A Community Approach

Alpine Health

Alpine Health, serving the Alpine Shire area, offers a unique suite of acute health and community services designed in cooperation with the community.

It is the largest multi-purpose state service in Australia – distinct from most mainstream health service providers – and is funded by the Commonwealth and the state government. Alpine Health employs a flexible funding model with a strong focus on community based care. Instead of employing the traditional top down approach of developing services and deploying them in the region, Alpine Health works in conjunction with its communities to provide appropriate care services that the people of the area have identified as being most needed.

Business Case Manager Mark Ashcroft is excited to discuss Alpine Health’s innovative approach to providing authentic community-based health care services, and describes how the group has found so much success in the Alpine Shire community.

In order to best serve its community, the group produces service plans on a five year basis, and those define what it will do and how it will structure itself. “We bring the community directly into the room during the planning process to help us map out what that service plan needs to look like and what the priorities across the community will be,” explains Mark. Residents of the community work closely with Alpine to identify the important health care issues that need attention and to create a service structure to deal with them.

“We have configured a range of committees and the Community Health Advisory Group, which provides a great conduit between the community and the organisation, which helps us test the direction of the delivery of our services into the community,” he says.

Alpine Health has three main sites located at the three larger centres in the Alpine Shire: Myrtleford, Bright and Mount Beauty. Each of these community centres offers an acute service program, an aged care service program and a district nursing program. Alpine Health also offers procedural services with visiting surgeons and its general practitioner partners across those services. “We offer a great range of service from an institutional perspective,” says Mark. “From a community perspective we have a strong investment in our early intervention health promotion team, which is a little bit unique. Alpine Health is investing strongly in terms of working with the community to get ahead of the demand for supply driven care.”

The health services group places a strong emphasis on predictive care and works closely with community partners to develop anticipatory, predictive health care models. These create proactive support structures that engage the shire community before issues of health care and social decline emerge and play themselves out as acute and unplanned admissions to health care institutions. “In order to take that focus forward, we are really starting to work much more closely than we ever had with the local government in the Alpine Shire and general practise in the primary care domain, joining up a lot of effort across the Alpine Shire to get ahead of that demand for supply driven care.”

Indeed, it is the people of Alpine Health who allow for such an innovative, community based approach to take root. It’s not just the health care providers, technicians and administrative staff, but also the community members who sit on committees and the professional partners who contribute to the project. “We have a variety of service providers, many of whom we provide ourselves, such as nurses, allied health support staff, and personal care workers, and then there are those that we have strategic relations with such as local government, general practice and other service providers that provide outreach service into our region.”

One of the things that attracts people to work with the group is that the interventions the group engages in to make a difference in the health and well-being of the community can be appreciated across the whole of the Alpine Shire. Working in a small rural environment, Alpine Health employees and partners have the benefit of providing service to the entire shire. This sort of attention to and understanding of community needs engenders a creative, supportive environment where professionals and partners feel valued by the community and truly appreciate the effect of their services. “People respond to working with communities in that way,” shares Mark.

To be sure, developing and providing services across a rural environment presents many complexities for service providers and the communities engaging in those services and Alpine Health encounters a range of health and social issues. “For people to access services means travel and cost,” Mark explains. “People look to us to provide the type of service that is responsive and complex and meets the needs of what everybody wants.”

Part of the major focus of the group is in building community support capacity before taking a step back and allowing the community to deliver the service. “A good close working relationship with the committee attracts the community to work closely with Alpine Health.” The services then delivered have been developed, as much as possible and when appropriate, in a way that makes sense for the community. The group has helped generate community support initiatives to address a range of needs including diabetes support, autism spectrum support and cancer support.

In order to provide these types of programs, it is paramount that Alpine Health engages continuously in relationship building and management with community groups and its service partners. “We can’t achieve what we need to achieve in isolation and that’s reflected quite clearly in our service planning approach and our annual strategic planning approach.”

Retaining strong contacts with its regional referral hospital is of great importance as well. Though Alpine Health recognises that it can’t support everybody for every social and health related issue, the group works to help community members understand where they can get a solution and what that solution may look like. More often than not, those solutions are possible because of the relationships Alpine Health has worked to build.

Discussing how Alpine Health’s process developed, Mark explains that, “It came from the community themselves. They’ve told us in no uncertain terms that we want to take some level of responsibility for the health and wellbeing of our community; what we don’t need from a health service is a program that does things to us, but a health service that does things with us.”

A major ongoing community project is the Bright Hospital Redevelopment project which, with community input, is working toward creating a redevelopment plan. “In terms of the Bright redevelopment, the Bright community is looking for a solution to their local health and community needs and, again, the community comes into the room with AH every year looking to refresh those assets in the community where they need refreshing.”

Alpine Health is making sure the discussion incorporates a strong dialogue in terms of: what will need to be represented in that structure; what kind of flexibility needs to exist that doesn’t exist now; and what kinds of allowances for service structure and service delivery are going to be important but for which the current infrastructure doesn’t provide. “We want it to be an engaging asset for the community, as well as an asset that actually helps us achieve those things that the community tells us are important. It’s not just about refreshing a building.”

As it moves ahead, the group looks forward to building even stronger ties with the Alpine Shire community, the state government and local partners. “Without doubt, we need to commit to joining up the business of local government, general practice and health care across the shire wherever we possibly can,” emphasises Mark.

And, as health and social services providers across the region essentially share the same community population, the stronger ties and shared processes will more efficiently and effectively serve the community. “As an example of three types of service provider across the shire, we are generally looking after and connected to the same population. So, if we can start to understand not only the health and social welfare needs of a community; we can start to identify some commonality in terms of our approach; we can come into the same room to conjointly plan; we can pool our intelligence about the community; and support the community in a joined up way.”

Making Sense of Management

Management is the art, or science, of getting things done through people. Sounds fairly straightforward – except for the fact that people are not robots waiting to do our bidding. People have their own minds, motivations, and goals. So how do managers keep operations – and the people behind them – running as planned?

December 16, 2018, 3:52 PM AEDT