Winter wellness check in the community

In an attempt to keep hospital admissions down and people well in their homes this winter, some Canterbury general practices have been trialling a new winter wellness initiative.

Woodend Medical Centre is one of those practices with Practice Nurse Marilyn Herbert asking some of their vulnerable respiratory patients to come in for a ‘Winter Wellness Check’.

This initiative has come from the Canterbury Initiative in partnership with Canterbury’s Primary Health Organisations. It involves general practices inviting patients who are at risk of an acute hospital admission during winter in for a check. It is completed by one of their practice health professionals and is free for the patient.

Older people, Māori and Pasifika (over 55yrs), people with complex health and social conditions, or a history of acute hospital attendance, can be considered for the checks.

It aims to keep people well in the community by keeping a close eye on their health needs during winter. The check may result in the patient being referred to a specialist, and /or having their medication or care plan reviewed.

Louise Weatherall, Clinical Nurse Specialist for the Canterbury Clinical Network’s Community Respiratory Service was asked by Marilyn to help review some of the practice’s patients with chronic respiratory issues, including asthma and Chronic Obstructive Pulmonary Disease (COPD).

“The checks have definitely been worthwhile. On one of my visits we reviewed four patients and by the end of the sessions we had updated two acute plans and created a new one, discussed an asthma management plan, referred two patients to pulmonary rehab, referred one patient for specialist physiotherapy, suggested changes to three inhaler prescriptions and asked the GP to create two new prescriptions,” says Louise.

The check starts with an in-depth discussion about any concerns the patient has about their current health and then looks at how they can manage their breathing if it starts to deteriorate at home.

“We also talked about self-management plans (the ‘blue card’) and acute plans. The response from patients has been great with everyone attending their appointments and I will now look at targeting patients with other chronic conditions,” says Marilyn.

Theresa Bennett (pictured) was one of the patients who came in for a check. She has COPD and was brought in by her daughter.

“We went through her management plan and reviewed her inhaler prescription. She is from Fiji and is going back for a visit, so it was a great opportunity for her to have a thorough check,” says Marilyn.  

“Having the expertise of Louise from the Canterbury Clinical Network’s Community Respiratory Service has been invaluable.”

The initiative runs until the end of August and it will be evaluated to check the impact it has made and inform plans for next winter. These results will be shared across the health system.

Pictured above: Marilyn and Louise with patient Theresa Bennett and her daughter Ruth Solly.

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