My name’s Kristi Morton.
I’m the Regional Operations Manager for TLC.
In aged care, we’ve got Residential In-Reach, which is linked to the hospitals.
We’ve got palliative care services and we’ve got other services that can come in as required.
So we’re very fortunate, but it’s at those moments when people aren’t available, say 3:00 AM in the morning.
VVED has just been an absolute game changer for us to look after our residents.
My name’s Edward Ryan.
I’m currently an aged care resident at TLC Whitewater in Mordialloc.
My name is Taryn.
I’m a registered nurse here at TLC Whitewater and also the Clinical Service Manager.
We have a medical clinic within TLC, which we can have doctors see the residents in their home, as well as other services available such as Residential In-Reach, but it’s also great to have the VVED option available when nobody’s able to come and see them in person.
My name is Dr. Ron.
I’m a General Practitioner who looks after this facility, TLC Aged Care.
After I go home, basically situations can arise and sometimes the nursing staff give us a call and explain the situation.
If I’m not really confident about the decision whether to keep the patient in the facility or the hospital, I just ask them to call VVED.
Once the patient's been reviewed by the VVED, they put their notes and the comments into my practice, so I know what has happened.
That gives me the heads up and I can get the positive outcome for the patient.
My name is Dr. Susie Miller.
I’m an Emergency Physician and the Director of Strategy, Quality and Technology at the Victorian Virtual Emergency Department.
The specific role of VVED at residential age care facilities is one of a safety net.
We are not here to replace any excellent services that already exist.
For example, Residential In-Reach programs, which allow a team of doctors and nurses to come into the facility to care for your patients.
And then of course, we can never replace our GPs and our locums in those circumstances where the Residential In-Reach team, our GP, aren’t available perhaps on nights or weekends, or in regional and rural areas where they simply don’t exist.
We are here for you in those emergency situations when you don’t know what to do.
My name’s Sam Peart.
I’m a MICA paramedic at Ambulance Victoria, and I’m also the alternate services lead.
The Victorian Virtual Emergency Department is amazing predominantly for their patients because it allows them to receive the care that they need in the place that they feel most comfortable.
It’s also a fantastic option for ambulance and paramedics as a whole because we know that we’re able to have the patients cared where they want to be and where their families want them to be.
One of the most important services that can be provided for residents in aged care facilities is palliative care for patients with end of life needs and life limiting illnesses.
The ideal way for these patients to be managed is through their general practitioner and their local palliative care service in accordance with their advanced care directive and goals of care when these services aren’t available.
There is the Palliative Care Advice Service, also known as PCAS, which is an over the phone specialist, palliative care advice service that can provide management when required and assistance to deal with these difficult situations.
When PCAS isn’t available, there is the Victorian Virtual Emergency Department who are also exceptional at dealing with these palliative care specialist cases.
If Triple Zero is called for these patients, it is possible to have them linked into these services through the AV secondary triage process, or if an ambulance is sent out to you, the paramedic crew can also utilise these services to help link the patients in to the most appropriate care in the most appropriate place.
The Primary Health Network have created this amazing toolkit.
It allows decisions to be made based on the resident’s needs at the time.
It provides all the information that a nurse needs to make an informed decision about the best avenue to go for resident care.
We have the PHN toolkit available, which it has things like the medical support checklist, which has a list of items that we should have on hand.
With us if we’re calling through to a doctor to get some support regarding our residents.
Also available is a family fact sheet that has different resources available so the families are aware what support we can provide to their loved one.
That information can then be passed on to their regular GP as well, so that everyone is working collaboratively.
The most common presentations we see in the Victorian Virtual ED from residential aged care facilities include falls, pneumonia, urinary tract infections, gastrointestinal infections, and cellulitis.
We also see quite a bit of behavioral disturbances from patients who are suffering from dementia or delirium.
And then near and dear to my heart is palliative care.
There are two ways for residential aged care facilities to contact the virtual ED.
The first is if you are concerned about a problem, you can come to us directly.
It’s quite simple.
All you need is a video capable device and a quiet area to speak in with an internet connection.
There is a portal that you’ll enter the patient’s information into, and then you’ll be put in a waiting room.
There are times, of course, that you may feel the need to call Triple Zero first, and that is fine, but don’t be surprised once they assess the patient that they might bring the Victorian Virtual ED in to do an assessment.
Here’s what to expect.
I’ll introduce myself and ask who you are, and then I’ll want a whole lot of information from you first without even seeing the patient.
For example, I need to know your facility name, how to contact you if the patient has a GP, and have you contacted him or her?
Is there a Residential In-Reach team that serves your facility and have you contacted them?
And then very importantly, what is the advanced care directive?
I’ll wanna know what’s happened, past medical history, medications, and then what’s happened.
Of course, with the vital signs, once we’ve gathered all that information together, normally you’ll walk into the room with the patient and using the video, I’ll meet the patient and go through an exam, but that’s not where this ends because there’s a whole lot of work we have to do after this consult.
I’ll often be calling family.
Sometimes I’ll be calling Residential In-Reach or the GP to get more information and see if I can refer on and close that loop with a plan of care.
Oh, it was so easy.
I found it quite comforting to be able to talk one-on-one with the doctor.
I could ask him questions that I had, and he answered them without any problem.
And my daughter, Melissa, was there, plus a nurse from TLC.
I felt quite happy with what he was saying.
And I presume he was happy with the answers he got from me and would’ve been then in a position to pass that information back to my GP.
VVED is a godsend because it allows residents to stay in the home for purely a consult that for most people, you know, have to go to hospital.
The process of VVED is simple.
There’s just the doctor on the other side, whoever the resident is, and of course part of the nursing staff from TLC is always here.
It’s quite interactive, conversation flows, questions are allowed to be asked and confirmed.
It’s a great experience.
When we communicate with the families, they are really impressed about the outcome that we generate through the VVED, you know, so that it’s making us feel comfortable.
And at the end of the day that gives the better health option for the resident.
Our main priority is to keep the residents at home where they can be cared for by those that know them.
So having VVED is amazing to prevent hospital admissions wherever possible.
It’s a win-win.
We all know there’s only a limited number of ambulances and paramedics to serve the Victorian community.
So it’s extremely important that we get the best care in the right place at the right times for our patients, and that we save triple zero only for emergencies.
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