of care to minimise functional decline for older people, with a focus on acute settings
  • Professional development activities to support workforce capacity building to better respond to the needs of older people in hospital settings

Outlined is a snapshot of the types of initiatives taken by health services relating to screening and assessment.

Health Service

Requirement Addressed and Project Summary

Alfred Health

Environmental Improvements – Purchase of IT equipment to support implementation of electronic assessment

Models of Care - An extensive review and revision of the Initial Nursing Assessment Tool (INAT) has been completed in partnership with the Improving Care for Older Persons (IC4OP) initiative and nursing services; implemented Electronic Documentation System (EDS) in subacute

Austin Health

Policy Development - Falls Risk Assessment Prevention & Management guideline introduced

Barwon Health

Models of Care - Introduction of Electronic Risk Assessments based on toolkit assessment tools and NSQHS Standards – implemented in acute wards, short stay and inpatient rehabilitation - continuing roll out; E-Risk assessments trigger automated e-referrals for dietetics, occupational therapy and physiotherapy

Bendigo Health

Policy Development - Redeveloped policies to reflect/incorporate IC4OP principles including Falls Assessment and Management; Nutrition Screening and Assessment; Pressure Ulcer Risk Assessment and Prevention

Models of Care - Generic Adult Admission Screen – reviewed and updated to incorporate all toolkit domains and uses toolkit icons and NSQHSS icons; education conducted; work on increasing compliance via file audits etc.

Melbourne Health

Models of Care - Development of nurse risk screening, assessment & care planning tool

Mildura Base Hospital

Models of Care - ‘Person Centred Admission Document’ (admission form) reviewed and updated - addition of falls risk assessment (Ontario Modified STRATIFY) and nursing discharge summary (copy given to patient on discharge)

Monash Health

Policy Development and Professional Development– Implementation of a pre and post fall assessment and management procedure. Staff education provided

Portland District Health

Models of Care - Introduction of models of care introduced and embedded into the sub-acute and acute wards - based on toolkit domains including assessment. Creation of clinical champion role for preventing functional decline with focus on person centred care and assessment

Professional development - Education sessions run by clinical champion for preventing functional decline, including falls risk assessment, functional assessment, pressure sore risk assessment and patient handling assessment

South West Healthcare

Professional Development – Existing policies reviewed to include PCC approach including screening and assessment

Models of Care - Introduction organisation wide of Cognition Risk Screen, Braden scale, Malnutrition Screening Tool (MST) and Falls Risk Assessment Tool (FRAT); introduction and roll out of new wound assessment tool including best practice guidelines; work on embedding use of pain assessment tools including cognitively impaired patients into practice via care plans

Swan Hill District Health

Models of Care - Development and implementation of admission and risk assessment tool – includes FRAT, pressure risk assessment, malnutrition screen, referral tool, cognition screen, thrombosis risk, medication risk

Werribee Mercy

Policy Development - Clinical practice guidelines developed for continence screening and management, malnutrition screening, depression screening, delirium and dementia screening

Western District Health Service

Policy Development - Policies reviewed and redeveloped to reflect IC4OP principles, including assessment policy, including use of screening tools

Models of Care - Assessment documentation consistent across organisation and sites

Professional Development - E-learning packages developed and competency compliance monitored – use of screening tools including Braden and FRAT

Western Health

Models of Care – implementation of revised screening and care planning tool across acute and subacute wards