The Multi-purpose Services Program: bringing flexibility into acute care
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A post written by Dr Paul Tait, Pharmacist, Rural Support Services, SA Health
Older Australians with complex needs are increasingly being cared for through the combined roles of acute and aged care services. While there is an argument for transfer of care to the service that best meets the person's needs, the transition between services often needs to flow better. Indeed, the literature provides a regular commentary on the challenges associated with this transition or innovative ways to avoid admission in the first place. Furthermore, acute and aged care services must provide solutions to these challenges related to setting transitions.
Acute or hospital care usually provides medical treatment to manage short-term and severe illnesses or injuries. Furthermore, data shows that older Australians repeatedly access acute services for various issues, including end-of-life care (EoLC). Depending upon the person's needs, this can involve an outpatient appointment with a palliative care service, an emergency department presentation for an acute exacerbation of their illness, or an inpatient admission in the last days of life. Importantly care in the public hospital setting is costly for the state or territory government yet often accessible by the community free of charge.
On the other hand, aged care services refer to long-term support for older Australians in a home environment. While the literature focuses on aged care services in residential aged care homes (RACHs), aged care providers also provide these services frequently in someone's private residence. In Australia, non-government organisations usually provide Aged Care services. While the funding is made available through the Australian government, there can be out-of-pocket expenses.
Because of the differences in funding, aged and acute care services are generally available through different locations. Yet, hybrid models have developed in various regional areas across Australia where the population cannot support a separate hospital and RACH. For example, the Multi-Purpose Services (MPS) Program provides co-located beds that are flexibly offered as either acute or aged care, depending upon the need. It allows regionally based older Australians to stay in their communities - close to their families and community ties - as they age.
Just as the MPS program provides a patient-centred approach to care, it has unintended - and valuable - consequences. In sharing a common workforce, the staff providing care for MPS beds are well-placed to collaborate; the same organisation that experiences the problems also is the organisation that governs the teams that can solve them.
In regional Australia, hybrid models to the traditional acute and aged approach to care have arisen. While programs such as the MPS have emerged to share resources in regional parts of the country, they offer ingenious methods to solve the challenges in caring for older people with shifting care needs.
Dr Paul Tait, Pharmacist, Rural Support Services, SA Health