THEY are the stories of greatest need in our community that rarely grab the headlines.
The Braybrook man showering with an outdoor hose in the depths of winter, as he’s too broke to fix the plumbing.
The single woman with no family to fetch her after surgery; the sick parents choosing between food and medical prescriptions; the impoverished refugee family living in a home so filthy it’s uninhabitable.
Sadly, they are the real-life stories of residents in the western suburbs, which often lead to a merri-go-round of hospital visits.
But after a staff member at Western Health had a brainwave during a coffee meeting with a colleague, the hidden issues are finally being addressed.
Community Services Division Operations Manager Cherie Hunter is behind a ground-breaking new program developed by Western Health that is revolutionising the way care is delivered, by delving beneath the surface to meet the practical and social needs impacting on patients’ health.
Take the man from Braybrook. Every winter, he was presenting to hospital with pneumonia.
When hospital staff discovered why, they offered to pay for his plumbing problem to be fixed.
Or the 92-year-old woman who was repeatedly treated for a urinary tract infection, as she was using a bucket to launder her reusable continence aids.
A new washing machine was sent to her home, and she hasn’t returned to hospital since.
Even simple things like cooking meals for the socially isolated, paying a bill or buying a phone for a homeless person so they can book medical appointments are making a substantial difference.
The outreach is particularly important in Melbourne’s western suburbs, which are home to some of the worst areas for disadvantage in the state, including high numbers of refugees and asylum seekers.
Ms Hunter says the need in the west is among the greatest she has seen in her career, with issues including low income and poor health literacy, a lack of family support, and a high prevalence of chronic and complex medical conditions.
But she says the traditional one-size-fits-all model of hospital care does not always solve the real problem, and can lead to an endless cycle of admissions.
She first had the idea to do things differently in December 2015, when a surgical nurse was telling her over coffee about the number of day surgery patients being admitted overnight as they had no one to care for them at home.
The cogs started turning in her mind and she set about developing the Rapid Discharge Support Service (RDSS) with her department. It was rolled out six months later at four sites, and is now being considered by other health services.
“It’s a significant shift for Western Health’s community services, it’s a really different way of thinking,” she says.
“What we were finding in the past was that we were attempting to make a difference in people’s lives, but they had to fit the funding guidelines.
“Patients kept coming back as the health service was not addressing the underlying issues that were resulting in their need to attend the hospital. We knew we had to stop the cycle of usage of the acute sector.”
In the past year, Western Health estimates it has saved 269 bed days at a cost of $171,000 through the RDSS.
Ms Hunter says there were initial concerns that unreasonable demands would be made on the health service once word spread of the non-conventional approach, but the opposite has happened.
Most people are reluctant to ask for anything, even a taxi ride home if they don’t have family to pick them up.
In the last financial year, Western Health sent 91 surgical patients with no home support to comfortable hotels to prevent the need for overnight social admissions before or after surgery.
Many had never stayed in a hotel room before, or experienced room service, and were overwhelmed with gratitude.
“Our experience has shown that people don’t ask for unrealistic things, they don’t want to see what’s in it for them,” she says.
“I’m consistently shocked at how little we need to do to make a difference.
“They aren’t wanting holidays to Queensland or chauffeur driven cars – they will say ‘Is it OK if someone stops on the way home so I can pick up some groceries?’.”
Under the RDSS, surgical nurses assess the needs of elective surgery patients pre-admission and refer them to the team if required, while ward and care coordination staff perform the screening for inpatients.
Ms Hunter says the service has resulted in myriad benefits on top of the cost savings, including discharging patients earlier, improved access and flow in the emergency department, and, ultimately, happier patients.
She is in charge of distributing Greatest Need Project funds in the Patients in Greatest Need category. These provide essential items which are currently not funded.
“For me, it’s incredibly pleasing to deliver what patients actually need, not what I think they need,” she says.
The Greatest Need Project is an online story-sharing website with two major goals – to help patients facing significant hardship and disadvantage, and to facilitate research, at Western Health.
As a staff member, Cherie Hunter is sharing her story in bid to help those at Western Health who need it most.
By making a donation on Cherie’s behalf – and sharing her story on social media – you are making a difference too. Thank you.