DAHS Transport Facilities
Many people in the Derby region do not have access to their own transport, and there is no public transport system in town. DAHS employs full-time transport officers, to ensure that a lack of transport is not a barrier to access to health care. The service provided by the transport officers include;
- Providing a wealth of local knowledge, especially for new or non-local staff, on the whereabouts of DAHS patients, their family connections, and so on
- Transporting patients between home and DAHS clinic
- Transporting DAHS patients from the clinic or from home to radiology services, physiotherapy, occupational therapy, dental services etc.
- Transporting DAHS patients who have been referred by the DAHS Doctors to visiting specialist appointments at the Derby Hospital
- Relaying messages, either verbal or written, from the clinic to patients, especially those with no phone or postal address
- Delivery appointment cards to DAHS patients for visiting specialists or DAHS specialists clinics
DAHS also employs a driver (for 1½ to 2 days per week) whose specific duty is to deliver medications to DAHS clients who have regular weekly Webster Packs.
There is some pressure on the transport officers to divert e.g. for banking or shopping – unfortunately DAHS transport resources are limited and we therefore restrict use of the service to DAHS patients for health purposes only. The hospital also employs Aboriginal Liaison Officers, whose role includes transport for hospital patients.
Patient Assisted Travel Scheme (PATS)
The Patient Assisted Travel Scheme (PATS) provides assistance to permanent country residents who are required to travel more than 100 km (one way) to access the nearest eligible medical specialist and/ or specialist treatment not available locally, via telehealth or from a visiting service. PATS provides a subsidy only, it is not intended to cover all the costs associated with travel to a specialist appointment.
Patients required to travel between 70 and 100 kms (one way) to access the nearest medical specialist treatment for cancer or dialysis are eligible for limited assistance.
PATS is administered through country health services across Western Australia. Applications for PATS assistance are made by the referring medical practitioner. The application for PATS assistance needs to be lodged via fax, mail, email or in person at the patients nearest health service, prior to travel.
For patients in the Kimberley, this often means assistance with travel to and from Perth, but also includes patients in remote communities travelling e.g. To Derby for health care which they cannot access in their own community.
PATS generally covers the cost of transport, by road or air, and the majority of accommodation costs, but does not necessarily cover other costs such as meals.
If a DAHS client requires PATS assistance, a yellow PATS form (found in all consulting rooms with spares at reception) is completed and forwarded to the PATS clerk located at the Derby Hospital.
Derby PATS Clerk
Phone: (08) 9193 3260
Many DAHS patients are not contactable by phone, do not have a postal address, and/or do not have ready access to a means of transport. Contacting a patient follow-up such as to communicate an abnormal pathology result, or when a patient is due for an injection or blood test etc requires lateral thinking.
DAHS utilises an electronic recall system through MMEX for follow-ups
- The recall is entered in the New Task section in the TO DO List
- A Drivers list is taken from tasks at the end of each day
- Each afternoon a meeting is held with the drivers and clinic staff to establish who has been contacted and which clients have presented to clinic
- The list is then updated
There are a few Recall Rules:
- Wherever possible, patients are asked whether they would be happy to have such a recall. They have the right to refuse, and it avoids an unpleasant situation for both the driver and patient at the time of the unwanted recall. This will not always be possible – e.g. for more urgent recalls, such as a patient who had blood taken and was found to have a dangerously abnormal result which needs urgent attention.
- In the interest of confidentiality, information recorded on the drivers list should be limited to what is absolutely necessary – enough that the drivers can provide a prompt for the patient, but without disclosing confidential information. For example, “review is due” or “discuss results”.
- If a patient is recalled urgently, staff from the clinic attempt to contact the person by phone. If they do not return, staff will inform the person who initiated the recall. If a patient is on the routine recall list, they will be contacted by letter. If they do not respond, the person who initiated the recall will be informed.
- Clinic staff should alert the person who has generated the recall if a patient consistently declines follow-up.
Individual staff are responsible for ensuring that specimens are collected in line with accepted Occupational Health and Safety guidelines, and the DAHS Clinic Manager is responsible for ensuring that appropriate equipment is ordered and available for the safe collection of specimens.
Samples collected after 4pm will not be processed by the laboratory until the next day. A centrifuge is provided in the clinic rooms at DAHS so samples can be spun and stored overnight in the specimen fridge.
Transport of Specimens
Pathology specimens collected at DAHS are placed in the pathology tray in the Utility room fridge, except those which need to remain unrefrigerated – these are placed on the bench next to the fridge with clear notification for the driver that they are awaiting transport.
The DAHS drivers are responsible for appropriately transporting the specimens to the PathWest laboratory, located in the Derby Hospital. The drivers have regular pick-up and delivery times for bloods. These times are 9am–9.30am, 12pm - 12.30pm, 3pm–3:30 pm and can be contacted on their mobile phones if there are specimens requiring more urgent transport. If the bloods are urgent it is practise to phone Pathology before the driver arrives and notify them.
If urgent results are needed, indicate this on the pathology form and ask the driver to alert PathWest staff of this when the specimen is delivered. Alternatively, phone PathWest staff directly to notify them.
Pathology results may be viewed as printed copies, or in electronic form through MMEx on DAHS computers, which receive direct downloads through PathWest.
Results are returned to DAHS Doctors electronically through MMEx. If the requesting Doctor is away then the doctor(s) rostered as Duty Doctor that week views the results and determines what action if any is needed.
Phone: (08) 9193 3310
The Derby Hospital Radiology Department performs standard X-ray during the hours of 8:30am – 4:00pm Monday to Friday, and on an on-call roster outside of these hours for emergency X-rays only. Referrals are sent electronically through MMEX. Patients do not require booking times for plain x-rays, however, every other investigation needs to be booked. The radiology department contact the booking staff at DAHS to inform them about the booking time. CT scans are performed at Broome hospital, and a written referral is required for all bookings, even urgent referrals.
A visiting Radiologist is provided once a month at the hospital, and can perform procedures, including IVPs ultrasound guided injections or aspirations and barium studies. Bookings are made through the Derby radiology department.
Phone: (08) 9193 3221
Fax: (08) 9191 1689
Section 100 Scheme
In 1999, the Commonwealth Minister for Health and Aged Care the Honourable Dr Michael Wooldridge, introduced new arrangements for supplies of pharmaceuticals to remote area Aboriginal Health Services through Section 100 of the National Act 1953. The introduction of this legislation followed intensive lobbying from the National Aboriginal Community Controlled Health Organisation, with support from the Pharmacy Guild of Australia.
“Section 100” enables Aboriginal Health Services, such as DAHS to place bulk orders with local community pharmacies for PBS medications, which are supplied at no cost to the health service and provided free of charge for the medications by billing the Health Insurance Commission directly. All DAHS clients are eligible for S100 medications; Aboriginal and non-Aboriginal.
This arrangement substantially increases access to medications for Aboriginal people by;
- Eliminating the financial barrier to PBS medications
- Addressing the difficulties of remote area access to community pharmacies to dispense scripts, and
- Bringing together the acts of prescribing and dispensing, and therefore maximising opportunities for clarification and education
ii. DAHS Section 100 and Webster Pack Arrangements
DAHS has a contractual arrangement for supplies of Section 100 pharmaceuticals through Kimberley Pharmacy Broome;
Kimberley Pharmacy Broome (for supply of Webster Packs and Section 100 medication orders )
Phone: (08) 9192 3611
Fax: (08) 9192 3699
The DAHS Aboriginal Medication Support Officer does a weekly stock take to check and place a Section 100 bulk order with the Kimberley Pharmacy Broome. Within a week, medications are supplied to DAHS for restocking.
If you notice regular stocks of medications running low or absent, please let the Aboriginal Medication Support Officer or Clinic Manager know so that gaps can be filled if need be before the next Section 100 order is due.
Many have chosen to have their medication managed through a Webster pack system, and a weekly order is faxed through to Kimberley Pharmacy Broome indicating which patients require a pack for the week ahead.
Patients commencing a Webster pack for the first time can be referred to the Aboriginal Medication Support Officer for explanation/education. The medications are charted on a special Webster Pack order sheet, which is sent electronically through to Kimberley Pharmacy in Broome and also in Derby if the order is urgent. The patient will be issued with the other regular Webster packs during the commencing week. Packs required urgently should be designated as urgent on the MMEx order.
Patients may collect the Webster pack from the clinic themselves; for frail or disabled patients or those who lack their own means of transport, DAHS offers a weekly delivery of Webster Packs.
Schedule 8 Drugs/Drugs of Addiction
These medications are stored in a lockable safe in the injectable medication cupboard, this cupboard is lockable and the keys carried by the Clinical Services Manager. All medications which enter and leave the safe must be recorded in the Drug Register and countersigned by an appropriately qualified staff member.
Kimberley Standard Drug List (KSDL)
i. Development and rationale
In December 2004 a Kimberley Standard Drug List (KSDL) was finalised and the process of implementing the KSDL commenced. The KSDL was developed through a collaborative effort between the Kimberley Aboriginal Medical Services (KAMS) and the Western Australian Country Health Service – Kimberley Region (WACHS – Kimberley), in consultation with a wide range of key stakeholders.
The purpose of drug rationalisation through the KSDL is to allow consistency in care across health services and consequently, have widespread benefits for both clinicians and patients. In particular, consistency in drug stocks will ensure;
- A mobile patient population can be guaranteed to find their regular medications in any community clinic as they travel through the Kimberley, minimising the risk associated with missed tablets or of changing medications.
- The cost, inconvenience and wastage which results from having to stock an exhaustive range of medications, including multiple drugs in the same class of medication, can be minimised
The drug list is intended for use in remote clinics in the Kimberley, including Aboriginal Community Controlled Health Services and remote Government clinics. It is also intended that the list will be reflected in hospital imprest stock, though hospitals will generally require a larger imprest range.
ii. Components of the KSDL
A 3-part format for the standard drug list was established as follows:
1. Essential drug list
This list consists of drugs that the steering committee recommends should be easily accessible to the Kimberley population and hence, included in all clinic medication imprests.
2. Supplementary list
This list consists of drugs that should be able to be accessed across the Kimberley, but will not be required by all clinics. Therefore, it is at the discretion of the senior clinicians as to whether or not these drugs are included on the clinics imprest. Drugs on the supplementary list are included for specific indications.
3. Emergency drug list
Drugs for inclusion in Emergency drug kits.