The Care Coordination Service assists those who frequently need to use the acute care sector for Chronic Obstructuve Pulmonary Disease (COPD), Chronic Heart Failure (CHF), Parkinson's Disease (PD) and other movement disorders. Clinical Care Coordinators provide individually tailored services including self-management strategies, education, facilitation and coordination of community and other support services.
More specifically, Clinical Care Coordinators provide:
- Comprehensive psychosocial assessment and individualised goal centered care plans to support clients to manage their chronic illness
- Education and support for patients and their family/carers regarding their chronic illness
- Ongoing communication and advocacy between client’s community and health care providers
- Assistance accessing community care and support
- Assistance with future planning through the completion of Enduring Power of Attorney and Advanced Care Plan documents through Advance Care Planning Clinics
For more information on care coordination, please feel free to contact us.