Optimised pathway for hip and knee replacement surgery at Fremantle Hospital
Fremantle Hospital has spent the last year designing an optimised pathway for hip and knee replacement surgery. This pathway will align the care at Fremantle Hospital with international best practice, improving the patient experience and reducing length of stay.
Key changes to the clinical pathway include:
- Improved patient education, providing consistent advice and managing patient expectations
- Supporting early post-operative mobilisation
- Minimising and managing post operative pain, swelling and side effects
- Providing continuity and supportive care through care coordination.
The joint replacement nurse team (clinical nurse specialist and clinical nurse) provide care coordination throughout the patient pathway including a contact point for patients before and after their surgery. When a patient is waitlisted for knee or hip arthroplasty they are given information including:
- Role and availability of the joint replacement nurses
- Expected length of stay (zero to one day/s for most patients)
- Anticipated levels of post operative pain and how this will be managed.
- Importance of early (day zero) mobilisation
- Recovery time and support required
- Preparing for surgery including prehabilitation, organising transport and support at home and preparing the home environment.
Available resources
Patient information is available on the Fiona Stanley Fremantle Hospitals Group website.
Patient information sessions are held fortnightly alternating between in person and video call (via healthdirect).
Dr Monica Lacey
Hospital Liaison GP, FS & FHG
monica.lacey@health.wa.gov.au
Available: Monday and Thursday
March 2019
Mental Health Adult Home Treatment Team
A new mental health service will enable patients to receive hospital-level care in the comfort of their own home.
The Fiona Stanley Fremantle Hospitals Group (FSFHG) Mental Health Adult Home Treatment Team (HTT) will offer a recovery-oriented alternative to hospital admission for patients in the FSHFH catchment.
The service will allow greater flexibility to meet the patient’s preferences and help them to:
• Maintain links in the community
• Maintain daily routines and relationships
• Prevent triggers and re-traumatisation associated with hospital environments.
Up to 12 ‘virtual inpatient’ beds will be assigned for up to 14 days to mental health patients experiencing acute mental health deterioration who would usually require admission to hospital. This service also provides a step-down for patients transferring from an inpatient ward stay.
The HTT, operating from the Fremantle Hospital Mental Health Service, will support patients to clinically address factors which may have contributed to deterioration in their mental health. The multidisciplinary team, including clinical nurse specialists, clinical nurses, social workers, psychiatrists, pharmacists, registrar and occupational therapists, will perform up to four daily visits depending on the patient’s needs.
Intensive mental health care including assessment, treatment and management, will be provided seven days a week, from 8.00am – 10.00pm. After 10pm patients requiring care can phone the MHERL or present to the emergency department.
Patients without a GP will be supported to find one and communication with the primary care provider will occur, at least, upon admission and discharge. Management of chronic and preventative physical health issues will remain with the patient’s GP where possible. Physical health issues related to psychotropic medication prescribed during the HTT admission and other mental health treatments will be managed by the team and guidance for ongoing monitoring and management included in the discharge summary.
Referrals into the HTT will come from a variety of sources including the FSH ED, Community Treatment teams and the Assessment and Treatment Team (ATT). GPs with potentially suitable patients would refer through the usual ATT referral process or by discussion with a current patient’s community Care Coordinator.
Dr Monica Lacey
Hospital Liaison GP, FS & FHG
monica.lacey@health.wa.gov.au
Available: Monday and Thursday
March 2012
Referring for cataract surgery – who does it best?
A recent audit of GP referrals for cataract surgery at Fremantle Hospital revealed that only 38 percent contained important ocular information such as visual acuity, cataract severity, intraocular pressure, glare/contrast symptoms and other ocular diagnoses. Referrals without such information will generally be assigned as Category 3 and subject to long waiting times. If GPs are unable to provide this degree of ophthalmic detail, the inclusion of an optometrist’s assessment with the referral can assist with more accurate triage. Inclusion of information about vision limited activities including any impact on occupation, driving and leisure/hobbies will also be taken into consideration, if included.
Dr Monica Lacey
Hospital Liaison GP, Fiona Stanley and Fremantle Hospital Group
Available: Monday and Thursday
Urgent eye referrals
The Fremantle Hospital Ophthalmology clinic runs 8am to 4pm, Monday to Thursday and 8am to 12pm on Fridays. The on-call Registrar is available between 8am and 5pm Monday to Friday via the switchboard on (08) 9431 3333 to discuss current eye clinic patients and to provide urgent, new patient assessment or advice. If you are advised by the on-call Registrar to send a patient directly to the clinic, an urgent referral should be faxed to (08) 9431 2726. Out of hours urgent advice from the on-call Registrar is available via the RPH switchboard on (08) 9224 2244. The referrer will be advised where to direct the patient emergency assessment, if required.
Dr Monica Lacey
Hospital Liaison GP, Fiona Stanley and Fremantle Hospital Group
Available: Monday and Thursday
March 2012
Mental health services for patients under 16 years not available at FSH
Please note that Fiona Stanley Hospital does not offer mental health assessment or treatment services for children under the age of 16 years. In order to reduce delays in treatment and avoid increasing the stress on patients and families, such referrals and requests for emergency assessment should be directed to Perth Children’s Hospital.
For more information on mental health services, see the ‘Mental Health Requests’ page on HealthPathways.
Dr Monica Lacey
Hospital Liaison GP, Fiona Stanley and Fremantle Hospital Group
monica.lacey@health.wa.gov.au
Available: Monday and Thursday
Mental health services for patients under 16 years not available at FSH
Please note that Fiona Stanley Hospital does not offer mental health assessment or treatment services for children under the age of 16 years. In order to reduce delays in treatment and avoid increasing the stress on patients and families, such referrals and requests for emergency assessment should be directed to Perth Children’s Hospital.
For more information on mental health services, see the ‘Mental Health Requests’ page on HealthPathways.
Dr Monica Lacey
Hospital Liaison GP, Fiona Stanley and Fremantle Hospital Group
monica.lacey@health.wa.gov.au
Available: Monday and Thursday