Unlike Emergency Departments that operate within public hospitals and some private hospitals, a Walk-in Specialist Emergency Clinic is located in the community and designed to provide comprehensive, coordinated acute care – from initial consultation and diagnostic services, to treatment and specialist referral if required – without the patient having to visit a hospital.
The first WiSE Clinic opened in Macquarie Park (North Ryde), New South Wales in early 2017, delivering immediate medical care when accidents or emergencies require more than a GP visit and are considered non-life threatening or unlikely to require admission to hospital.
Australian health journal spoke to the visionary, founder and CEO behind this WiSE Specialist Emergency clinic, Dr Pankaj Arora.
Dr Arora talks about the origins of his journey in emergency departments working in four continents as an Emergency Room physician for the past 28 years. His passion is to develop health care systems to help acute care in the community.
Stating 70% of people presenting at Emergency Departments in Australian Hospitals, not getting admitted, 7 years ago Dr Arora modelled these patients presenting to ER but breaking away from the hospital setting. This break away setting would deliver treatment by a team of doctors, allied health specialists, radiology, fracture clinic, chest pain clinic, TIA clinic, early pregnancy clinic and pathology services all co-located in the single facility.
Since putting the model in place and opening in 2017, the Macquarie Park WiSE Emergency Specialist Clinic has treated over 70,000 patients. Dr Arora sees it as a very efficient and cost effective model, where the patient is seen by a specialist in a multidisciplinary team within half an hour and receives results within an hour. He emphasises the clinic has not replaced General Practice nor the Emergency Department in hospital.
From the success of the Macquarie Park, NSW clinic, last year Dr Arora set his plans in motion to open a 2nd WiSE emergency specialist care clinic, this time in Queensland. This happened only after 3 years of planning and modelling prior to the opening of the new centre in September 2022. However since opening in Robina, Gold Coast, the new WiSE clinic has been treating on average 20 patients per day – a faster rate than the first 6 months of the Macquarie Park, NSW clinic.
In closing Dr Arora talks about the differences between the WiSE model and urgent care clinics. Scaled down versions of emergency care departments in urgent care centres fail to address the treatment required for patients between General Practice and at hospital emergency departments.
His plans now include opening 10 clinics in the next 5 years, with an expectation that 20-50 clinics would be needed across Australia in the medium to long term.
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Handling modern day diets and misinformation as a HCP
Laureate Professor Clare Collins AO in Nutrition and Dietetics at the University of Newcastle, emphasises the need for accurate and reliable nutrition information to reach the public. Prof Collins believes that it is vital for clinicians to stay up-to-date with cutting-edge nutrition science and work with communication organisations to disseminate information to the general public. This is particularly important as social media is full of both reliable and unreliable information on dietary patterns, such as veganism.
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Continuity of Care under COVID-19
Series 3, Episode 1
Under the COVID-19 pandemic, the Australian Healthcare system has handled the public health crisis by monitoring and responding to challenges in supply chains, testing & tracing of new infections and stock piling of essential equipment.
The public has largely responded by practising social distancing, understanding how hand hygiene can spread contagion and recently installing the COVIDSafe mobile application. Public health messaging has been largely effective and literacy improve, to combat the dangers of misinformation.
To open up access to medical advice during the pandemic, in March the Australian government issued MBS item codes for telehealth consultations, for advanced practice nurses as well as GPs and other specialists.
According to AMA President Dr Tony Bartone, as of mid-May 2020, around 10 million Medicare-funded telehealth services have been provided, either over the phone or via video, a significant majority of which have been provided by GPs and other specialists since the Medicare telehealth items were introduced in March.
However in recent months, the health system has mounting concerns on:
- a reduction in general practice visits for testing, investigation or immunisation
- lower rates of elective procedures resuming since being halted
- reduction in laboratory testing
- reduction in treatments and diagnosis of chronic and acute conditions
- access to, and continuing to take medications
Those with pre-existing conditions have been urged to keep appointments and routine treatments to maintain their health.
Industry has taken action such as the newly formed Continuity of Care Collaboration (CCC). The 15 health organisations forming CCC are an Australian first national communication collaboration of Peak Bodies, Industry and Healthcare Organisations coming together to stress the importance for people to continue monitoring their health and maintaining their regular care.
This Australian Health Journal episode on the continuity of care was produced with commentary from the following health industry associations and organisations: APNA – Australian Primary Health Care Nurses Association, RACGP, Medical Technology Association of Australia (MTAA), West Cessnock Medical Practice, Consumers Health Forum of Australia, Medicines Australia
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Stroke care advances in translated research
New nurse-led protocols for stroke patients, based on ACU research, led by the Nursing Research Institute, have resulted in changes to policy, guidelines and clinical practice in Europe and Australia. The protocols were developed through the Quality in Acute Stroke Care (QASC) Trial (published in the Lancet, 2011) to manage fever, hyperglycaemia and swallowing (FeSS) post-stroke.
