Monash University Department of Rural and Indigenous Health

Transforming Rural Urgent Care Services (TrUCs)

This project commenced in 2005 and completed in March 2008. The attached flyer is announcing the official start of this Community Health Service for Mt. Buller residents. This was a joint project between the Alpine Resort Management Board (ARMB) and MUDRIH and a summary is provided below.

Background:

The TrUCs model developed initially following research into the Urgent Care needs of small rural communities. On completion of the research the team identified the need for a whole of community involvement when decisions surrounding urgent care were to be made. The TrUCs process is a five-stage community development approach to identify urgent health care needs for rural populations. The Victorian Department of Human Services provided funding for two pilot projects. The first project completed was in Mallacoota during 2003/2004 and the Community Ambulance Officer role was specifically developed to meet the identified needs.

The Mt.Buller context:

The opportunity for the second pilot project arose from the release of the ‘Alpine Resorts 2020 Strategy’ report and following a telephone conversation with Dr Phillip Jolly from Mansfield and a subsequent meeting with Mr Phil Nunn between March and May in 2004. A collaborative partnership between the ARMB and Monash University School of Rural Health enabled the implementation of the Transforming Rural Urgent Care Systems (TrUCs) program. The TrUCs Mt. Buller/Mt.Stirling project officially commenced in December 2005 with the aim to identify and implement an appropriate, locally accessible and sustainable year round health service. A local Community Development Officer was appointed to drive the project and build community capacity.

Mt Buller, attracts thousands of visitors during the snow season with the village situated at the top of the mountain. During winter the population can exceed 7000 people. Outside the snow season the permanent resident population is under 200 people. Over the snow season the population influx is well supported by comprehensive twenty-four hour medical and emergency services operating from the Mt Buller Medical Centre. There are no equivalent services offered during the remainder of the year. Residents and visitors experiencing a need for medical emergency or urgent care services are required to drive to Mansfield to seek professional assistance; or wait for an ambulance on the mountain.

Following community surveys and committee discussion it was decided that the most appropriate service level was a local health service (community), which provides a community, nurse-led service over limited hours, with the capacity for emergency resuscitation and stabilization, and the delivery of primary health and urgent care. The health professional would be a registered nurse division 1 with Advanced Practice Nursing skills; governance and clinical support provided by Mansfield hospital and support from CFA, Rural Ambulance Victoria and ‘Nurse On Call’ telephone service would continue to provide after hours emergency services. The services available will include: emergency and primary health services including health screening, monitoring and education; assessment of acute medical presentations; treatment of minor wounds; medication management; liaising with medical practitioners; counselling and referral to medical or allied health services.

The outcome:

The Advanced Practice Nurse has been appointed. She has worked in the Snow-season clinica through the winter and is currently functioning in the new role over the non-ski season. The new service commenced operations officially on 17th November 2008 and is to be officially opened by the Health Minister in the near future.