POAC News and Information
POAC Update October 2019
It’s hard to believe it is October already! Where has the year gone?
The POAC programme continues to grow and successfully give positive experiences to our patients. Thanks to you all for your hard work and commitment.
We would like to extend a warm welcome to Cook Street Health Centre who have recently joined as a new POAC provider.
ED redirection pilot: We are pleased to report that our 3-month ED Redirection Pilot was very successful and we have had the OK to continue this for a further 12mths. ED Redirection pilot is a new initiative that allows low acuity patients to be triaged in ED and offered the opportunity to be referred out to a POAC referral site where they can be assessed and treated under the POAC programme. We are looking to see how we can build on this partnership with ED in the future. Thanks to all those involved who made this pilot a success.
Key updates and messages from recent case reviews:
COPD Pathway – One of the purposes of having the COPD pathway as part of the POAC programme is to remove financial barriers for patients and encourage them to return for follow up reviews including action planning. There seem to be a few cases coming through where practises are just claiming for an initial consultation (which may include ordering a chest x-ray) and there is no evidence of a follow up appointment. We encourage you all to refer to the COPD pathway and use this opportunity to support and monitor patients with a focus on updating action plans.
Cellulitis Pathway – Please note we have made some improvements to the District Nursing referral form. Please see the Cellulitis pathway for the most up-to-date version and dispose of any previous copies. [NB: Our POAC pathways are now hosted on HealthPathways – to navigate to the pathways, login to HealthPathways, then click on the link ‘MOM – MidCentral’ (listed on right side of home page). If you need a login for HealthPathways please email CCP@thinkhauora.nz .]
DVT Pathway – After discussion with Daryl Pollock Haematology CNS we have decided to no longer provide DVT ‘starter packs’ with clexane and warfarin. These were initially fabulous when we started out, but as the new treatment options have come in, namely rivaroxaban and dabigatran, the packs now tend to expire and medication is being wasted. We will continue to stock clexane singles of two strengths (120mg and 150mg) which can be used if the USS is unavailable until the next day or after a weekend. Once the USS is completed with a positive diagnosis you can apply for special authority and obtain further clexane if that is the treatment option chosen for that patient. You can order the singles by emailing Daryl Pollock Daryl.Pollock@midcentraldhb.govt.nz .
Iron Deficiency Anaemia Pathway – It is important that sites adhere to the clinical criteria. This includes patients with raised CRP – Ferritin must still be under 50. Consider checking full iron studies, including saturation % if this has not already been investigated. If there are instances where there are patients outside of the criteria who you feel would benefit from an iron infusion, there needs to be specialist input. Haematologist Elayne Knottenbelt is happy to discuss and is best contacted by email Elayne.Knottenbelt@midcentraldhb.govt.nz . Encourage your team to make use of this resource and record all discussions/phone consultations with specialists in the patient’s medical record.
Please remember to use the most up-to-date version of the referral form – see the IDA Treatment and Guidelines pathway for the latest version. Also please remember to forward a copy of your Iron Infusion request forms to the POAC team. We don’t seem to be receiving these in the same numbers as the claims recently.
General – To make it easier for your colleagues and for case review purposes, please encourage all staff to annotate POAC clearly in the clinical notes.
Feel free to contact us at any time at
POAC@thinkhauora.nz or Cell: 027 274 8106