Department of Health

Key messages

  • The Health Independence Program (HIP) provides services that support a person’s transition from hospital to home.
  • The HIP consists of six components, including short-term supports and access to specialist services.
  • A person can be referred to HIP from a hospital setting, community service, or they can self-refer.

The Health Independence Program (HIP) provides a range of services that deliver healthcare to support the transition from hospital to the home. These services can also prevent the need for a hospital presentation or stay, with many people accessing them directly from the community.

Components of HIP

There are six main components of HIP. They are:

  • Short-term supports
  • ambulatory rehabilitation
  • access to specialist services, including specialist assessment
  • care coordination – short-term or complex
  • complex psychosocial issues management
  • consumer self-management, education and support.

To meet their care needs, a person can require one of these services, or a combination of them. During an episode of care this may involve moving between services. The challenge is to ensure that the person receives the right care, in the right place, at the right time, unhampered by program boundaries.

HIP model of care

The HIP model of care articulates six stages of service delivery designed to successfully support people's transition from hospital to home:

  • access to the service and initial contact
  • initial needs identification
  • assessment
  • care planning and implementation
  • monitoring and review
  • transition and exit from the service.

Care coordinators support people to navigate through each stage.

Referral to HIP

A person may be referred to HIP from hospital settings that include emergency departments, acute wards and admitted subacute services.

People can be referred from community services that include community health services, Aged Care Assessment Service, general practitioners and other primary health practitioners.

People can also refer themselves to HIP, or be referred by a family member or residential care facility.

How HIP works with community services

During the HIP episode, HIP services work collaboratively with various community services and supports. HIP services complement the ongoing care that longer term services provide.

People may be referred to, or linked in with a variety of community services for ongoing management during, or at the completion of a HIP episode.

HIP workforce - interdisciplinary team approach

The HIP workforce includes medical, nursing and allied health working as part of an interdisciplinary team. An interdisciplinary approach to client care ensures team members work together toward the common goal of improving a person’s journey.

HIP service delivery setting

HIP services may be delivered to people in the community, ambulatory setting or a person’s home. This may include the following:

  • home
  • community rehabilitation centre
  • community health facility
  • workplace
  • educational facility
  • other ambulatory setting
  • general practice
  • residential aged care
  • supported accommodation
  • hospital.

Reviewed 03 January 2024

Health.vic

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