Western Sydney Wellness Trust
The Western Sydney Wellness Trust provides community health care and social care services to a population of 2,000,000 people living in the Western Sydney Area of Australia. The Trust was formed five years ago from the merger of the then separate Community Health Care Trust and Social Services Department.
The Community Health Care Trust employed staff with medical training from a variety of disciplines such as District Nurses and Physiotherapists. They visited patients in their home and provided care to them.
The Social Services Department employed staff with non-medical care skills, from a wide variety of disciplines, such as Adult Carers and Child Protection Officers, which visited clients in their own home also, yet provided social care. The objective of both organisations was to enable people to go on living in their own home for as long as possible, thus delaying their move to Trust-funded Nursing homes.
The merger of these two organisations was the result of a new central government policy being piloted in the region in which Western Sydney falls. There are nine other Community Trusts within the region, none of which are as progressive in their thinking as the Western Sydney Health and Social Care Trust. The objectives of the government policy are to improve the care provided and reduce the overall cost of providing that care. The new combined Trust was given a large degree of organisational and financial autonomy within the framework of overall management by the local region, and an energetic, forward thinking Chief Executive, Jim James, previously the Director of Social Services, was appointed to lead the new combined Trust. Jim James immediately appointed the hardworking Operations Director of the Community Health Care Trust, Dr Robert Northy to the position of Business Development Director – effectively his deputy.
The Trust is headquartered in an old Victorian-style Mental Health Hospital facility in Parramatta with 50 other offices, clinics and care homes scattered over the geographical area served by the Trust. Very few of these offices have been purpose-built.
The Trust now employs 3000 staff split into a relatively small Head Office team including Finance, Personnel and Business Development and the professional care staff who are divided into 3 Directorates as follows:
• Adult Care
• Mental Health Care
• Child Care
The main IT software systems used in the Trust are not integrated with each other and comprise:
• The legacy Social Care system, which is primarily concerned with providing a basis for analysing the type and source of referrals received by the individual social care teams and recording the type of care and cost of care delivered in response to the referral. No attempt is made to record the outcome of the care delivered and all notes made by the social workers are handwritten and filed locally
• The legacy Health Care system which is primarily concerned with collecting details of the activities carried out by the health care workers so that mandatory statistical analyses can be forwarded to the Ministry of Health in federal government
• An effective email system linking all of the offices together
• A financial management and payroll system
The legacy systems are old and not user friendly, and staff activity data is entered by clerks located in the scattered offices and then used for statistical report generation by the central IT Department. None of the health and social care professionals ever make use of the information in these systems.
The network linking all of the offices together is the responsibility of the IT Team in the Regional Office. They have wider and deeper IT infrastructure skills than the Trust.
Company’s Creation and Use of Information
The Trust is one of only a few separate organisations which deliver care to the geographic area of Western Sydney. The other organisations are:
• Separate NSW Government-managed Hospitals who provide Accident & Emergency services, maternity services and a full range of clinical services to perform operations on patients as required
• Doctor Practices (Clinics) that are all contracted independently to the National Health Service and run effectively as individual small businesses, paid by Medicare depending on how many patients are served by them
People in need of care are referred to the Trust from a range of sources, for example Centrelink, Medical Doctors, Hospitals, Police, Schools, neighbours or next of kin.
Referrals contain wide disparities in the quality and quantity of their information. They are normally directed to a local Trust office which may or may not house the professional care team capable of dealing with the particular problem, so the referral is then forwarded on within the Trust, finally reaching the correct team who takes action. Referrals are received on a 24-hour basis 7 days a week and are actioned immediately if they are deemed to be urgent.
The key actions following receipt of the referral are typically:
• A visit to the referred person in need of care by a senior care professional from the most relevant care team, who carries out an assessment of the patient and may generate referrals to other teams within the Trust for their follow-up
• Creation of a handwritten care plan. Some care plans are very complicated and some very simple. For example, the Child Protection teams draw up very complex plans to solve the domestic problems leading to abuse of the child whereas the Podiatry teams are only concerned with scheduling visits to cut elderly patients’ toenails
• Signoff of the costs of delivering the care by the Team Manager, or adjustment if too expensive
• Delivery of the care services, which vary in duration from one hour to several years depending on the discipline and type of care
• Review of progress and revision of the care plan as necessary
Each professional care discipline has developed its own style of assessment form and care plan to record information about the patient, and each uses its own medical and care jargon to describe the same condition. Although a patient may receive care services from several teams in parallel, each of which is delivering its own speciality – for example district nurses dressing leg ulcers or occupational therapists modifying the home environment – no attempt is made to coordinate the care delivery or exchange care plans between the teams so they may well turn up at the same patient’s house on the same day and at the same time and one will then have to reschedule their visit.
The teams are traditionally suspicious of sharing patient related information in case they make patient diagnosis mistakes, and the mental health and child protection teams are particularly concerned about security of information for their patients and clients.
Email to Client
We at Pinnacle Software are excited to have the opportunity to propose a tailor-made software solution for the Western Sydney Wellness Trust, and hope that you go forward with us for this project.
Please find attached to this email the specification document, for your review. However, we have just a few questions to ask of you to ensure that we completely understand your requirements for this project.
Data flow: referrals originate from centrelink, doctors, hospitals, police, schools, etc. May vary widely in quality and quantity of info. They are then received by local trust offices, who will either act on them with a professional team they have, or forward them to a nearby office who have an appropriate team. These referrals then have their type and source recorded by the team, and then later the care and cost of care delivered in response to the referral.
What level of integration is appropriate or desired between the social care systems and the health care systems?
What are the main complaints about the systems in place from the users? Too slow, too cumbersome?
Can you give specifics about what kind of analysis is done in the current social care and health care system? What kind of data does the user input, e.g. details about care and cost of care?
Would the benefits in the digitization of handwritten notes that are currently made by social workers and filed locally, outweigh any negatives (e.g. additional legal overhead due to privacy laws)?
Is there a benefit for health and social care professionals to be able to access an integrated health care/social care system – being able to access care histories and details that they currently don’t/can’t?
This page should have the name of your company, the name of the document and who the document is intended for. This should be a professional title page, not a simple heading. It will be representing Pinnacle Software Inc, therefore ensure the title page reflects that.
The executive summary is a brief summary of the document’s purpose, what is in it, and outcomes or actions relating to the document. It is not a summary of the project brief.
This section should be a brief summary of what is in the document. A good approach is to outline the purpose of the document and then the result achieved by fulfilling this purpose. As this is a specification document, a summary of the requirements is needed.
Table of Contents
There should be a table of contents of 1st level headings, and any 2nd level headings.
Company and Client Objectives
Why proposing this, what will be done to achieve it, how will it be done and on what timescale, who are the stakeholders and how does choosing us benefit the client
The overall goal of Pinnacle Software in this project for the Western Sydney Wellness Trust is to design, develop and support a major, tailor-made overhaul to some of the systems in place. These systems are those that are in need of a significant upgrade to improve outcomes for patient care, improve efficiency in processing, and ensure that future upgrades can be installed with minimal or no interruption to regular service.
This project will be supported by Pinnacle’s teams, based in Brisbane, Perth, and Bangalore (India).
Objective 1 of this project is to completely rebuild and integrate the legacy social care and health care systems. These systems have significant room for improvement, that will be realised through the tailor-made solutions that Pinnacle will provide.
The first improvement that will be made is the modernising of the user experience. This is a critical part of any system upgrade – how users interact with a system can make the day-to-day operation of an organisation significantly more efficient, as users are no longer fighting against the system just to get something done. This will be refined closer to completion with the help of user feedback to ensure that the switch over from old systems requires as little retraining as possible.
Because Pinnacle specialises in tailor-made solutions, we can provide a user experience that is designed with the unique requirements of the Trust in mind.
Timetabling for professionals’ patients
Professionals can add and edit appointments they’ve booked with a patient to that patient’s individual digital timetable.
This timetable system is needed to coordinate care of single patients who are receiving treatment from different professional care disciplines. The creation of a timetabling system will mean that the chance of a clash between two care disciplines is eliminated, reducing wasted hours that could be spent treating other patients.
A patient can view their own timetable online.
Patients can access appointments booked in their digital timetable by professionals themselves online.
The creation of one timetable per patient means that appointments can be booked well in advance, and if the patient requires at some point between booking and the appointment itself, they can easily retrieve the details that were recorded on booking through an online interface, without having to divert time and attention away from professionals.
A professional can control and restrict an appointment’s details visibility.
Professionals can make details about a patient’s appointment hidden to other professionals in different disciplines.
To ease privacy concerns about the sharing of information about a patient that may not be appropriate for other professionals in other disciplines to see, the adding of an appointment on their timetable may simply be tagged as private, restricting the visibility of any details beyond the time and day to professionals in the same discipline as who booked it. This is especially important for professionals who work with children or in mental health.
A summary of what was presented within the document and any next actions.