Project ECHO:WVPHN Hub- COVID 19 ECHO network: Recent Episodes
Bianca Forrester
Timestamped recordings of the panel didactic component of the COVID 19 pandemic response in primary care series. Hosted by the West Vic PHN, GP facilitator brings the worlds primary and tertiary health care, infection prevention and control and policy together through panel didactics and interactive discussions. Infectious diseases updates, health pathways guidance, clinical case discussions and interactive discussion about bringing policy to practice in regional Victoria, Australia.
Happy 2 year anniversary of COVID ECHO everyone. Happy Birthday team!Two years ago tweets from Italian ICU doctors, calls to action by WHO epidemiologists and fears for family members sprang us all into action. With our late February gP refresher cancelled due to risks of mass events, The PHN workforce development team, the leadership team, Kate Graham, Deb Friedman, Raquel Cowan and I pulled together a new team to launch project ECHO the pandemic response series.You guys came along to seek out updates and knowledge about this novel virus and together we worked to make sense of the pandemic work for GPs and nurses in regional victoria through case based discussions over zoom.And here we are, 2 yrs and 75 sessions later, still finding lots to talk about.This mornings session will bring up updates as always and seek to answer your questions about testing for COVID infections.* How are we using RATs in practice and what are the shortfalls * How might we use PCR this coming winter * Is serology useful * And what’s going on behind the scenes with COVID surveillance
AGENDA Dr Kate Graham, COVID Clinical Advisor and COVID Health Pathways leads Editor, WestVic PHN * Guidelines update, RAT testing and Health Pathways * Dr Nom Mothobi, Public Health Physician, BSWPHU, Barwon Health * * Dr Peter Atkinson, GP Lorne Medical Centre * Testing in rural * Naomi White, COVID positive Care Pathways Manager, WestVic PHN * PHN update
Recorded on Thursday 31st March, 2022Western Victoria PHN Project ECHO HubCOVID-19 ECHO TeamBianca Forrester (Facilitator)Jemma Missbach, Katrina Martin (ECHO Co-ordinators)Fiona Quigley, Workforce ManagementJayde Buller, audio production
As case numbers have been decreasing and things seem manageable on the COVID care front, primary care is confronted with requests to return to business as usual care models, to consider catch up care and to prepare for the flu season. In primary care we have been frontline workers in a health crisis, have rallied time and time again for our community despite the challenges and the odds, the brutal fatigue and the charged emotions.As a workforce, we are moving from disaster response to disaster recovery.But as we hear news of Japanese encephalitis and influenza and Omicron BA2, we wonder what’s going on for you? What are your fears? Are we confronting another cycle of reactive survival as we look ahead towards another winter? Are we ready to begin proactively preparing?What does a sustainable response look like and what does resilience even mean ?These are some of the concepts that I’ve been puzzling over the past few weeks as we prepare for whatever the next stage of whatever it is that we are currently living in.Parents and grandparents will know how the story goes...When going on a bear hunt-.you can’t go under it, you can’t go over it, you have to go through it...So what does going through this next stage look like.According the the UN Disaster risk reduction strategy- moving from Disaster response to disaster preparedness involves A risk informed systems based approach to decision making----sounds like lofty ideals that couldn’t be applied on the ground...doesnt it?So let’s start to try to make sense of what this could mean in primary careIn our coming sessions, we'll consider how to embed communicable diseases resilience into the work we do day to day in primary care. What does a strong and resilient primary care response look like? * What needs to change to support this work? * what are our priority actions would we like to implement now, in the short and medium terms? * Dr Kate Graham, COVID Clinical Advisor and COVID Health Pathways leads Editor, WestVic PHN * Guidelines update, RAT testing and Health Pathways * Raquel Cowan, Head of ID at Ballarat Health services and Infectious diseases physician at the North Eastern Public Health Unit * Omicron BA2 update and from COVID-19 to communicable diseases more broadly, challenges facing primary care * Case Presentation and discussion (audio not included) * Naomi White, COVID positive Care Pathways Manager, WestVic PHN* * PHN Update
Recorded on Thursday 24th March, 2022Western Victoria PHN Project ECHO HubCOVID-19 ECHO TeamBianca Forrester (Facilitator)Jemma Missbach, Katrina Martin (ECHO Co-ordinators)Fiona Quigley, Workforce ManagementJayde Buller, audio production
As GPs, we pride ourselves in knowing quite a bit about everything, differentiating presentations and sitting with uncertainty. So far this pandemic challenged us in 2020 to refresh our knowledge of epidemiology and public health, in 2021 to step up to a relationship with vaccinology and 2022 to confront those knowledge recesses of med school immunology. I don’t think I’ll be alone in suggesting that these snippets of immunology banked down dusty hallways of memories have proved both at most the most difficult to retrieve, but also the most compelling of knowledges to seek out. For within the study of immunology is perhaps the code for enabling us to better differentiate many of the contemporary presentations to primary care. For research in this area has potentially exploded since we were all in medical school with advances in technology enabling new insights into the complex interplay between the host genetics, epigenetics, the microbiome, pathogens, toxic stress and the mediators of non-communicable diseases on inflammatory pathways. There is just so much that we could talk about, but with our eye on the SARS COVID 2 pandemic or endemic, let’s start there.This morning we’ll refresh our knowledge of* Innate and adaptive immune responses * Vaccines and the immune response * COVID-19 and the immune response * Common immunological complications from the vaccine and COVID and how they are mediated
AGENDA Dr Kate Graham, COVID Clinical Advisor and COVID Health Pathways leads Editor, WestVic PHN * Guidelines update, RAT testing and Health Pathways * Dr Arvind Yerramilli, Infectious Diseases Registrar | Public Health Unit | Barwon Health * Naomi White, COVID positive Care Pathways Manager, WestVic PHN*
Recorded on Thursday 17th March, 2022Western Victoria PHN Project ECHO HubCOVID-19 ECHO TeamBianca Forrester (Facilitator)Jemma Missbach, Katrina Martin (ECHO Co-ordinators)Fiona Quigley, Workforce ManagementJayde Buller, audio production
Happy international women’s day/week everyone.This years theme: Changing Climates: equality for a sustainable tomorrow invites us to celebrate the work of women and girls working to change the climate of gender equality and build a sustainable future.For me personally, this community of practice that we have built locally, using the ECHO platform, represents these values in action.Over the past 2 years, we’ve come together as a collection of diverse stakeholders all invested in supporting our community and our colleagues against a health threat and a social crisis.We’ve engaged in a respectful dialogue that seeks to include grounded experiences of the and perspectives in a systems-focused and solutions orientated way.This week invites you to not only acknowledge our colleagues in their work responding to the pandemic, please celebrate a woman or girl in your life who you recognise as contributing to the building of an equitable and sustainable future...and let’s continue these conversations over the coming weeks and months as we together consider how to support our workforce.
But, today, in a GP led series we’ll be putting into practice the work of accessing antiviral therapies in western victoria.The who, what, where and how.
Last week the mask mandate came to an end and many of the public health orders that we’ve lived with for the past few months shifted. In the spirit of moving into COVID normal and opening up Victoria, there was a flurry of excitement as tickets for an international band went on sale for an open air stadium event in our own West vic region. Did anyone else miss out on tickets? Were your reactions times, like mine, slow and perhaps indicative of a sense of caution as we adjust to this next phase of pandemic recovery in the community?So, how are we adjusting to these changes in primary care?* What has been changing in your systems and processes over the past week? * What are you wearing as the mandate drops and more importantly, what are patients ready, willing and able to do to protect us as health care workers and other priorty groups in our waiting rooms. * With booster rates stalling, how are we going in primary care with keeping up the promotion of third primary doses? * And who are we prioritising for these doses at this time and how are we promoting and administering these doses? * And finally, What’s new in vaccines and how will we implement these changes?
Agenda Dr Callum Maggs, ID Physician, Clinical Lead VicSIS, Barwon Health * Vaccines * Dr Mike O'Sullivan, GP, Ballarat Medical Centre * Case Presentation * Dr Kate Graham, COVID Clinical Advisor and COVID Health Pathways leads Editor, WestVic PHN * Guidelines update, vaccines and Health Pathways * Naomi White, COVID positive Care Pathways Manager, WestVic PHN* * PHN Update
Recorded on Thursday 3rd March, 2022Western Victoria PHN Project ECHO HubCOVID-19 ECHO TeamBianca Forrester (Facilitator)Jemma Missbach, Katrina Martin (ECHO Co-ordinators)Fiona Quigley, Workforce ManagementJayde Buller, audio production
This week we mark anniversary of the vaccine rollout in Australia. In just 12 months, long months though they seemed at the time, we adapted to this new technology and collectively rolled out 2 doses to over 95% of our adult community and followed this up with a 3rd dose to over 60%. While we’ll revisit vaccines in next weeks series, it is the other biological interventions for SARS COV2 that we’ll be discussing today and marking a new milestone in the legacy of this pandemic: oral antivirals.One month ago, the oral antivirals molnupiravir (Lagevrio) and nirmatrelvir + ritonavir (Paxlovid) were approved by the TGA for use by eligible patients and to be distributed at first through the national medical stockpile to priority populations as prescribed by their GP.The questions we’ll be asking this morning are:* How do these oral antivirals compare and differ? * Who is eligible for these therapies and in whom would sotrovimab infusion or paxlovid be preferred? * What are the drug interactions, adverse effects and contr-indications that we need to be aware of prior to prescribing? * What are some of the practical issues in regards to administration? * How do we in the primary care sector work with our colleagues in health services, RACFS and ACCHOS to consider priorisation of these medications? * How will the national medical stockpile work and how will GPs and or patients access these medications in a timely manner? * What is forecast for this medication in regards to it’s availability through the PBS?
AGENDA Dr Kate Graham, GP and Clinical Editor Health Pathways and COVID Clinical Advisor Western Victoria PHN * Policy and resources update * Dr Raquel Cowan, Head of Infectious Diseases, Ballarat Health Service * Oral antiviral therapy and how to access it * Dr Nom Mothobi, ID Physician, Barwon Health and Barwon South West Public Health Unit * Accessing oral antivirals in the Barwon South West region * Linda Govan,* Regional Senior Manager, Western Victoria PHN * •PHN Update
Recorded on Thursday 24th February, 2022Western Victoria PHN Project ECHO HubCOVID-19 ECHO TeamBianca Forrester (Facilitator)Jemma Missbach, Katrina Martin (ECHO Co-ordinators)Fiona Quigley, Workforce ManagementJayde Buller, audio production
Schools have been back for 3 weeks now and despite this increased mixing and crowding, we seem to be progressing through the downhill slope of this Omicron wave.At the beginning of this series, we’d anticipated that Omicron might cause a little more mischief and here at ECHO we’ve prepared for the worst and expected the best.This morning we’ll focus on PIMS-TS or Paediatric Inflammatory multisystem temporally associated with SARS-COV-2. Early in our Omicron wave, there were a few cases admitted locally, and it seemed best that we get our heads around this rare but concerning syndrome.But I also wonder if understanding PIMS TS might help us to understand other inflammatory conditions associated with COVID, such as long COVID and or other unusual symptoms that might be presenting to primary care. And to illustrate this point, we’ve got a GP case in store for you this morning.Finally, I’m keen to hear your thoughts on* whether our response to COVID and infection in primary care means that there are paediatric care needs that are being deferred or missed? * Are we missing that bacterial infection? * Or are we putting things down to COVID that might be explained better by other differentials. * When will the prevalence of COVID decrease such that we can revert to business as usual models again? Or is even mentioning the end of a wave bad luck?
Recorded on Thursday 17th February, 2022Western Victoria PHN Project ECHO HubCOVID-19 ECHO TeamBianca Forrester (Facilitator)Jemma Missbach, Katrina Martin (ECHO Co-ordinators)Fiona Quigley, Workforce ManagementJayde Buller, audio production
We’ve run 3 or 4 Paediatric series over the past 2 years, focusing on COVID care, return to school risk mitigation measures and vaccinations. Looking back, while the virus has mutated and changed in it’s virulence and transmissibility, so too has our understanding of these dynamics and the tools we have used to risk mitigate.We’ll kick off our 2 part Paeds mini-series, today with discussion about common presentations such as questions about testing and quarantine and the paediatirc vaccine rollout. We’ll seek to understand where the evidence sits in regards to long COVID in kids and the risk benefits of the vaccine vs the virus and in whom do we need to pay special attention due to immunocompromise.In our next session, we’ll move onto slightly trickier presentations, such as PIMS-TS....so if you have a case, we’d love to hear from you.What are the other common paediatric issues rising up at this stage of the pandemic and what are information or knowledge frameworks do you need to address these issues in your clinic setting?AGENDA Dr Kate Graham, COVID Clinical Advisor and COVID Health Pathways leads Editor, WestVic PHN * Guidelines update, RAT testing and Health Pathways * Dr Jane Standish, Paediatrician, Barwon Health, MCRI and RCH * back to school, vaccines and clinical issues * Linda Govan, Regional Senior Manager, Western Victoria PHN* * PHN Update
Recorded on Thursday 10th February, 2022Western Victoria PHN Project ECHO HubCOVID-19 ECHO TeamBianca Forrester (Facilitator)Jemma Missbach, Katrina Martin (ECHO Co-ordinators)Fiona Quigley, Workforce ManagementJayde Buller, audio production
American Sociologist C.wright Mills coined the phrase “Personal (or private) troubles and Public issues” to describe twin born problems that are inseparable and equally significant. As schools in Victoria re-open in the midst of a public health issue (or pandemic) there will no doubt be a number of private troubles presenting to primary care.At the policy level, government departments will have been busy articulating guidelines describing a suite of risk mitigation measures, schools will have been scrambling to implement these and provide Rapid antigen testing kits to families ahead of return and in individual households across both states, families and staff members will be navigating a complex risk/benefit calculations that will determine how they feel and think about returning to these crowded settings in this stage in the pandemic.In this session we’ll seek to highlight the public health directives and guidance and untangle the personal issues and concerns that will drive help seeking in primary care.We’ll consider the common scenarios that might be presenting and we’ll be relying on participants to share their experiences and questions in the chat so that we can seek to resolve common issues presenting to primary care.What are the concerns of workers in educational facilities and what is our role in primary care in supporting these workers with vaccinations, certificates or exemptions, information and advice?What are the concerns of families and children and how can we support them to balance the risk of harm from COVID vs the risk of harm from school exclusion?In whom, at this time, does COVID infection represent a significant risk worth creating special measures to shield them from infection?And in whom might we play a role in supporting return to the business of education through information and tailored advice?Dr Kate Graham, COVID Clinical Advisor and COVID Health Pathways leads Editor, WestVic PHN Guidelines update, RAT testing and Health Pathways * Dr Akhtar Hussain, Public Health Physician, BSWPHU, Barwon Health * Return to school, Public Health Strategy and implementation considerations * Dr Jeff Urquhart, GPLU Barwon Health * Managing Mild COVID * Panellist: Dr Jane Standish, Paediatrician, Barwon Health, MCRI and RCH * Naomi White, COVID positive Care Pathways Manager, WestVic PHN * Linda Govan, Regional Senior Manager, Western Victoria PHN* * PHN Update
Recorded on Thursday 3rd February, 2022Western Victoria PHN Project ECHO HubCOVID-19 ECHO TeamBianca Forrester (Facilitator)Jemma Missbach, Katrina Martin (ECHO Co-ordinators)Fiona Quigley, Workforce ManagementJayde Buller, audio production
Welcome back to our first ECHO session for 2022.In 2020 the word unprecedented was used more than a few times to describe the SARS COV2 pandemic and in 2021 this word was eclipsed by the phrase “vaccine roll out”. Delta kept us pretty busy but with biological prevention on our side, with both vaccines and sotrovimab infusions we were able to temper the impact of this variant on both individuals and ICU beds.As we reached vaccine milestones and public health measures eased, we anticipated a rise in cases and in response, we ran an entire series dedicated to COVID care pathways and managing COVID in the community. You can check out the resources and materials in the box by following the links in the chat and on this slide to catch up on missed content, still relevant today.Late last year, with 95% vaccination rates across our region and sotruvimab infusion pathways in place, things seemed to be fairly under control across all quarters of the healthcare system.Enter Omicron, a variant which has again changed the game and “expect the unexpected” became the new tagline for the coronavirus pandemic. In primary care, we were forced to pivot yet again delivering boosters alongside childhood vaccines. managing COVID cases alongside business as usual under new risk and furloughing matrices and on top of this many of us would have experienced disruptions due to staff infections and quarantining…all at a time when we had hoped for a much needed slow down period.This series will have a focus on COVID care pathways…both the clinical care aspects and the implementation.You’ll be bringing us tricky cases to discuss with peers and specialist colleagues and we’ll consider how COVID is similar and different to other viruses we’ve encountered.And we’ll be seeking to learn how to adapt and innovate alongside our peers as we progress through this stage of the pandemic.How do we put those care pathways into practice in primary care in our local contexts?What new models of care have emerged over the past few weeks and how can we better normalize this into routine care and better integrate with health services?What new knowledge, skills and resources do we need to support this adaptation our work in primary care?What needs to be done at an organizational level to support this work and what needs to be advocated for at the commonwealth and state levels?This morning we’ll hear the perspectives of a GP, a public health physician and an ID consultant.We’ll be reviewing the life of a stressed health care system these past few weeks, we’ll be considering new ways of thinking about our approach to service delivery, we’ll cover some of the pressing issues and support needs at this time.Dr Anna Glue, GP Ballarat Medical Centre* Key challenges facing primary care?
Prof Rosemary Aldrich, Medical Director, Grampians Public Health Unit* Grampians Public Health Update and Public Health perspective
Dr Caroline Bartolo, Infectious Diseases Physician, BSWPHU, Barwon Health and Ballarat Health Services* View from the health services and Sortovimab eligibility criteria
Dr Jeff Urquhart, GPLU Barwon Health* Barwon South west remote patient monitoring update
Dr Alison Miller, GPLU Ballarat Health service* Ballarat @ home remote patient monitoring update
Linda Govan, Regional Senior Manager, Western Victoria PHN * PHN Update
Recorded on Thursday 27th January, 2022Western Victoria PHN Project ECHO HubCOVID-19 ECHO TeamBianca Forrester (Facilitator)Jemma Missbach, Katrina Martin (ECHO Co-ordinators)Fiona Quigley, Workforce ManagementJayde Buller, audio production
This year, as a collective, we’ve adapted to big changes and made some massive gains.We’ve achieved >95% vaccination for our region, we’ve lived through lockdown 7 or is it 8, we’ve seen the establishment of 2 new local public health units and the development of COVID care pathways within our health services, we’ve adapted our practices to this airborne hazard and deciphered multiple iterations of vaccine eligibility from the commonwealth and risk matrixes from the state and we’re all hopefully a little better prepared to manage COVID in primary care, when the time eventually comes. And even though I imagine we’re all pretty happy to down tools for a bit I think it’s fair to say that we are gradually learning to live with this virus.This morning, in addition to our usual public health, vaccination and covid care pathways updates, from our local team, we’ll be joined by A/Professor Deborah Friedman, Deputy Chief Health Officer and ECHO regular in 2020 and I’ll be asking her the following questions: What have we collectively achieved in public health and as a health system in 2021 * what have we learned about this “novel virus” that we can take forward so that it feels a little less novel and little more predictable * How might we think about the coronavirus as a hazard and risk in the year to come in the local and global context? * And I’ll be asking her for tips for what to pack in our holiday doctors bags and suitcases for this hot vaxxed summer in regional vic?*
AGENDA Linda Govan, Regional Senior Manager, Western Victoria PHN * PHN update * Dr Kate Graham, GP and Clinical Editor Health Pathways and COVID Clinical Advisor Western Victoria PHN * Public health, vaccinations and COVID care update * A/Prof Deb Friedman*, Deputy Chief Health Officer * Where are we and where are we heading in the COVID 19 Pandemic
Recorded on Thursday 9th December 2021Western Victoria PHN Project ECHO HubCOVID-19 ECHO TeamBianca Forrester (Facilitator)Jemma Missbach, Katrina Martin (ECHO Co-ordinators)Fiona Quigley, Workforce ManagementJayde Buller, audio production
As Victoria opens up and we take the next steps on the commonwealth roadmap towards living with COVID, it appears that COVID is learning to live with us too. With a new variant of concern emerging from south Africa, it seems that we’ll need to keep our public health hats on for a little longer as we make sense of this next stage of the pandemic. We knew that variants would emerge, we knew that this would happen in countries with low vaccination rates and we suspected that immunocompromised vaccinated hosts would play a role. This morning we’ll address this briefly in our clinical updates and please presubmit questions in the chat for next weeks session as we’ll feature COVID variants in the context of our covid summer in regional victoria then.While we await for the story to unfold a little more, we take the opportunity this week to finish off our COVID care series with a focus on the exit point of the pathway.Our didactic will focus on Post acute COVID our case vignette and discussion will focus on how we can best support patients following the COVID care pathways and exit from isolation.We’ll be focusing on the following questions:What is important to patients and how can we best support them in this?In the setting where specialist input might be required, what could good individualised multi-disciplinary care look like?What can we achieve for patients in rural and regional settings?What knowledge gaps do we need to fill to enable primary care to manage this syndrome?Agenda* Linda Govan, Regional Senior Manager, Western Victoria PHN * PHN update * Dr Kate Graham, GP and Clinical Editor Health Pathways and COVID Clinical Advisor Western Victoria PHN * Public health, vaccinations and COVID care update * Dr Arvind Yerramilli, Registrar, Infectious Diseases Barwon Health * Post COVID Syndromes *
Recorded on Thursday 2nd December 2021Western Victoria PHN Project ECHO HubCOVID-19 ECHO TeamBianca Forrester (Facilitator)Jemma Missbach, Katrina Pilbeam, (ECHO Co-ordinators)Katrina Martin, Fiona Quigley, Workforce ManagementJayde Buller, audio production
Our COVID care series to date, has focused on the clinical risk stratification, clinical care monitoring and and care escalation. We have come to an understanding of how this care pathways have been implemented through our major health services and we will continue to discuss the role of smaller regional health services over time. Through our case based discussions, we’ve been able to consider how we could manage patients determined to be on low risk and medium risk pathways and we’ve considered the clinical care needs through the parallel lens of managing other respiratory viruses in the community.Interestingly, many of the questions that have come up in the past few weeks, have been in relation to the requirements of COVID positive patients to quarantine and also the need to comply with public health orders. And so, in this mornings session we’ll take a deep dive into the public health orders put upon a household living with COVID and the social care needs that arise for individuals and households with respiratory illness placed under public health orders to isolate.We’ll be focusing our discussion upon the question:What are the health and public health literacy gaps and social care needs of patients on COVID care pathways?What is our role in primary care alongside the public health units and remote patient monitoring teams?Going forward, what could social care responses co-ordinated through GP settings look like?And we’ll layer this with a culturaly lens this morning and consider the needs of First Nations Australians in the event of an COVID positive member of a household and community.Our community outbreak case discussion this moring will ask the question:How can services and sectors work together to provide culturally and socially responsive care?Agenda Linda Govan, Regional Senior Manager, Western Victoria PHN * PHN update * Dr Kate Graham, GP and Clinical Editor Health Pathways and COVID Clinical Advisor Western Victoria PHN * Public health, vaccinations and COVID care update * Dr Karen Aarons, Fractional Specialist, Grampians Public Health Unit * Public Health orders and social care needs of COVID positive households * Adam Muir, Aboriginal Project Officer, Western Vic PHN & Barwon Public Health Unit * Outbreak Case Discussion*
Recorded on Thursday 25th November 2021Western Victoria PHN Project ECHO HubCOVID-19 ECHO TeamBianca Forrester (Facilitator)Jemma Missbach, Katrina Pilbeam, (ECHO Co-ordinators)Katrina Martin, Fiona Quigley, Workforce Management* Jayde Buller, audio production
To date our COVID care series has focused on the steps in the COVID Positive care pathways- from that positive diagnosis through the PHU intake, the risk stratification and clinical assessment process, through clinical management, remote patient monitoring and patient self monitoring.In this session, we’ll break away slightly from the steps in the pathway to consider the needs of special groups- and today’s session will focus on our littlest members of the community- kids.So, how does COVID care in children look?What are the needs of this group in regards to the illness, monitoring and escalation points?How do we consider their care in the context of their households and families?Finally what can be borrowed from our experiences of managing other viruses in general practice that can now be applied to managing this novel virus in the community with this special group of community members.AgendaMs Linda Govan, Regional Senior Manager, Western Victoria PHN * PHN update
Dr Kate Graham, GP and Clinical Editor Health Pathways and COVID Clinical Advisor Western Victoria PHN * Update on the state Public Health guidance, vaccines and COIVID care * and Rapid Antigen testing
Mr Matthew Drake, Paediatric COVID Navigator, BHS at Home, Ballarat Health Services* Paediatric care pathways
Recorded on Thursday 18th November 2021Western Victoria PHN Project ECHO HubCOVID-19 ECHO TeamBianca Forrester (Facilitator)Jemma Missbach, Katrina Pilbeam, (ECHO Co-ordinators)Katrina Martin, Fiona Quigley, Workforce ManagementJayde Buller, audio production
In our COVID care pathways series, we continue along the pathways this week with a focus on the patient’s role in self-management and monitoring. To date our series has focused on patient triage, clinical assessment and remote patient monitoring and the entry points of a patient in this pathway has been through the public health units and health services with an emphasis on risk stratification and safety.Today we’ll be exploring some of the principles of patient centred care that is a core component and aim of GP care models and we’ll do this by placing the patient at the centre of the COVID journey.We’ll be considering how patients can actively participate in with monitoring and self care, we’ll consider the safety of the home environment as a setting for care and how telehealth and patient self-care apps can support the interface between the home and the clinic.We’ll be considering patient safety, responsibility, preferences and communication and shared decision making in the context of COVID illness and we’ll open up the conversation about care in the family context and for a whole household.Our didactic will focus on patient self monitoring and our case today raises questions about how we might bring low risk pathway COVID care to life in a primary care model.The question we’ll focus on this morning is:How could we manage very low risk/low risk patients in the community through general practice?And to assist us to place the patient in the centre of the discussions, we’re privleged to have a trusted ECHO colleague and now health consumer on our panel to contribute to our discussions today about their experiences of COVID care pathways.AgendaMs Linda Govan, Regional Senior Manager, Western Victoria PHN * PHN update
Dr Kate Graham, GP and Clinical Editor Health Pathways and COVID Clinical Advisor Western Victoria PHN * Update on the state Public Health guidance, vaccines and COIVID care * and Rapid Antigen testing
Prof Lena Sanci, GP and Head of the Department of General Practice, University of Melbourne* Patient self-monitoring
Case PresentationDr Alison Miller, GP Ballarat Medical Centre and BHS at Home, Ballarat Health ServicesPanel for discussion: Rachel Robinson,* Health Consumer and Project Coordinator, MCRI
Recorded on Thursday 11th November 2021Western Victoria PHN Project ECHO HubCOVID-19 ECHO TeamBianca Forrester (Facilitator)Jemma Missbach, Katrina Pilbeam, (ECHO Co-ordinators)Katrina Martin, Fiona Quigley, Workforce ManagementJayde Buller, audio production
Welcome to the COVID positive care pathways series at the West Vic PHN COVID ECHO network. This series follows the patient journey from testing to triage, risk assessment, clinical assessment and monitoring and this morning we’ll focus our didactic on novel therapeutics for COVID as well as considering the use of familiar therapeutics in the management of this novel virus.And as always, we’ll be considering our role as prescribers or in the referral pathways or engagement support and follow up for these treatments.But I’d also like to back track a little, to the beginning of the COVID care pathway, but still in the spirit of novel innovations.With the release of home based rapid antigen testing kits in supermarkets this week, we’d like to bring you a timely update on these testing kits and how we might integrate them into both our public health test, trace and isolate advice and also our clinical care algorithms in primary care. We’ll feature a small case vignette seek to bring to life the grounded experience of advising patients with positive tests.AgendaMs Linda Govan, Regional Senior Manager, Western Victoria PHN * PHN update
Dr Kate Graham, GP and Clinical Editor Health Pathways and COVID Clinical Advisor Western Victoria PHN * Update on the state Public Health guidance, vaccines, COVID care and Rapid Antigen testing
Dr Caroline Bartolo, Infectious Diseases Physician, Barwon Health and Barwon South West Public Health Unit* COVID-19 Therapeutics
Panel for discussion: Dr Karen Aarons,* Fractional Specialist, Grampians Public Health Unit
Recorded on Thursday 4th November 2021Western Victoria PHN Project ECHO HubCOVID-19 ECHO TeamBianca Forrester (Facilitator)Jemma Missbach, Katrina Pilbeam, (ECHO Co-ordinators)Katrina Martin, Fiona Quigley, Workforce ManagementJayde Buller, audio production
In our previous 2 sessions, our didactic presentations covered risk stratification and clinical assessment and we discussed COVID cases as they related this these aspects of the patient care journey. In this mornings session, we progress onto the management phase of the pathways focusing on remote monitoring this week and next week we’ll feature therapeutic interventions. In our GP case discussions we’ll consider the key question:What is the role of the GP and primary care team alongside these hospital-led community monitoring pathways?Agenda:Dr Kate Graham, GP and Clinical Editor Health Pathways and COVID Clinical Advisor Western Victoria PHN * Update on the commonwealth vaccine rollout, the state Public Health guidance and the COVID care pathways
Ms Linda Govan, Regional Senior Manager, Western Victoria PHN * PHN update
Dr Will Naughton,Medical Lead, Barwon Southwest Public Health Unit* Barwon Community care and remote patient monitoring
Recorded on Thursday 28th October 2021Western Victoria PHN Project ECHO HubCOVID-19 ECHO TeamBianca Forrester (Facilitator)Jemma Missbach, Katrina Pilbeam, (ECHO Co-ordinators)Katrina Martin, Fiona Quigley, Workforce ManagementJayde Buller, audio production
In our last session, our clinical didactic focused on an overview of COVID care pathways and risk stratification processes that form the entry point for the patient care journey. Through our case discussion we considered the relevant information and knowledge that GPs and Practice nurses as well as health services and organisations would need to consider if we are to bring these care pathways to bear in community primary care settings. This mornings didactic focuses on the next step of the care pathway: remote clinical assessment. Dual training ED and GP clinician, Belinda Carne, will discuss clinical assessment and clinical deterioration/care escalation. We'll seek to bring you updates from our health services and the primary health network about how our systems for escalation and after hours care are shaping up.And, as we plan to do through out our COVID care series, we’ll be putting these principles and processes into practice through our COVID case discussion.This mornings session aims to respond to the question:For a patient with co-morbidities, when is the riskiest time in the illness?When should we consider escalating care?And who do we escalate care to and through which communication mechanisms?AgendaDr Kate Graham, GP and Clinical Editor Health Pathways and COVID Clinical Advisor Western Victoria PHN * COVID update for Primary care, COVID exposure hotline, Safer Care guideline
Dr Jeff Urquart, GPLUBarwon Health Services* COVID-19 Remote Patient Monitoring (RPM) Program,
Dr Belinda Carne, GP and Emergency Physician, Barwon Health* COVID assessment and signs of clinical deterioration/care escalation
Dr Anita Phillips, GP Case presentationDiscusion - allPanelist- Dr Caroline Bartolo, Infectious Diseases Physician Ballarat Health Service and Barwon South West Public Health UnitMs Linda Govan, Regional Senior Manager, Western Victoria PHN * PHN update
Recorded on Thursday 21st October 2021Western Victoria PHN Project ECHO HubCOVID-19 ECHO TeamBianca Forrester (Facilitator)Jemma Missbach, Katrina Pilbeam, (ECHO Co-ordinators)Katrina Martin, Fiona Quigley, Workforce ManagementJayde Bueller, audio production
Last week, series 7 of ECHO began with a call to action for primary care to consider whether we were ready, willing and able to provide COVID care to patients in our communities.This week we kick off an 8 session series of COVID care education through Project ECHO with the aim of improving confidence in managing COVID in the community.While our local COVID care pathways are still being developed at the regional and subregional levels, there are elements of COVID care that will be fairly standardised across the region and it is this content that we’ll aim to bring to your through our suite of didactic presentations each week.Then in our case based discussions we'll aim to bring your grounded experiences of bringing community based COVID care to life. We’ll be asking those how to in context and where to in my area questions when it comes to pathways, supports, escalation, referrals & discharge.Things are changing rapidly and in the coming weeks we’ll be inviting those of you taking on COVID care to bring us your cases in the spirit of all teach all learn....and my job will be to make this as easy and rewarding as possible...but in the meantime, please just come along with your curious questions and problem solving ideas for our interactive sections.Today, we’ll be kicking off our COVID care suite discussing COVID care pathways and the risk stratification assessment process at the early stages of the COVID patient journey.Our case vignette will seek to get you thinking about Low risk care pathways and we’ll be focusing on the key question for this session:What else would I need to know about this patient and consider before agreeing to take on this patients’ care?AgendaDr Kate Graham, GP and Clinical Editor Health Pathways and COVID Clinical Advisor Western Victoria PHN•COVID update for Primary careDr Callum Maggs* Vic SIS update 3rd doses
Dr Karen Aarons, Fractional Specialist, Grampians Public Health Unit* Risk Stratification in COVID care Pathways
Ms Linda Govan, Regional Senior Manager, Western Victoria PHN•PHN updateRecorded on Thursday 14th October 2021Western Victoria PHN Project ECHO HubCOVID-19 ECHO TeamBianca Forrester (Facilitator)Jemma Missbach, Katrina Pilbeam, (ECHO Co-ordinators)Katrina Martin, Fiona Quigley, Workforce ManagementJayde Bueller, audio production
Welcome to the 7th cohort series for Project ECHO- Pandemic response network and this week the LGAs across the West Vic PHN hit an incredible milestone of 88.5% first dose vaccine coverage by Monday....5% ahead of the state average. Providing us with the confidence that we can peak into the post 80% double dose crystal ball in our region and perhaps the post 90% coverage ball too.In this series over the coming months, we’ll be having conversations about the work of bringing our communities across the line in regards to achieving ambitious vaccine milestones, we’ll be exploring the changes in public health social distancing and Trace, test, isolate and quarantine strategies as we move further along in the national plan and outbreak and we’ll be rapidly moving into COVID positive care education as our role in primary care and we’ll shifts to monitoring COVID Care in the community.As always, we’ll be inviting participants to bring cases for discussion, share issues, challenges, struggles and pain points in the spirit of action-oriented peer learning.So thanks again for joining us in this community of practice.Today our content pushes will bring a number of updates from 3 of our key themes and we’ll be asking our experts the following questions:1)Vaccine rollout-milestones and mandates – what is the GP role?2)Public Health restrictions and measures – what needs to change in the primary care workplace to prepare for increased community transmission?3)Outbreak response & Trace, test, isolate and quarantine strategy (felt by primary care as the dreaded furlough)- How will the DoH and PHUs work with primary care to minimize the impact of furloughing and enable sustainable service delivery?And in our regular GP case discussion we’ll be bringing up the topic of COVID care in the community and asking the questions: What will our role in primary care be across the regions? * How will we be working with the public health units, ED and infectious diseases teams? * What do we need to be thinking about at this time in preparation?*
Speakers:Ms Rowena Clift, West Vic PHN CEO* Update on COVID positive pathways * EOI primary care
Dr Kate Graham, GP and Clinical Editor Health Pathways and COVID Clinical Advisor Western Victoria PHN•Vaccination milestones and mandates, Infection prevention and control guidance for primary careDr Bianca Forrester, GP Clinical advisor workforce development Western Vic PHN* Vaccination coverage data
Professor Rosemary Aldrich, Medical Director, Grampians Public Health Unit•GPHU update, Vaccination progress and gaps, what to expect in COVID careDr Gerard Ingham, GP Springs Medical Centre, Daylesford* How are we going to manage COVID in the community?
Ms Linda Govan, Regional Senior Manager, Western Victoria PHN•PHN updateRecorded on Thursday 7th October 2021Western Victoria PHN Project ECHO HubCOVID-19 ECHO TeamBianca Forrester (Facilitator)Jemma Missbach, Katrina Pilbeam, (ECHO Co-ordinators)Katrina Martin, Fiona Quigley, Workforce ManagementJayde Bueller, audio production
In all of the LGAs out west we hit the milestone of 70% first dose vaccinations by this Monday, ahead of expected milestone being reached by the rest of the state this weekend. Many players, one community- a great achievement.And We’ve experienced the easing of regional Victoria’s restrictions.We experienced our first local furloughing in primary care late last week and our first LGA specific lockdown began last night at Midnight, with thoughts to our colleagues in Daylesford and Ballarat respectively.In the first half of the session we'll focus on the following questions:What have we learnt in the past week and how have our systems and planning held up?What are the ongoing threats and the opportunities that we need to better understand and explore?With the vaccine rollout continuing at pace and kids rolling up their sleeves from the age of 12 yrs from this Monday, we’ll turn our clinical minds to the task of providing education, vaccine access and managing the rare but important adverse events of the mRNA vaccines.We’ll be considering in whom we need pre-vacine advice and or referralWe’ll explore the myocarditis and pericarditis pathways once again and consider in house and referral pathways from both the perspective of clinical guidelines and local systems in the west vic regions.Agenda for session Dr Bianca Forrester, GP Clinical Advisor Workforce Development, Western Vic PHN•Vaccine rollout updateDr Kate Graham, GP and Clinical Editor Health Pathways and COVID Clinical Advisor Western Victoria PHN•Guidance and Health Pathways updateProfessor Rosemary Aldrich, Medical Director, Grampians Public Health Unit•GPHU update , Evaluating Risk in the rural and regional Primary care settingDr Jane Standish, Paediatrician, Barwon Health and RCH Melbourne & Honorary research fellow MCRI•Vic SIS Clinic update, Evidence in Practice- Brand guidance for vaccinating teensDr Alan Applebe, Cardiologist, Barwon Health•COVID –19 and the vaccine Myocarditis/pericarditisMs Linda Govan, Regional Senior Manager, Western Victoria PHN•PHN updateRecorded on Thursday 16th September 2021Western Victoria PHN Project ECHO HubCOVID-19 ECHO TeamBianca Forrester (Facilitator)Jemma Missbach, Katrina Pilbeam, (ECHO Co-ordinators)Katrina Martin, Fiona Quigley, Workforce ManagementJayde Bueller, audio production
While we’ve been racing towards 70% in regional Victoria, we’ve been stepping carefully across that river we discussed a few weeks back. Taking a step, observing and assessing the change around us and considering where to place our next step.With restrictions easing in regional Victoria, as health care workers we’ll be taking our next tentative steps tonight. Credit is due to our regional Public health units and contract tracing for bringing our local outbreak under control. Our compliant communities have made this work possible and of course our primary care workforce has been spinning plates to continue the vaccine rollout at pace, safely assess symptomatic COVID and continue blended remote and face to face models of care with new infection control guidance and settings....It’s been a a juggle and a balance...So what could this next step look like for Primary care?We’ll have one eye on the canary in the mineshaft up north and the other on the “ring of steel”Over the coming weeks we’ll be amplifying our discussions about outbreak planning priorities for primary care and developing a series of Town halls to address issues emerging from these sessions.I’m delighted that we are joined by Medical Director of the Grampians PHU this morning to perhaps foreground some of these discussions as we re-orientate ourselves and our workplaces to the new settings and prepare ourselves for the next steps in preparedness and planning.Our key questions for the first half of the session will be:What are our infection control and prevention priorities in regional primary care at this time? How can we make sense of our role in the vaccine rollout and make the best use of increased mRNA allocations that will be coming through the commonwealth from a public health perspective?Schools in regional Victoria with reopen and we’ll be prioritising yr 12s who will return to school and be seeking vaccination prior to the exams on the 4th of October. Last week we discussed transmission rates in kids and impact of infection and we opening the conversations up about communication skills with this age group and their families. You can listen to the podcast recordings to catch up on these conversations.* How will we organise this in primary care * How will we support young people facing barriers to vaccine such as geographic or health literacy based * How will consent work for 16-18 yr olds presenting independently? * And how will we be thinking about rights and consent in the 12-15 age groups?
SpeakersDr Kate Graham, GP and Clinical Editor Health Pathways and COVID Clinical Advisor Western Victoria PHN* Guidance and Health Pathways update
Associate Professor Rosemary Aldridge, Medical Director, Grampians Public Health Unit* GPHU update *
Dr Jess Kaufman, Research Fellow, Vaccine Uptake Group, Murdoch Children's Research Institute* Vaccine hesitancy and communication practices
Mr Matt Dixon, Director First Nations Health and COVID-19, Western Victoria PHN,* PHN update *
Panel: Dr Jane Standish, Paediatrician, Barwon Health and RCH Melbourne & Honorary research fellow MCRIDr Lena Sanci, Head of the Department of General Practice, University of MelbourneRecorded on Thursday 9th September 2021Western Victoria PHN Project ECHO HubCOVID-19 ECHO TeamBianca Forrester (Facilitator)Jemma Missbach, Katrina Pilbeam, (ECHO Co-ordinators)Katrina Martin, Fiona Quigley, Workforce ManagementJayde Bueller, audio production
Yesterdays announcement of a shift from the COVID zero triggers a readjustment which many of us have seen coming of the previous weeks. We’ll be working together over the coming hours, days, weeks and months to collectively make sense of this shift and what this means for our work. But this morning we’ll focus on the kids.Last week Melbourne school students passed the grim milestone of 200 days in lockdown since the COVID-19 outbreak began with a fair proportion of that time was spent in remote learning or homeschooling.While we all recognise the importance of this public health measure to save lives and minimise burden on the public health and hospital system, perhaps more urgently than ever comes the call to consider a life beyond lockdown for our youngest community members as many are struggling and few are thriving in this environment.To provide a voice to a group that often struggle to be heard, I’ll put the questions for these discussions to the group from a passage written by young vaccine advocate:Anhaar Kareem a 14-year-old student in year 9 at Al Noori Muslim school in Sydney’s westWhat I, and other young people want, is to feel safe and informed. We need to be given the vaccine or, at the very least, we need to know when we will have access to the vaccine.We need to be addressed as young adults.We need answers to our many questions....* What does the research say on vaccinating 12 to 15-year-olds? * Will we be able to get vaccinated before we go back to school? * How will consent work with those aged 12 to 15? * What would occur in situations where parents are anti-vaccination but their child wants to receive the vaccine? Could children under 16 consent to being vaccinated?
Finally* When will life return to normal for us young adults?
These are some of the questions we’ll be seeking to answer as a group, and as always we’ll consider our role in primary care in creating an effective systems response that enables young people and their families and carers to receive appropriate information, advice and support to access COVID-19 vaccinaton in a timely way. Dr Kate Graham, GP and Clinical Editor Health Pathways and COVID Clinical Advisor Western Victoria PHN * Dr Karen Aarons, Grampians Community health * Dr Jane Standish, Paediatrician, Barwon Health and MCRI * Dr Jess Kaufman, Research Fellow, Vaccine Uptake Group, Murdoch Children's Research Institute * Ms Linda Govan - Western Victoria PHN, Senior manager, Ballarat Goldfields * •PHN update*
Recorded on Thursday 2nd September 2021Western Victoria PHN Project ECHO HubCOVID-19 ECHO TeamBianca Forrester (Facilitator)Jemma Missbach, Katrina Pilbeam, (ECHO Co-ordinators)Katrina Martin, Fiona Quigley, Workforce ManagementJayde Bueller, audio production
As we anticipated last week, we again meet in lockdown while the current outbreak is being contained.This week the Victorian Health Service Guidance and Response to COVI-19 risks (VHSGR) have determined that we are operating in COVID Peak risk rating conditions.So what does this mean for Primary care? What does optimal practice look like in the setting of an outbreak of this nature and what needs to change to achieve this?* What do we need to be considering at this time in regards to infection control, triaging and screening * How will we safely maintain business as usual care in this context? * What needs to change in our vaccination services at this time? * How can we play our role in triaging and assessment of acute respiratory illness and fevers in the context of this outbreak
And how can we understand our role in primary care in relation to our local public health units and health services at this time? Dr Kate Graham, GP and Clinical Editor Health Pathways and COVID Clinical Advisor Western Victoria PHN * Professor Eugene Athan OAM,* Director Public Health Unit, Barwon Health
Dr Aaron Bloch,Infectious Diseases Clinician, Director Grampians Public Health Unit •Grampians Public Health Update & update on testing technology, COVID morbidity * Dr Belinda Carne, GP and Emergency Physician, Barwon Health * Assessing acute respiratory illness and fevers in primary care in the context o an outbreak * Ms Linda Govan - Western Victoria PHN, Senior manager, Ballarat Goldfields * •PHN update*
Recorded on Thursday 26th August 2021Western Victoria PHN Project ECHO HubCOVID-19 ECHO TeamBianca Forrester (Facilitator)Jemma Missbach, Katrina Pilbeam, (ECHO Co-ordinators)Katrina Martin, Fiona Quigley, Workforce ManagementJayde Bueller, audio production
Architects, accountants sex worker and a Pizza guy was one of the headlines describing our Melbourne brand of viral transmission activity last night. This conjures up all sorts of imagery about what our public health units might be up too, one thing it does perhaps remind us of is that this virus does not discriminate. And so with the Melbourne lockdown extended and transmission appearing difficult to contain, in regional Victoria we remain ever vigilant with that ring of steel only 75km up the road from our major health services and centres.So how do we maintain outbreak vigilance and vaccine momentum at this time?Our primary care workforce is tired and there is a lot of extra work on the ground that is being expended due to the commonwealth eligibility criteria and navigating the state and federal systems.While we understand these criteria are driven by high level concerns about operating in a resource constrained environment and we know that these criteria are to ensure those most vulnerable and those made vulnerable have equitable access to the vaccine...it’s probably fair to say that the view from the frontline of primary care is that people are tired and it’s feeling kinda swampy for both patients and clinicians alike as we puff through this next stage before supply ramps up.* So, how do we maintain momentum in primary care at this time? * What is driving us all in our respective roles? (pop this in the chat) * What’s energising you at this time to keep up your vaccine and outbreak preparedness efforts? * And how can we all work together to only get maximal jabs in arms but to also connect the dots between our most vulnerable and the vaccine? * Finally, how can we regional Victoria make the most of our outbreak status and get the jump on vaccination before things change and we face lockdown 7.0
This morning we’ll all be reflecting upon this question:If the eligibility were to open right up to everyone who wants a vaccine (and it is safe according to TGA/ATAGI) to do so, who would you be most concerned about missing out? Ms Rowena Clift, CEO Western Vic PHN * Dr Kate Graham, GP and Clinical Editor Health Pathways and COVID Clinical Advisor Western Victoria PHN * •Pfizer myocarditis and pericarditis Health Pathway * Dr Callum Maggs, Infectious diseases clinician, Clinical Lead Barwon Vic Specialist Immunisation Clinic (VicSIC) * •Data- Vaccine risk, COVID-19 transmission and case fatality rates * A/Prof Rosemary Aldrich,Clinical Director Grampians Public Health Unit * •Grampians Public Health Update & mobile and inreach models * Emma Johns, General manager, Dr Gerard Ingham and Lee-anne Potter, clinical team leader, Springs Medical * •Springs Medical Community partnerships Model of care * Ms Linda Govan - Western Victoria PHN, Senior manager, Ballarat Goldfields * •PHN update*
Recorded on Thursday 19th August 2021Western Victoria PHN Project ECHO HubCOVID-19 ECHO TeamBianca Forrester (Facilitator)Jemma Missbach, Katrina Pilbeam, (ECHO Co-ordinators)Katrina Martin, Fiona Quigley, Workforce ManagementJayde Bueller, audio production
Well since we last met we’ve come through the shortest regional lockdown on the states record and the commonwealth have progressed policy from having a vaccine strategy to a plan, or roadmap. Things are looking more promising for the month of August with supplies of Pfizer set to increase over the coming weeks, vaccine eligibility has been expanded to include adolescents with underlying medical conditions. And we have a new vaccine player on the metaphorical horizonWith things changing and moving around us so fast the path to vaccine coverage is a little more like a flowing river crossing than a road. We’ve placed the first few stepping stones and we've seen the way the water flow changes around them and now we need to place the next. In this session, we are joined by the directors of both Grampians Public health unit and the Barwon Public health units and I’ve invited each of them to respond to the question:If the path to good population level coverage was a river crossing what would the placing of the next stepping stone look like?Agenda for session: Dr Kate Graham * GP and Clinical Editor Health Pathways and COVID Clinical Advisor Western Victoria PHN * Ms Misha Coleman, Co-Director Barwon Public Health Unit * Barwon Public Health Update & Stepping stones to 70% in our region * A/Prof Rosemary Aldrich,Clinical Director Grampians Public Health Unit * Grampians Public Health Update & Stepping stones to 70% in our region * Dr Callum Maggs, Infectious diseases clinician, Clinical Lead Barwon Vic Specialist Immunisation Clinic (VicSIC) * Pfizer myocarditis- incidence, early recognition and management in primary care * Ms Linda Govan- update * Western Victoria PHN, Senior manager, Ballarat Goldfields * PHN update, stepping stones to 70%, Vaccine data*
Recorded on Thursday 12th August 2021Western Victoria PHN Project ECHO HubCOVID-19 ECHO TeamBianca Forrester (Facilitator)Jemma Missbach, Katrina Pilbeam, (ECHO Co-ordinators)Katrina Martin, Fiona Quigley, Workforce ManagementJayde Bueller, audio production
With lockdown 5.0 behind us and restrictions slowly easing I think we can take a moment to celebrate our position at this point in time. The success of this lockdown, amongst many things, is largely attributed to the efforts of our central and regional public health teams. The combination of efficient contact tracing and rapid response in partnership with the collective effort of every member of our community who abided by public health orders have made this a success. Acknowledgement goes to our primary care workforce who rapidly pivoted again to COVID active settings, kept their teams safe, maintained care for the community and contribute to the public health response through testing, support and communications as well as the important and ongoing work of vaccination.Our conversations this morning will focus on the theme of prioritsation of vaccine in the community.How might we think about prioritization at a public health level and what are some of the practical considerations on the ground in primary care?How will we maintain the balance between supply and demand whilst ensuring that those who are deemed as high priority can access safe vaccine through GPs clinicsAnd we’ll turn the spotlight on a special group who have recently been deemed eligible under Phase 1b; pregnant women…how can we support pregnant women to access vaccine through primary care and the state hubs?What do pregnant women want to know? and what has guided decision making regarding this group?• Dr Kate Graham GP and Clinical Editor Health Pathways and COVID Clinical Advisor Western Victoria PHN• A/Prof Rosemary Aldrich,Clinical Director Grampians Public Health Unit• Robyn Wilson, Operations Director Grampians Public Health Unit and Directorate of the Chief Medical Officer, Ballarat Health Services• Dr Geraldine Masson, Director of Women’s Services Health, Barwon HealthMs Linda GovanWestern Victoria PHN, Senior manager, Ballarat GoldfieldsRecorded on Thursday 29th of July 2021Western Victoria PHN Project ECHO HubCOVID-19 ECHO TeamBianca Forrester (Facilitator)Jemma Missbach, Katrina Pilbeam, (ECHO Co-ordinators)Katrina Martin, Fiona Quigley, Workforce ManagementJayde Bueller, audio production
Thursday 22nd of July 2021As our CHO described earlier in the week, this outbreak has touched all corners of the state with cases in Philip island, Bacchus Marsh, Barwon Heads and Mildura in addition to metropolitan Melbourne. And we are now becoming acquainted with the transmission dynamics of the delta variant, which is behaving in different ways than we’ve experienced with previous strains. How do we manage this vaccine rollout in a strategic way given that we are operating within a complex system with supply constraints?* How do we continue to balance Pfizer supply and demand? * How do we navigate the Pfizer eligibility advice from both commonwealth and state and * Do GPs have any discretion when it comes to providing doses in an outbreak setting? * Which groups are facing access barriers and how can we open priority access pathways in primary care? * How do we manage our AZ provision and dosing intervals in the context of an outbreak?
·How are we doing in Primary care? I know my pulse has been on the steady increase this week new exposure sites and now an outbreak in our area.So let’s dive straight in.This morning we’ll be focusing on the following questions:· How prepared are we for the next outbreak and what do we need to do now to prepare for this next one?· What roles might we be playing in supporting our community members either in quarantine, isolation and seeking to manage their risks?· What roles would primary care be playing in the event of positive cases in our communities?· In the context of a local outbreak, how might we need to think about vaccine prioritisation at this time?
As we continue the race to vaccinate our community, primary care face dual pressures of managing increasing demand and responding to increasing hesitancy. AZ safety concerns remain on the front page and front of mind with the terrible news of a second death likely linked to the Astra Zeneca vaccine.And so this morning we stay with the question:* how can we best build our patient confidence in accessing available AZ vaccination at this time?
Last week we discussed responding to vaccine associated thrombosis and how to investigate and refer appropriately in our region. This morning we’ll be exploring common questions arising from a different group of patients- those with auto-immune rheumatological conditions and those on immunosuppressing medications.What advice can we provide in primary care and when is specialist input warranted?And with the Pfizer in primary care EOI announcements made yesterday, we’ll also be considering our role in either provision and or supporting GP colleagues with managing patient expectations. Dr Kate Graham, GP and Clinical Editor HealthPathways and COVID Clinical Advisor Western Victoria PHN * A/Prof Rosemary Aldrich, Clinical Director Grampians Public Health Unit * Dr Tom Souchen, Bellarine Respiratory Clinic * Dr Gemma Strickland, Rheumatologist, Barwon Rheumatology Service, Geelong * Clinical Vignettes * Expert panel: Dr Callum Maggs, Infectious Diseases Physician, Clinical lead Barwon Specialist Immunisation Clinic (SIC), Barwon Health * PHN update: Linda Govan * Western Victoria PHN, Senior manager, Ballarat Goldfields*
Recorded on Thursday 17th June, 2021Western Victoria PHN Project ECHO HubCOVID-19 ECHO TeamBianca Forrester (Facilitator)Jemma Missbach, Katrina Pilbeam, (ECHO Co-ordinators)Katrina Martin, Fiona Quigley, Workforce ManagementJayde Bueller, audio production
After a slow start, vaccine demand and uptake is increasing in Victoria.· Work is being done in the RACF resident and worker space to catch up and cover these communities and we continue to follow conversations about whose responsibility it is an just how many need to be done.· While under 50s are now able to receive Pfizer, supplies are low and many willing face access barriers.· For the over 50s, the risk benefit analysis has changed and pleasingly demand and uptake has increased. While for others the hesitancy is being expressed in more demanding ways.How can we best build our patient confidence in accessing available AZ vaccination at this time?While a rare event, how will be recognise, assess and manage vaccine associated thrombosis?In the more likely event that patients present with other thrombotic events contemporaneously more common differentials co-incide with vaccination.This morning we’ll be unpacking the new guidelines for assessment and management and considering how we might apply these guidelines our varying contexts across the western vic regions.A/Prof Deb Friedman, Medical Director, Infection Prevention, Control and Response unit, Vic DH, ID physician at Barwon HealthDr Kate Graham, GP and Clinical Editor Health Pathways and COVID Clinical Advisor Western Victoria PHNCase presentation Penny Scott, GP, Drysdale clinic and ED Barwon HealthDr Callum Maggs, Infectious Diseases Physician, Clinical lead Barwon Specialist Immunisation Clinic (SIC), Barwon HealthMs Linda Govan, West Vic PHN- PHN updateRecorded on Thursday 10th June, 2021Western Victoria PHN Project ECHO HubCOVID-19 ECHO TeamBianca Forrester (Facilitator)Jemma Missbach, Katrina Pilbeam, (ECHO Co-ordinators)Katrina Martin, Fiona Quigley, Workforce ManagementJayde Bueller, audio production
Back in lockdown and “COVID active” in our practices.This state is becoming a familiar place for our network to meet.While we await news about the easing of restrictions in regional Victoria, which will certainly make the lives of our families better, we know that this will not come without challenges to each of us as health care providers, leaders and managers in regional and rural Victoria.This lockdown shouldn’t have caught us off guard, bit it seemed to have. Were we COVID ready? And what does outbreak preparedness now mean in primary care?We thought we understood this virus fairly well, but now it seems to be transmitting in a different way. What is going on locally, what role can we play in primary care to support our local public health units to enable our community to be COVID safe?While we’ve been working to shoehorn the commonwealth vaccine rollout into routine practice, and roll with the hesitancy, the demands and now the demanding hesitancy by consumers, what other urgent priorities in vaccination must be considered? And what role will be play in primary care to address these priorities?PanelProf Eugene Athan, Clinical Director of the Barwon South West Public Health Unitto bring us an update on the Anglesea exposure site statusDr Kate Graham, GP and Clinical Editor Health Pathways and COVID Clinical Advisor Western Victoria PHNA/Prof Deb Friedman, Medical Director, Infection Prevention, Control and Response unit, Vic DH, ID physician at Barwon HealthMs Rowena Clift, CEO, West Vic PHN- PHN updateDr Callum Maggs, Infectious Diseases Physician, Clinical lead Barwon Specialist Immunisation Clinic (SIC), Barwon HealthRecorded on Thursday 3rd June, 2021Western Victoria PHN Project ECHO HubCOVID-19 ECHO TeamBianca Forrester (Facilitator)Jemma Missbach, Katrina Pilbeam, (ECHO Co-ordinators)Katrina Martin, Fiona Quigley, Workforce ManagementJayde Bueller, audio production
- Well we are now in our 5th Series of the COVID Pandemic response ECHO and it’s been over 14 months since both the WHO declared this pandemic and we’ve been meeting as a group.
- This is the second of our sessions in the monthly format and it’s been an interesting month for primary care, PHUs, state vaccination centres, for the public and in the media, to say the least.
- At the beginning of our fourth series, we worked as a group to develop models of care for vaccination in GPs clinics and struggled with a number of uncertainties and variables that compromised our planning. Many of the concerns we had regarding booking systems and supply played out over the past month.
- Concerns regarding thrombosis with thrombocytopenia syndrome amplified and the federal government adopted ATAGI advice regarding the risk and safety analysis for astrazeneca resulting in a new iteration of the vaccine rollout strategy for the under 50s.
- And the vaccine rollout limped along in public view, we witnessed the tussle between federal responsibility and accountability and state control play out, with the federal government again calling a war cabinet in what we can only imagine was a plea for help from the states.
So, this morning we’ll be asking the following questions:* How is the phase 1b and early 2 a rollout progressing in primary care? * What has changed from a federal and state governance point of view and how is this playing out on the ground in regional Victoria? * How can eligible under 50s access Pfizer and vulnerable groups access the astra zeneca at this time in our region and what is in the pipeline? * How are remaining 1a groups being vaccinated? (for eg nursing home staff and GPs visiting nursing homes) * How will the under 50s receive their vaccination? Both HCW, critical workers and medically eligible? * How will those mobility issues and those not engaged in primary care access vaccination? * How can we most effectively communicate the balance of risks regarding thrombosis as we proceed in this rollout?
Speakers:Dr Kate Graham, GP and Clinical Editor Health Pathways and COVID Clinical Advisor Western Victoria PHNDr Callum Maggs, Infectious Diseases Physician, Clinical lead Barwon Specialist Immunisation Clinic (SIC), Barwon HealthRobyn Wilson, Operations Director Grampians Public Health Unit and Directorate of the Chief Medical Officer, Ballarat Health ServicesMisha Coleman, Co-Director Barwon Public Health Unit , Barwon HealthDr Deb Harley, GP, Medical One Waurn Ponds, GeelongRecorded on Thursday 6th May, 2021Western Victoria PHN Project ECHO HubCOVID-19 ECHO TeamBianca Forrester (Facilitator)Jemma Missbach, Katrina Pilbeam, (ECHO Co-ordinators)Katrina Martin, Fiona Quigley, Workforce ManagementJayde Bueller, audio production
With donut days all week and vaccinations ramping up now in community alongside the health services, we continue our conversations about primary care models in the shadow of the pandemic. One of the most pressing non COVID and non vaccine related issues causing us to pause and reflect at this time is the burden of respiratory viruses circulating in our community creating increase burden on emergency departments around the state.We kicked off these conversations last week describing the need to balance:· VicDH testing guidance and recommendations· ViCDH guidance around appropriate PPE use at this time· COVID safe practices in primary care and prevention of HCW infections· the use of engineering and PPE controls to prevent staff illness from other viruses· the possible dangers downstream if emergency departments are overwhelmed· our important role in Acute respiratory assessmentWith a novel vaccine rollout occurring in tandem, how are we going to adapt our models of care so as to enable appropriate triaging and face to face assessment where required?· What can we learn from other practices about what works and why?· What do emergency services need to understand about our system and practice constraints and capacity at this time? and what do we need to know about theirs?· How can we play a role in primary care that balances our own professional and workplace needs and demands within a broader health system, such as problems like this demand?Health Pathways update:Dr Kate Graham, Clinical Editor – Health Pathways and COVID Clinical Advisor Western Victoria PHNEmergency Department update:Dr Alison Miller, Medical Officer ED BHS and GP at Ballarat Medical CentreCase Presentation: Dr Lee Meakin, Anna Glue and Kerry Archer, and colleagues, Ballarat Medical CentrePanellist for discussion: Ms Janine Rigby, GPLU Ballarat Health ServicesDr Belinda Carne, GP ED Barwon HealthRecorded on Thursday 25th March, 2021Western Victoria PHN Project ECHO HubCOVID-19 ECHO TeamBianca Forrester (Facilitator)Jemma Missbach, Katrina Pilbeam, (ECHO Co-ordinators)Katrina Martin, Fiona Quigley, Workforce ManagementJayde Bueller, audio production
It’s been 12 months since the WHO declared the COVID-19 pandemic.With only 2 active cases in Victoria we are in the enviable position of focusing most of our COVID-19 aliquot of attention on the vaccine rollout logistics.Meanwhile, the shadow of the pandemic stalks us as a health system and many of us are taking stock of rising mental health presentations and more recently the out of tempo seasonal viruses running through our communities.With our pandemic response systems and processes now well worn goat tracks in primary care, the questions we will be asking this morning are:· Are our COVID safe practices causing problems downstream?· What is the role of primary care in regards triaging respiratory illness and fevers at this time?· What models of care might we adopt in the interim whilst we await biological protection of primary care HCWs through our commonwealth vaccination program?· And how do we work these models in with some of the operational realities of our primary care system?
Recorded on Thursday 18th March, 2021Western Victoria PHN Project ECHO HubCOVID-19 ECHO TeamBianca Forrester (Facilitator)Jemma Missbach, Katrina Pilbeam, (ECHO Co-ordinators)Katrina Martin, Fiona Quigley, Workforce ManagementJayde Bueller, audio production
March 11th, marks the anniversary of the COVID-19 pandemic declaration. The tally at that time was 118,000 cases in 114 countries, and the death toll had risen to 4,291. Over the past 12 months we’ve seen case numbers rise by a factor of 1000 and deaths by almost that amount. However, over 265,000,00 doses of vaccine have now been administered, signaling a race against the virus that we stand a chance of winning as a global community. Now, in the first 3 months of the pandemic response primary care, change was upon us so thick and fast that Senior GP commentators were heard to describe our adaptation as akin to twenty years of primary care reform. Now, as we enter the starting lane and prepare to join the vaccination workforce this month, it all but seems as though the race to immunise the Australian population is struggling to get out of the gates. This week GP clinics were underwhelmed by the early allocation of vaccine doses following the call to prepare models of primary care high throughput immunisation clinics. So, what do we make of this new announcement? What seems to be the plan? How can we work together to get the population of Western Victoria immunised. These are some of the questions that we’ll be seeking solutions and answers to this morning.Health Pathways update:· Dr Kate Graham, Clinical Editor – Health Pathways and COVID Clinical Advisor Western Victoria PHNPHN Update:· Ms Rowena Clift, CEO West Vic PHNGrampians PHU update:· A/Prof Rosemary Aldridge, Clinical Director Grampians Public Health Unit· Ms Robyn Wilson, Operations Director Grampians Public Health Unit and Directorate of the Chief Medical Officer, Ballarat Health ServicesRecorded on Thursday 11th March, 2021Western Victoria PHN Project ECHO HubCOVID-19 ECHO TeamBianca Forrester (Facilitator)Jemma Missbach, Katrina Pilbeam, (ECHO Co-ordinators)Katrina Martin, Fiona Quigley, Workforce ManagementJayde Bueller, audio production
EOI announcements were made last week with a large number of clinics within our catchment now being advised that they are eligible to participate in the phase 1b roll out.Some of you will be early adopters and will have been busy discussing your models of care, some of you will decline and may be here this morning to hear about models of care for later adoption and some of you will be considering your role alongside the phase 1b roll out.Over the coming weeks, we’ll aim to focus our conversations on the systems and processes being put in place across the west with the aim of enabling each other to short cut our thinking and avoiding duplication of effort in these systems and processes.We’ll be talking through the broad planning and the small grain details. And we’ll be discussing key activities and behaviours as well as system enablers that will either make or break the rollout from the perspectives of primary care.Agenda for session Health Pathways update:* Dr Kate Graham, GP and WVPHN Health Pathway Clinical Adviser
Specialist immunisation Clinic Barwon Health:* Dr Callum Maggs– Infectious Diseases Physician Barwon Health * Specialist Immunisation Clinic Update
Service system Presentation:* Ms Danielle Trezise, UFS Dispensaries
PHN Update:* Ms Linda Govan - WVPHN Regional Senior Manager, Ballarat/Goldfields
Recorded on Thursday 4th March, 2021Western Victoria PHN Project ECHO HubCOVID-19 ECHO TeamBianca Forrester (Facilitator)Jemma Missbach, Katrina Pilbeam, (ECHO Co-ordinators)Katrina Martin, Fiona Quigley, Workforce ManagementJayde Bueller, audio production
- Well a milestone was reached this week and the first members of our community received vaccination to protect against the COVID-19 disease.
- And it’s been an eventful week to say the least.
- We’ve hit the low point of our first nationally reported vaccine error and the high’s of being some of the first recipients to receive vaccine in the state through our newly established PHU hubs.
- The EOIs should have now come out and many of you will be thinking about your roll as vaccinators in the coming months but this morning we’ll seek to keep our conversations focused on the 1a rollout. We’ll hear from a diverse group of presenters about adverse events, side effects and roll out logistics and management.
- We’ll work through some case vignettes that will be representative of some of the early conversations that many of you with be having with patients and their families in residential aged care facilities.
- And in the early stages of a battle that has been described to be fought and won on the grounds of good communication and engagement, we’ll seek to refine the messages and supports that we offer our community, some of what we do best in primary care, through these conversations this morning.
Grampians PHU update: Ms Robyn Wilson*
Infectious Diseases Update: Dr Raquel Cowan, Infectious Diseases Physician Ballarat Health Services * Understanding Adverse events and Side effects in the elderly*
Health Pathways update: Dr Kate Graham, Clinical Editor – Health Pathways and COVID Clinical Advisor Western Victoria PHN * Commonwealth readiness toolkit * Adverse events reporting pathways*
Case Vignettes: Dr Alison O’Neil, GP special interest in Aged Care*
DiscussionPHN Update: Ms Linda Govan*
Recorded on Thursday 25th February, 2021Western Victoria PHN Project ECHO HubCOVID-19 ECHO TeamBianca Forrester (Facilitator)Jemma Missbach, Katrina Pilbeam, (ECHO Co-ordinators)Katrina Martin, Fiona Quigley, Workforce ManagementJayde Bueller, audio production
This series beings on the morning that Victoria comes out of a 5 day "short sharp lockdown". We take stock of it's effectiveness, learn about new COVID-19 variants and transmission dynamics and discuss the new strategy in regards to contact tracing in Victoria. Public health units have become established in Geelong and Ballarat and have been busy planning the vaccine rollout to begin next week as part of Phase 1a of the National Vaccine rollout plan. We've had a few weeks to better understand the new suite of vaccines and to consider our role in this multi-faceted rollout Plan.·This morning we kick off with a case discussion about a theoretical model of vaccine rollout in primary care. (audio not included)Health Pathways update:· Dr Kate Graham, GP editorInfectious Diseases update:· Dr Raquel Cowan· Brief GPLU updateCase Presentation- Dr John Henderson, Bannockburn SurgeryDiscussion· Panellists- Dr Jeff Urquhart, GP RACGP Digital Health Committee· Ms Linda Govan, WVPHN Regional Senior Management GoldfieldsRapid Fire Q&APHN Update- Ms Rowena CliftRecorded on Thursday 18th February, 2021Western Victoria PHN Project ECHO HubCOVID-19 ECHO TeamBianca Forrester (Facilitator)Jemma Missbach, Natalie Love (ECHO Co-ordinators)Katrina Martin, Fiona Quigley, Workforce Management
The WVPHN hosts the second town hall style session for primary care clinicians to follow up on the next stages of the EOI process for the COVID-19 Phase 1b vaccination rollout. Released in entirety, the session features panel didactics and moderated Q&A.GP facilitator: Dr Bianca ForresterPHN update Ms Rowena Clift*, CEO of Western Victoria PHN
Commonwealth Vaccine Plan Dr Lucas DeToca* , Acting First Assistant Secretary of the COVID-19 Primary Care Response
Pathways and Guidelines update Dr Kate Graham,* Lead Clinical Editor for COVID-19 Health pathways Vic/Tas
Public Health Unit Update Associate Professor Rosemary Aldrich, Clinical Director Grampians Public Health * Ms Robyn Wilson, Operations Director Grampians Public Health Unit and Directorate of the Chief Medical Officer, Ballarat Health Services * Prof Eugene Athan , Director of the Barwon South West Regional Public Health Unit and director of Infectious Diseases at Barwon Health * Ms Misha Coleman*, Co-director, Barwon South West Public Health Unit
The WVPHN hosts a town hall style session for primary care clinicians interested in the EOI process for the COVID-19 Phase 1b vaccination rollout. Released in entirety, the session features panel didactics and moderated Q&A.GP facilitator: Dr Bianca ForresterPHN update Ms Rowena Clift,* CEO of Western Victoria PHN
Commonwealth Vaccine Plan Dr Lucas DeToca* , Acting First Assistant Secretary of the COVID-19 Primary Care Response
Recorded on Thursday 28th January, 2021WVPHN
Welcome to the 31st session of our COVID 19 ECHO network. We’ve travelled through 2 lockdowns together and we’re now one day away from our 28th day of zero cases, the working definition of viral elimination…fingers crossed. Following a series that has largely reflected upon getting back to business in a healthcare service COVID normal, we turn our attention in this session to innovations in health service delivery. This session showcases new Healthpathways, the development of three vaccines, Surgical disruptions and return to service. We'll hear about the first ePrescription in Australia, in our own community and integrated COVID care approaches across primary care and tertiary services. We hope that you enjoy our regional showcase and we'll see you again, via zoom, in 2021! Have a safe (and well ventilated) early summer season.
The COVID 19 Virus has had such an impact upon our communities that it seems we’ve all become armchair infection control and epidemiology experts. In this session we'll use some of the principles and emerging skills we've learned through the pandemic and apply them to the most commonly notifiable infections in our communities, STIs.
We'll examine the epidemiology of common STIs and consider the role of primary care in getting back to the business of testing, treating and importantly interrupting transmission of communicable diseases.
Health Pathways update:• Dr Kate Graham, GP editorSTIs testing and management in primary care• Sarah HuffamPHN Update- Katrina Martin - Workforce Development Education & Support.
Recorded on Thursday 19th November, 2020Western Victoria PHN Project ECHO HubCOVID-19 ECHO TeamBianca Forrester (Facilitator)Jemma Missbach, Natalie Love (ECHO Co-ordinators)Fiona Quigley, Workforce Management Lead
Always was, and always will be… The connection of Australia’s first nations people to land and country. The theme of this years NAIDOC week.This morning we’ll bring together these themes of getting back to business as (COVID) usual with the business of advancing the strategy of closing the gap on health inequity for aboriginal people.So, what can we learn from a people who maintain the worlds longest continuous connections to country and culture?A group who have experienced disruptions time and time again and fought to maintain their health , physically, socially, emotionally and culturally and have fought to maintain the wellbeing of their community?What is NAIDOC week all about and how can we engage in a respectful dialogue about it’s meaning for all of us as proud Australians?Why is it important to explore the impact of colonialization and social determinants of poor health outcomes such as racism and discrimination?And what can we learn about culture and it’s role as a determinant of positive health and wellbeing?Finally, what role might we play within our communities and with our health services to bridge the gap of health inequality for Aboriginal people and communities.Health Pathways update:• Dr Kate Graham, GP editorPublic Health Update and Infection Control advice for Back to Business in Primary care:• A/Prof Deborah Friedman- Infectious Diseases Physician, Infection Prevention, Barwon Health and Vic DHHS• COVID update• COVID and our first nations peopleKey Presentation:NAIDOC week- Always was, always will be• Adam Muir- Aboriginal Project Officer Barwon health and West Vic PHN•Case Vignettes/Discussion PHN Update- Rowena Clift, CEORecorded on Thursday 12th November, 2020Western Victoria PHN Project ECHO HubCOVID-19 ECHO TeamBianca Forrester (Facilitator)Jemma Missbach, Natalie Love (ECHO Co-ordinators)Fiona Quigley, Workforce Management Lead
So with low case numbers and multiple donut days this week, (as the CHO Brett Suton and team are known to call them) the state is re-opening. Victorian’s are heading back to business and back to their workplaces with a COVID safe plan.While we in primary care never stopped being in business, the way we have provided services has been significantly disrupted with one of the most significant changes being the integration of telehealth as a vehicle for patient interaction. Further to this, many patients have delayed presenting with key symptoms due to concerns of risk of CVOID in health care settings.So what impact has the reduction in face to face consults had upon cancer screening, early detection and early intervention?What impact will delayed diagnosis have on patients and our health care system over the coming 6 months?and how can we confidently and safely bring about recovery of these services in primary care?Agenda for session Health Pathways update:• Dr Kate Graham, GP editorOptimal Care Pathways (OCPs)Public Health Update and Infection Control advice for Back to Business in Primary care:• A/Prof Deborah Friedman- Infectious Diseases Physician, Infection Prevention, Barwon Health and Vic DHHSCOVID updateCommon Cancer screening investigations: Using Hierarchy of controls to mitigate riskKey Presentation:Victoria Cancer Strategy 2020-2024• Dr Bernard Shiu and Bianca ForresterKey priorities – Victorian Cancer Plan 2020-2024Key actions- Strategies for RecoveryCase Vignettes/Discussion Breast Screen Update- Di Sartori, Program Manager, Grampians Breast ScreenPHN Update- Linda GovanRapid 5 Answers: Infectious Diseases Recorded on Thursday 5th November, 2020Western Victoria PHN Project ECHO HubCOVID-19 ECHO TeamBianca Forrester (Facilitator)Jemma Missbach, Natalie Love (ECHO Co-ordinators)Fiona Quigley, Workforce Management LeadWith support from Linda Govan- Senior Manager Ballarat Goldfields, West Vic PHN
· The pandemic has proven to be a big systems disruptor. It has challenged us, as health professionals, to be flexible in the way that we provide services and to rapidly adopt new practices and technologies. At the tail end of the second wave, we take time, in this session to pause and acknowledge collective efforts and to consider the new service landscape. In this session we'll consider innovative models that have emerged in response to and alongside the pandemic response. A/Prof Deb Friedman describes the standing up of our regional public health team in Barwon and Paediatrician Dr Billy Garvey and Rachel Robinson describe an innovative model of accessible Paediatric care in the Wimmera.Health Pathways update:• Dr Kate Graham, GP editorPost COVID Screening tips· Dr Karen Aarons- Clinical Lead Djerriwarrh Health ServicesPublic Health Update and preparedness advice:• A/Prof Deborah Friedman- Infectious Diseases Physician, Infection Prevention, Barwon Health and Vic DHHS• COVID update• Regional Public health teams: work to date• COVID preparedness as a regionPushing the boundaries of telehealth and co-consultation· Dr Billy Garvey, Paediatrician Royal Children’s Hospital and researcher at MCRI· Highlight gaps and opportunities of telehealth in providing specialist care in rural areas· Describe a model of Co-consultation and team based care being developed in the Wimmera regionCase Vignettes/DiscussionPHN Update- Linda Govan, Senior Manager, Ballarat GoldfieldsRecorded on Thursday 29th October, 2020Western Victoria PHN Project ECHO HubCOVI19 ECHO TeamBianca Forrester (Facilitator)Jemma Missbach, Natalie Love (ECHO Co-ordinators)Fiona Quigley, Workforce Management LeadWith support from Matt Dixon- Director of Special projects
The re-opening of schools in regional Victoria will be a happy experience and welcome change for many.· However for some, returning to school be a daunting experience.· With old anxieties reawaked, new issues cropping up or a sense of struggle or falling behind as we all take stock of learning lost. While we expect that initial jitters and first week back nerves will settle as life goes back to normal, for some, targeted interventions may be required to mitigate the risk of long term issues.· So, what issues are anticipated and presenting?· What plans do schools have to support students to get back on track?· Who might need targeted interventions either through the school or in communities and what can we in primary care do to help?Health Pathways update:• Dr Kate Graham, GP editorInfectious Diseases Update and public health advice:• A/Prof Deborah Friedman- Infectious Diseases Physician, Infection Prevention, Barwon Health and Vic DHHS• COVID update• Current prioritiesDepartment of Education and Training Update• Ms Cat Salt- Area Executive Director-Barwon, South West Victoria Region• Ms Jan Smith- SSS Branch ManagerRecorded on Thursday 22nd October, 2020Western Victoria PHN Project ECHO HubCOVI19 ECHO TeamBianca Forrester (Facilitator)Jemma Missbach, Natalie Love (ECHO Co-ordinators)Fiona Quigley, Workforce Management LeadWith support from Matt Dixon- Director of Special projects
· Last week we heard from the Principal health adviser to the Dept of Education at training (DET) as she outline the plan for re-opening and safely keeping schools open in term 4.· Claire outlined key risk and hazard mitigation strategies and outbreak management planning and highlighted the important role that we may play as GPs in supporting families and children to return to school at this time, or make recommendations to stay away if they have COVID compatible symptoms. (to catch up)· As a group we discussed the timing of hayfever season and the incredibly quick bounce back of rhinovirus, now with its favorite hosts ….kids…..back out in the circulation in the community.· So, this morning we’ll take the opportunity to refresh best practice in Paediatric care and consider any remaining barriers to returning to the core business of primary care in looking after kids with respiratory symptoms.Health Pathways update:Dr Kate Graham, GP editorInfectious Diseases Update and public health advice:A/Prof Deborah Friedman- Infectious Diseases Physician, Infection Prevention, Barwon Health and Vic DHHS· Barwon and surrounds Update· Review of Evidence: transmission and susceptibility in kids, schools and their role in transmissionPaediatric Respiratory Update and refresherSpecial Guest· Dr Chris Cooper· Issues facing this group due to the Pandemic Response· Hayfever and Asthma refresher· Tips for common problemsDr Lee Meekin Case Vignettes QuestionsPHN UpdateAlison Elliot- West Vic PHN Nurse immunization advisorHealth Pathways update:Dr Kate Graham, GP editorInfectious Diseases Update and public health advice:Dr Raquel Cowan- Infectious Diseases Physician, Ballarat Health Services· Ballarat and surrounds Update· Public Health Unit updateA/Prof Deborah Friedman- Infectious Diseases Physician, Infection Prevention, Barwon Health and Vic DHHS· Barwon and surrounds Update· Review of Evidence: transmission and susceptibility in kids, schools and their role in transmissionDepartment of Education and Training Priorities and planning AdviceSpecial GuestDr Claire Tobin- Principal Health Adviser COVID-19 Deputy Co-ordinatorFor the Department of Education and Training,Key findings and recommendations from the MCRI report· COVID Safe Plan for Schools· Primary care role in Supporting families with decision making about school attendance/non-attendance· COVID 19 Outbreak response planQuestions (audio removed)PHN UpdateRowena Clift CEO of West Vic PHNRapid 5 Answers: Infectious DiseasesRecorded on Thursday 15th October, 2020Western Victoria PHN Project ECHO HubCOVI19 ECHO TeamBianca Forrester (Facilitator)Jemma Missbach, Natalie Love (ECHO Co-ordinators)Fiona Quigley, Workforce Management LeadWith support from Matt Dixon- Director of Special projects
In this podcast, we’ll be reviewing the evidence base supporting the re-opening of schools and reviewing the risk mitigation strategies that will support return to school at this time. We’ll aim to tease out some of the issues that might surface over coming weeks and months and how we in our roles as primary care clinicians can support families to safely re-engage with this vital part of their child’s growth and development.Health Pathways update:Dr Kate Graham, GP editorInfectious Diseases Update and public health advice:Dr Raquel Cowan- Infectious Diseases Physician, Ballarat Health Services· Ballarat and surrounds Update· Public Health Unit updateA/Prof Deborah Friedman- Infectious Diseases Physician, Infection Prevention, Barwon Health and Vic DHHS· Barwon and surrounds Update· Review of Evidence: transmission and susceptibility in kids, schools and their role in transmissionDepartment of Education and Training Priorities and planning AdviceSpecial GuestDr Claire Tobin- Principal Health Adviser COVID-19 Deputy Co-ordinatorFor the Department of Education and Training,Key findings and recommendations from the MCRI report· COVID Safe Plan for Schools· Primary care role in Supporting families with decision making about school attendance/non-attendance· COVID 19 Outbreak response planQuestions (audio removed)PHN UpdateRowena Clift CEO of West Vic PHNRapid 5 Answers: Infectious Diseases Resources:-MCRI Report: COVID-19 in Victorian Schoolshttps://www.mcri.edu.au/news/covid-19-victorian-schools-and-childcare-mainly-driven-community-transmission-analysis-finds%C2%A0-Susceptibility to SARS-CoV-2 Infection Among Children and Adolescents Compared With AdultsA Systematic Review and Meta-analysishttps://jamanetwork.com/journals/jamapediatrics/fullarticle/2771181ASCIA Management Planshttps://allergy.org.au/hp/ascia-plans-action-and-treatment/Recorded on Thursday 8th October, 2020Western Victoria PHN Project ECHO HubCOVI19 ECHO TeamBianca Forrester (Facilitator)Jemma Missbach, Natalie Love (ECHO Co-ordinators)Fiona Quigley, Workforce Management LeadWith support from Matt Dixon- Director of Special projects
As we progress, through steps 2 and into 3 in regional Victoria we ask the questions about what has changed about the way we work in primary care and what do we need to do to gear up for key stages such as the return to school and increasing provision of face to face consultations to ensure continuing care.· How do we progress towards the COVID normal, and at the same time maintain a level of vigilance required if we are to jump quickly upon outbreaks such as that, which we learned about in Colac last week?· How do we message the relaxing that is required to bring vulnerable members of our community back to primary care, whilst continuing the messaging of being COVID safe?
Health Pathways update:• Dr Kate Graham, GP editorInfectious Diseases Update and public health advice:• A/Prof Deborah Friedman- Infectious Diseases Physician, Infection Prevention, Barwon Health and Vic DHHSRegional Road map- Public health rationaleThe “Geelong Corridor and surrounds (Colac)”Understanding the trigger points/public health advice that might influence re-opening considerations• Dr Raquel Cowan- Infectious Diseases Physician, Ballarat Health ServicesBallarat update
The regional roadmap for re-opening.With the regional roadmap in hand, as we gaze down the country road in Western Victoria we ask the following questions....Where are we? Where are we heading and how can we as primary care providers best assist our communities to adapt and survive within the restrictions of the currently selected strategy in Victoria. Regular panellists and experts in Infectious Diseases and infection prevention and control A/Prof Deb Friedman and Dr Raquel Cowan provide join us again to answer these questions. Dr Kate Graham provides the Health Pathways update. Dr Seung Baek presents a case for discussion. (audio of case presentation and discussion not included in this podcast). To register for the series and join the discussions: https://westvicphn.com.au/health-professionals/health-topics/digital-health/project-echo-covid19/Open to clinicians, health care providers and managers in the Western Vic PHN region. Observers welcome by request.
In this session, Infectious Disease Physicians A/Prof Deb Friedman and Dr Raquel Cowan provided the local Infectious Diseases Update and the Disability care sector outbreak prevention and response planning. Ms Chris Faulkner, NDIA General Manager Operations and support & Incident Management Controller, described the National Disability Insurance Scheme and it's role in outbreak prevention and response planning.She and disability Jacqui Pierce described the Health/Disability interface. Discussion focused on in reach and mobile testing and interim advice provision regarding isolation and infection prevention. Dr Kate Graham provided the Health Pathways Update.Facilitated and Co-ordinated by:Bianca Forrester- GP and ECHO session FacilitatorJemma Missbach- WVPHN Practice Facilitator and ECHO session Coordinator
In this session, Infectious Disease Physicians A/Prof Deb Friedman and Dr Raquel Cowan provided the local Infectious Diseases Update. Deb described the transmission dynamics of COVID in households and people who are unable to independently care as vulnerable to infection due to close contact requirements (audio not included). Disability sector advocate, Ms Jacqui Pierce, provided an overview of accomodations and governance frameworks. She described strategies to redirect the workforce during the pandemic response and important considerations for GPs and Pas advocating for the care needs of this sector. Discussion focused on in reach and mobile testing and interim advice provision regarding isolation and infection prevention. Dr Vinay Menon described key point of care advice phone lines and Dr Kate Graham provided the Health Pathways Update.Facilitated and Co-ordinated by:Bianca Forrester- GP and ECHO session FacilitatorJemma Missbach- WVPHN Practice Facilitator and ECHO session Coordinator
In this session, A/Prof Deb Friedman (Infectious Disease Physician) provided the Infectious Diseases Update, A/Prof Lisa Clinnick, Director of Aged Care, Ballarat Aged care services reflected upon what we have learned in the past month in regards to outbreak planning and response in RACF. GP Josh Bye presented a case (not included in this audio) and Disability Sector advocate Jacqui Pierce reflected upon lessons that could be translated to other vulnerable groups. Dr Kate Graham provided the Health Pathways Update.Facilitated and Co-ordinated by:Bianca Forrester- GP and ECHO session FacilitatorJemma Missbach- WVPHN Practice Facilitator and ECHO session Coordinator
In this session, A/Prof Deb Friedman & Dr Raquel Cowan (Infectious Disease Physicians) provided the Infectious Diseases Update, A/Prof Mark Yates, Director of Clinical Studies, Ballarat Clinical School highlighted key priorities for GPs visiting RACFs and progressed the conversation on to medical management in this population. Dr Anita Phillips, Director of Medical Education and Training at Barwon Health presented the iValidate work in regards to Goals of care communication and documentation. Mr Matt Dixon provided a PHN update and Dr Kate Graham provided the Health Pathways Update.Facilitated and Co-ordinated by:Bianca Forrester- GP and ECHO session FacilitatorJemma Missbach- WVPHN Practice Facilitator and ECHO session Coordinator
In this session, A/Prof Deb Friedman & Dr Raquel Cowan (Infectious Disease Physicians) provided the Infectious Diseases Update, A/Prof Mark Yates, Director of Clinical Studies, Ballarat Clinical School described roles and responsibilities for GPs visiting RACFs and highlighted key priorities. A/Prof Lisa Clinnick Director Aged Care Services, Ballarat Health Services presented their planning process, local outbreak response and lessons learned. Dr Kate Graham provided the Health Pathways Update.Facilitated and Co-ordinated by:Bianca Forrester- GP and ECHO session FacilitatorJemma Missbach- WVPHN Practice Facilitator and ECHO session Coordinator
Index:00.00- Introduction and Priorities03.3 0- ID Update 12.30- RACF Outbreak Case Study 25.00- GP roles, responsibilities, key priorities in planning43.00- Rapid Fire Q&A 48.00- Health Pathways update
In this session, Dr Raquel Cowan present the COVID 19 update, Quality Manager of a Private Residential Aged Care Facility (RACF) (Caitlin Yates) presents lessons learned from Melbourne Outbreak, Director of Medical Services at Barwon Health (Dr Piraveen Pirakalathanan) presents the Rapid Response Plan for a COVID 19 outbreak in RACF and Director of Infectious Diseases (Prof Eugene Athan) describes the reality of our situation in regional Victoria and priorities at this time.
Index:00.00- Introduction and Priorities05.30- ID Update (Raquel Cowan)13.00-RACF Outbreak Case Study (Caitlin Yates)27.00- Outbreak Response Multi-system Response Framework (Piraveen Pirakalathanan)43.30- State of play and priorities at this time (Prof Eugene Athan, Dr Lisa Mitchell, GP feedback)
A/Prof Deb Friedman provided a Victorian Overview and update for Geelong and surrounds. Dr Raquel Cowan provided an update for Ballarat. We discussed the role of GPs and nurses in providing interim and auxiliary advice to patients asked to isolate and quanratine and tested this advice with some case scenarios (not included here). The GP-led respiratory clinic staff provided an update of services and PHN an update. Next Week....Aged Care.
In this session, Infectious Diseases Physicians Deb Friedman and Raquel Cowan provide local updates for Geelong and Ballarat. Contact Tracing in Regional Victoria is discussed.
In Session 13, continued the conversation about the role of primary care in suicide prevention. A/Prof Deb Friedman, Infectious diseases Physician, provided a local COVID 19 update. This session concludes the first cohort series in the COVID 19 Pandemic Response Project ECHO education sessions. The second series will commence on Thursday 16th July with a focus on complex case discussions, COVID 19 updates and discussions of emerging models of primary care in the context of the pandemic.
In session 12, we introduced the difficult conversation about Youth Suicide. Our guest panellist Kristen Douglas, Manager of headspace schools, outlined postvention responses in the community and the important role that frontline workers in health and education play in supporting young people at risk. Special guest Ms Christine Morgan, CEO of the Mental Health Commission and adviser to the PM on suicide prevention attended and provided reflections to the group. A/Prof Deb Friedman, Infectious diseases Physician, provided a local COVID 19 update.
A/Prof Deb Friedman explains the recent cases of positive tests in Geelong. *spoiler alert- the recent one was a false positive. Quick listen - almost a 6 minute consult.
In session 11, we continued our mental health series with a deeper dive into the perinatal period, this time examining formal referral pathways. Jane Campbell from Ballarat Mother & baby unit, describes how to support families to access care through the tertiary mental health system. A/Prof Deb Friedman, Infectious diseases Physician, provides an overview of restoration and recovery activities and how we've progressed since the relaxing of restrictions.
In session 10, we launched our mental health series with an overview of the Aboriginal Social and Emotional Framework for mental health. Panellist A/Prof Deb Friedman, Infectious diseases Physician provided an epidemiological overview of COVID 19 and presented our status within the global context. Psychologist and proud Gunditjmara and Wathaurong woman Tania Dalton, discussed putting the Aboriginal social and emotional framework into practice during this time.
In session 8, we continued our 3 part mini-series focusing on childhood presentations during the COVID19 pandemic response. Panellists A/Prof Deb Friedman, Infectious diseases Physician and Dr Kate McCloskey, Paediatrican, discussed pressing issues facing vulnerable families at this time. Deb provided an overview of the evidence, to date, regarding immunosuppressed patients and COVID and Kate described the educational inequities and concerns for those on the threshold for school refusal and disengagement as we approach a return to school in Victoria.
In session 7, we continued our 3 part mini-series focusing on childhood presentations during the COVID19 pandemic response. Panellists A/Prof Deb Friedman, Infectious diseases and infection control and Dr Chris Cooper, Director of Paediatrics presented an approach to non-COVID presentations at this time. Case discussion focused on non COVID respiratory illness and how to guide parents of children who are immunocompromised about returning to school.
In session 6, we launched our 3 part mini-series focusing on childhood presentations during the COVID19 pandemic response. Panellists A/Prof Deb Friedman, Infectious diseases and infection control and Dr Chirs Cooper, Director of Paediatrics presented on COVID and non COVID respiratory illness at this time. Case discussion focused on triage and assessment in practical terms in primary care. How are GPs in Western Vic making decisions about where to see and what PPE to wear?
In session 5, we continued our conversation about Emerging hybrid models of tele-health and face to face care during the pandemic response. Workflows, platforms, second consults and medicare compliance considerations, billing. What are GPs in Western Vic considering when it comes to managing these models fo care?
In session 4, we focused our discussion on Emerging hybrid models of tele-health and face to face care during the pandemic response. This excerpt is taken from the panel discussion at the beginning and a brief set of answers to arising infection control questions at the end. The twenty minute interactive discussion between participants and panelists is not available here.
In session 3, we continued our discussion on the Pandemic response in our aged care sector. This exerpt is taken from the panel discussion at the beginning and is followed by a rapid fire response to questions arising throughout the interactive session.
In session 2, we focused our discussion on the Pandemic response in our aged care sector. This exerpt is taken from the panel discussion at the beginning. This was followed by a 30 minute interactive discussion (not available here).