This was an innovation project supported by the former Better Care Victoria Innovation Fund.
Monash University Department of Translational Nutrition
Gastrointestinal symptoms suggestive of irritable bowel syndrome (IBS) are one of the most frequent presenting complaints to Australian general practitioners and the most common reason for specialist referral to a gastroenterologist.
However, for many of these patients, medical intervention is not always necessary; sometimes evidence-based allied health interventions can be more effective and economical.
To provide more timely, effective and person-centred care, Alfred Health implemented a nurse and allied health-led model of care to more effectively triage patients referred to its functional gastrointestinal disorders (FGIDs) clinic.
- Establish and implement a nurse and allied health-led diagnosis and triage clinic for patients referred from primary care with a suspected diagnosis of IBS or other FGID
- Achieve faster symptom relief in FGID patients
- Improve the patient journey by providing timely access to therapy, enhanced support and better patient education
- Improve clinic efficiency and cost per patient
- Saw 2.75 times more new patients under the new model of care and increased the total number of patients seen by almost 50 per cent
- Achieved an almost three-fold reduction in wait times and decreased time to first clinic appointment from 345 to 120 days
- Decreased symptom severity for patients seen in the nurse and allied health-led clinic by 21.6 per cent
- Reduced the number of patients requiring medical review by 36 per cent
- Almost halved the cost per new patient from $887 to $484
- Received high patient satisfaction scores and reduced ‘did not attend’ rates from 13.5 per cent to 3 per cent
December 2020 – Unfortunately, Alfred Health was unable secure sufficient funding to sustain the face-to-face nurse triage program. The online questionnaire is still used to triage patients as high risk or low risk, however, all patients are required to see the gastroenterologist before engaging with allied health therapy which has impacted on waiting times. Dietitian sessions and the helpline have been maintained. The team are currently exploring the use of telehealth to improve follow up of patients and to reduce the rate of ‘did not attend’ appointments.