Shows
The Mental ElfPeople powered change: Bianca Forrester and Paresh DawdaBianca Forrester and Paresh Dawda speak to Laura Hemming from The Mental Elf about their sessions at the Quality Forum in Melbourne in October 2023.Bianca Forrester is a GP Academic at the Western Victoria Primary Health Network. Her talk at the Quality Forum in Melbourne is entitled: "Towards a regional primary care learning health system: from crisis response to resilience".Dr Paresh Dawda MB BS, DRCOG & DFRSH, FRCGP, FRACGP, is Adj Prof at the University of Canberra, and Adj Assoc Prof at UNSW - Prestantia Health. His talk at the Quality Forum in M...
2023-10-0521 min
The Maze PhaseNeurodiversity and neurodevelopmental disorders in teens-How can the GP help?In this episode, GP Bianca Forrester speaks with child and adolescent psychiatrist Prof Sandra Radovini about increasing requests for neurodevelopmental disorder assessments in primary care. We talk about the issues that many young people are facing in getting back on track with school routines and why transitions have been particularly challenging for some young people.Shownotes:Best Practice Guidelines for the assessment and support of autismAustralia's First National Guideline for the Assessment and Diagnosis of Autism Spectrum Disorders https://www.autismcrc.com.au/access/national-guidelineBest Practice Guidelines for the...
2023-03-1452 min
Project ECHO:WVPHN Hub- COVID 19 ECHO networkSeries 10: Session 3- Accessing appropriate COVID care: Health service pathways, community pathways and escalation of careIn our last session we discussed the announcements regarding the first stage of transition of COVID positive care pathways from Health service to Primary care and other community care providers.This transition began with thelaunch fo the National coronavirus hotline andnew system of notification for GPs and GPRCs linking patients who may not have reported a positive result into carethis announcement was accompanied by discussion of a transitional period where arrangements would be put in place to move medium risk pathways to primary and communtiy care.While this has not taken place yet, it is timely for us to be...
2022-08-311h 05Project ECHO:WVPHN Hub- COVID 19 ECHO networkSeries 10: Session 2 Updates in COVID prevention and outbreak preparedness: Evusheld and preparing our patients in RACF and SRS settings.Over the past few years, through these forums we have been considering our role in the system so that we can make good decisions about care and to assist our communities as we navigate the rough seas of this pandemic.For many of us, who’ve been concerned about fragmentation within the system, there is perhaps a hopeful approach to these conversations: that if we can get integrated care right with COVID, we can apply this to other conditions that fall victim to the divide between state and federal systems.While state and federal policy announcements continue to be...
2022-08-2947 min
Youth Friendly CareHave a good nights sleepThis term we are focusing on the foundations of good health.Our last session focused on disordered eating and in this session we’ll explore the common presentation of disordered sleep.It’s such a common presentation to primary care and perhaps even more common in teens presenting to the DiSS clinic post the pandemic lockdowns. Whether it is the presenting issue or something that we pick up on our comprehensive screen, I think many of us are quite familiar with working with this problem.But how do we quantify this issue?How much sleep is enough sleep and does qual...
2022-08-2927 min
The Maze PhasePart 2 -Young people in out of home care- How can the GP help?In this episode, GP Bianca Forrester continues the conversation with researcher Dr Susan Webster and Paediatrician Dr Karen McLean about overcoming the barriers that young people in out-of-home care face in accessing health care and supporting their health, social and educational transitions."The single best contribution that doctors and nurses can make, is to form that ongoing therapeutic relationship with a person who has lived with this kind of adversity. That beyond anything else, can really help.""I think anything that keeps the young person engaged at school and learning, is going to be a...
2022-08-1044 minYouth Friendly CareDiSS Breakfast Serial: Session 2-Opening with Cereal box of brief interventions with Orygen· Welcome to DiSS Breakfast serial· a short order clinical training offering for the Doctors in Secondary schools clinical training program,· brought to you by the Department of General Practice in Collaboration with Sexual Health Victoria· and I’d like to acknowledge the support of the Victorian Government in the production of this series.· It’s Wednesday the 3rd of august 2002 and this morning we’ll be offering up a healthy serve of cereals, scientifically tested and proved to promote improved mental health and wellbeing. This morning we’ll be opening the cereal box of brief interventions for mental health.· In this mornings...
2022-08-0324 minYouth Friendly CareEating Disorders beyond the basicsWelcome back to ECHO.As we move into term 3 at the schools, we’ll focus on the fundamentals of health.Eating well and sleeping well- 2 of the basics needs that we as human animals must achieve if we are feel secure, safe and steady in our foundations before we build upon those lovely idelas of psychological growth, flourishing and self actualization.As clinicians working with young people, we see issues with eating and sleeping so commonly as to know in our gut how crucial it is to get these things right. In these sessions we’ll be focusing on how to r...
2022-07-2726 minProject ECHO:WVPHN Hub- COVID 19 ECHO networkSeries 10: Session 1- Balancing competing demands on primary careWelcome back to Project ECHO Series 10.In this series we will be reflecting on how we can improve our practice to make use of the lessons learned from the pandemic and support our workforce to respond to increasing pressure and demands.AGENDANaomi White, Covid Positive Pathways ManagerProf Rosemary Aldrich, Medical Director, Grampians Public Health UnitPublic health updateDr Jeff Urquhart, GPLU consultant, GP Liaison unit, Barwon HealthBarwon Health updateDr Kate Graham, GP and Clinical Editor Health Pathways and COVID Clinical Advisor Western Victoria PHNQuadruple aim and...
2022-07-251h 01Project ECHO:WVPHN Hub- COVID 19 ECHO networkSeries 9: Session 5- Acute respiratory assessment in primary care: revisiting primary care modelsWelcome back to this extra-ordinary session this morning. In view of the high case numbers of respiratory infections and the changing recommendations for testing and assessment, we as an ECHO team across COVID care pathways, workforce development and health pathways, wanted to create a space to continue last weeks conversations. This morning we’ll be focusing on four key piece:We'll review the public health recommendations and changes in regards to testing, assessment and treatmentWe'll have an update on oral antivirals and influenza management recommendationsWe'll be reviewing our models of care for acute respiratory assessmentWe'll consider how implementation of di...
2022-06-2940 minProject ECHO:WVPHN Hub- COVID 19 ECHO networkSeries 9: Session 4- Connecting the dots in COVID care for rural communitiesFrom the 1st of July, the public health system makes a shift to a decentralised system. A dawning of a new era of regional public health units, one that has been operating in our neighbouring state for decades. So what will this mean for us in primary care?We’ll again revisit antivirals and consider how prescription for them is going in primary care and consider the role of pre-emptive planning for our regular patients with chronic diseases and co-morbidities.We’ve got a few quizzes in store this morning and an update for the Grampians public health unit regarding acce...
2022-06-291h 03
The Maze PhaseKids in out of home care- How can the GP help?In this episode, GP Bianca Forrester speaks with researcher Dr Susan Webster and Paediatrician Dr Karen McLean about the health needs of kids in out of home care and how we can bridge the gaps they face in accessing health care."One of the things to keep in mind for these young people is that when abuse or neglect has occurred, it has been in the privacy of the young person's home. Their parents may not have accessed health care....so kids may have big gaps in their health and medical care." "They do know what is most...
2022-06-2041 minYouth Friendly CareResilience building after a crisisIn this third lecture series we are going to focus on strengthening some of the foundations of good mental health. Safety, Sleep, eating and relationships. In our last session Sandra explored the theme of mental health recovery and resilience and we asked the question:Who is presenting?What are they presenting with?What have been their experiences through the pandemic crisis?How might this have impacted upon normal development and how might we consider a management plan that helps them access recovery?In this session we’ll focus a little deeper on some of the things they may have missed ou...
2022-06-0824 minProject ECHO:WVPHN Hub- COVID 19 ECHO networkSeries 9: Session 3-Long Covid management in primary care, part 2We’ll pick up pir conversations about Long COVID from where we left off a few weeks ago.Our allied health colleagues will share some information about screening and triage tools as well as pacing in primary care.We’ve got a patient case that raises some of the key concerns that no doubt many of you have about following up patients in primary care:What baseline tests will assist us to track and monitor progressWhen will further investigations be requiredWhen is specialist allied health recommendedWhere can patients access this care in our regionRecorded on Thursday 2nd June...
2022-06-0732 minProject ECHO:WVPHN Hub- COVID 19 ECHO networkSeries 9: Session 2- Understanding post viral recovery: post viral, post hospital and long COVID syndromesGood morning and welcome again. This session will kick off a 2 part series on Post COVID syndromes.We’ll focus on clinical presentations that follow in the immediate post infectious, post admission time and consider how to differentiate this from those who might be experiencing a more chronic and prolonged complex of symptoms. Our didactic will provide a brief overview of the evidence to date for this syndrome both overseas and here in Australia.And our case presentation will focus on practical strategies that can be implemented in the community setting.We’ll be asking the question:What can be mana...
2022-06-0741 minProject ECHO:WVPHN Hub- COVID 19 ECHO networkSeries 9: Session 1- Paxlovid on the PBS- safe prescribing and accessGood morning and welcome back to ECHO. ECHO breaks always give pause to reflect upon just how much changes week to week in the context of a pandemic crisis. And the past 4 weeks, while slightly quieter than over summer, brings a lot of changes in relation to how we live, how we care for patients and the options for communicable diseases management.The oral antiviral agent, Paxlovid, otherwise known as Nirmatrelvir plus ritonavir 300/100 to be prescribed BD for 5 days within the first 5 days of symptoms, came onto the PBS this week, without much in the way of fanfare.In the...
2022-06-071h 05Youth Friendly CareMental health wellbeing and Recovery: what does it mean for teens?Mental health wellbeing and Recovery: what does it mean for teens?We kick off our 3rd series of the adolescent mental health ECHO network for clinicians working with school aged teens.Welcome back to those of you who have been with us for previous sessions and a special welcome to any newcomers.The COVID-19 pandemic crisis has created a context of stress, disruption, pressures, change and fear on a global level. During this time we have witnessed and no doubt experienced first hand an increased number of young people presenting with distress and mental health issues.This series will...
2022-05-1229 minProject ECHO:WVPHN Hub- COVID 19 ECHO networkSeries 8: Session 10 - COVID testing: your questions answeredHappy 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...
2022-04-0456 minProject ECHO:WVPHN Hub- COVID 19 ECHO networkSeries 8: Session 09- Pandemic Recovery and communicable diseases preparednessAs 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...
2022-03-2546 minProject ECHO:WVPHN Hub- COVID 19 ECHO networkSeries 8: Session 08-Immunology 101As 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 p...
2022-03-211h 00
The Maze PhaseRecovery and resilience in teens- how can the GP help?In this episode, GP Bianca Forrester speaks with Professor of Public health Professor Lisa Gibbs Melbourne School of Population and Global Health"The conversation needs to be around strengths and vulnerabilities and how do we provide opportunities for kids to demonstrate their competence and supports where it's needed and when it's needed." ShownotesProf Lisa Gibbs’ researchhttps://findanexpert.unimelb.edu.au/profile/187995-lisa-gibbsArticle referenced: Giving Students time for recovery and learninghttps://pursuit.unimelb.edu.au/articles/giving-students-time-for-recovery-and-learningRisk resilience frameworkincluded on page 57 of theAdolescent Health GP Resource kit2nd editionBy Peter Chown, Dr Melissa Kang, Dr Lena Sanci, Verity Ne...
2022-03-0435 minProject ECHO:WVPHN Hub- COVID 19 ECHO networkSeries 8, Session 6: Vaccine Round-UpLast 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 co...
2022-03-0445 minProject ECHO:WVPHN Hub- COVID 19 ECHO networkSeries 8, Session 5: Accessing oral anti-viral therapyThis 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 t...
2022-03-0133 minProject ECHO:WVPHN Hub- COVID 19 ECHO networkSeries 8, Session 4: What do GPs need to know about PIMS-TS?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...
2022-02-1840 minProject ECHO:WVPHN Hub- COVID 19 ECHO networkSeries 8, Session 3: COVID-19 and kids: back to school, vaccines and clinical issues, part1We’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...
2022-02-1430 minProject ECHO:WVPHN Hub- COVID 19 ECHO networkSeries 8, Session 2: Back to school: balancing public health measures and personal concernsAmerican 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 stat...
2022-02-0449 min
The Maze PhaseWorking with FamiliesIn our last podcast, Old enough to have a medicare care but too young to vote, we discussed the rights and responsibilities of young people independently accessing health care services. This episode continues that conversation. Bianca speaks with Sandra Radovini about when it might be best practice to facilitate family involvement and how to navigate that fine balance between supporting young people's independence and choices with their best interests in supported health care. Importantly, we discuss some of the nuances such as timing and risk, some of the reasons for resistance and how to prepare parents and carers for these...
2022-01-3129 minProject ECHO:WVPHN Hub- COVID 19 ECHO networkSeries 8, Session 1: Responding to Omicron- primary care, public health and health service perspectives over summerWelcome 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 path...
2022-01-2841 minYouth Friendly CareDraft- Recovery and resilience in teensDraft pending approval for releaseRecovery and resilience in teens- how can the GP help?In this episode, GP Bianca Forrester speaks with Professor of Public health Professor Lisa Gibbs Melbourne School of Population and Global Health"The conversation needs to be around strengths and vulnerabilities and how do we provide opportunities for kids to demonstrate their competence and supports where it's needed and when it's needed." ShownotesProf Lisa Gibbs’ researchhttps://findanexpert.unimelb.edu.au/profile/187995-lisa-gibbsArticle referenced: Giving Students time for recovery and learninghttps://pursuit.unimelb.edu.au/articles/giving-students-time-for-recovery-and-learningRi...
2021-12-1335 minProject ECHO:WVPHN Hub- COVID 19 ECHO networkSeries 7: Session 10- 2021 Pandemic Response Network wrap up: Looking back, thinking forwardThis 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 ima...
2021-12-0959 minProject ECHO:WVPHN Hub- COVID 19 ECHO networkSeries 7: Session 9- Understanding COVID positive Care Pathways , Part 8- Discharge and follow upAs 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 addr...
2021-12-0344 minProject ECHO:WVPHN Hub- COVID 19 ECHO networkSeries 7: Session 8- Understanding COVID positive Care Pathways , Part 7- Public Health orders, social care needsOur 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.Inte...
2021-12-0342 minProject ECHO:WVPHN Hub- COVID 19 ECHO networkSeries 7: Session 7- Understanding COVID positive Care Pathways , Part 6- Paediatric and household careTo 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 poin...
2021-11-2236 minProject ECHO:WVPHN Hub- COVID 19 ECHO networkSeries 7: Session 6 -Understanding COVID positive Care Pathways Part 5, Patient self- management supportIn 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 patien...
2021-11-1138 minProject ECHO:WVPHN Hub- COVID 19 ECHO networkSeries7- Session5- Understanding COVID positive Care Pathways, Part 4. Therapeutic Interventions (and a Rapid Antigen testing update)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...
2021-11-0544 minProject ECHO:WVPHN Hub- COVID 19 ECHO networkSeries 7: Session 4-Understanding COVID positive Care Pathways, Part 3, Community Care pathways and Remote PatIn 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...
2021-10-3132 minProject ECHO:WVPHN Hub- COVID 19 ECHO networkSeries 7-Session 3: Understanding COVID positive care pathways, Part 2: Clinical AssessmentIn 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...
2021-10-2131 minYouth Friendly CareWorking with kids in out-of-home-careIn our last session we discussed the context of families in the care and recovery of young people with mental health presentations.Sandra described the continuum of caregiving and interventions to support families through their own struggles and the impact of crisis on caregiving.In this session, we’ll be focusing on the group of young people living in out of home care.Guest speaker and expert in this field, Dr Susan Webster, will highlight the needs of this group of young people and in our case based discussion we’ll consider how we as GPs and nurses in school clin...
2021-10-2015 minProject ECHO:WVPHN Hub- COVID 19 ECHO networkSeries 7-Session 2: Understanding COVID positive care pathways, Part 1: risk stratificationLast 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...
2021-10-1841 minYouth Friendly CareTeens, families and relationshipsTeens, families and RelationshipsThroughout the ECHO series we’ve maintained a focus on the young person’s presenting issues in the context of their families.In our case based discussions we’ve evaluated these important relationships both as predisposing, preciptating and perpetuating factors in mental health presentations and as protective factors for intervention and recovery.In this session, we’ll take a deeper dive into the themes of caregiving and harm and consider some useful frameworks through which to better understand how to work with natural supports and where professional services may play a role.Presenter: A/Prof S...
2021-10-1120 minProject ECHO:WVPHN Hub- COVID 19 ECHO networkSeries 7-Session 1: Beyond 80% fully vaccinated: primary care through the crystal ball...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 p...
2021-10-0835 minProject ECHO:WVPHN Hub- COVID 19 ECHO networkSeries 6-Session 9:COVID-19 vaccinations and teens, part 3: preparing for the vaccine rollout to 12 to 15 yr oldsIn 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 l...
2021-09-1740 minProject ECHO:WVPHN Hub- COVID 19 ECHO networkSeries 6-Session 8:COVID-19 vaccinations and teens, part 2: preparing for the vaccine rollout to 12 to 15 yr oldsWhile 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 va...
2021-09-1040 minYouth Friendly CareUnderstanding poor school attendance in teensIn our previous sessions we’ve discussed the impact of environmental stressors on the developing teen and the predisposing, precipitating, perpetuating and protective factors on the mental health of young people.In this session we’ll take an occupation or perhaps functional approach to understanding teen presentations to the DiSS clinic and discuss the drivers and issues that lie behind a presentation of poor school attendance.In this session, child and adolescent Psychiatrist, A/Prof Sandra Radovini describes the key presentations of poor school attendance, key areas of enquiry as part of a comprehensive assessment and provides some tips...
2021-09-0919 minProject ECHO:WVPHN Hub- COVID 19 ECHO networkSeries 6-Session 7:COVID-19 vaccinations and teens: preparing for the vaccine rollout to 12 to 15 yr oldsYesterdays 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 publ...
2021-09-0359 minProject ECHO:WVPHN Hub- COVID 19 ECHO networkSeries 6- Session 6:Outbreak Preparedness in regional Victoria: What needs to happen next?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 screeningHow will we safely maintain business as usual care in...
2021-08-3029 minYouth Friendly CareIs it Borderline Personality Disorder? - the importance of early recognitionIn our last session we explored the common presentation of self harm and discussed some of the dilemmas that clinicians face when working with teens expressing maladaptive behaviours in response to distress.This perhaps foregrounds this next theme quite well as while for many this behaviour may be self limiting and easily treated, for others it may be the first presentations of a more complex suite of difficulties for a young person and we might find ourselves asking the question:Is this Borderline Personality Disorder?In this session, child and adolescent Psychiatrist, A/Prof Sandra Radovini describes why early recognition...
2021-08-2519 minProject ECHO:WVPHN Hub- COVID 19 ECHO networkSeries 6- Session 5: Stepping stones to 70%: maintaining momentum and focusing our effortsArchitects, 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...
2021-08-2029 minProject ECHO:WVPHN Hub- COVID 19 ECHO networkSeries 6-session 4 Vaccine priorities, part 3: Stepping stones to 70%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 cr...
2021-08-1333 minYouth Friendly CareA brief intervention for self-harmIn this session we’ll focus on another common presentation of distress- Self harmWe’ll seek to understand the feelings behind the behaviours, the difficulties that these teens experience in processing and regulating emotions in more adaptive ways and we’ll discuss the principles of management.Presenter: A/Prof Sandra Radovini, Child and Adolescent Psychiatrist, Director of Mindful, University of MelbourneRecorded on Tuesday 10th August 2021University of Melbourne ECHO HubDepartment of General PracticeBianca Forrester (Facilitator)Ann-Maree Duncan (ECHO Co-ordinators)Bianca Forrester, audio production
2021-08-1114 minYouth Friendly CareAnxiety at the intersectionsIn this session, we'll beexploring Anxiety through the lens of social determinants of health and considering the needs of young people who may be experiencing discrimination and or disadvantage due to their status as CALD, refugee, LGBTI, ATSI and or experiencing a disability.Presenter: A/Prof Sandra Radovini, Child and Adolescent Psychiatrist, Director of Mindful, University of MelbourneRecorded on Tuesday 27th of July 2021University of Melbourne ECHO HubDepartment of General PracticeBianca Forrester (Facilitator)Ann-Maree Duncan (ECHO Co-ordinators)Bianca Forrester, audio production
2021-08-1114 minProject ECHO:WVPHN Hub- COVID 19 ECHO networkSeries 6-session 3: Vaccine priorities part 2, Prioritising pregnant women for COVID-19 vaccinationWith 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...
2021-07-3032 min
The Maze PhaseOld enough for a medicare card, too young to vote - the medico legal frameworkYoung people have the right to access health services independently; as early as they are able to access them. As health care professionals, there are a number of medico-legal and ethical considerations that may play out in any health care consultation with teens.Firstly, we have a duty of care to assess their competence and maturity as it pertains to decision making around the treatment goal proposed. We can assist them on their help seeking journey by creating opportunities to develop health literacy and to participate in making decisions appropriate to their age and developmental stage. Judgement must also...
2021-06-1842 minProject ECHO:WVPHN Hub- COVID 19 ECHO networkSeries 5, Session 5: Common concerns about COVID-19 Vaccination, part 1: ImmunosuppressionAs 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 ex...
2021-06-1843 minProject ECHO:WVPHN Hub- COVID 19 ECHO networkSeries 5, session 4: Vaccine associated thrombosis- recognition, assessment and management in primary careAfter 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 bes...
2021-06-1125 minProject ECHO:WVPHN Hub- COVID 19 ECHO networkSeries 5, Session 3: Lockdown 4.0- Reviewing our outbreak preparedness agendaBack 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 though...
2021-06-0333 minProject ECHO:WVPHN Hub- COVID 19 ECHO networkSeries 5, Session 2: The vaccine rollout revisited: Access to vaccination in the Western Victorian regions, Part 1Well 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 uncert...
2021-05-1037 min
The Maze PhasePeriod pain in teensPeriod pain is common and commonly impacts upon teens. While 90% of teens described experiencing pain, around 20-30% of teens missed out on school or other important activities due to period pain and associated symptoms.So what is the role of primary care clinicians when it comes to recognition and assessment of menstrual and cyclical pain? How can we educate and advocate for patients experiencing the impact of moderate and severe pain? What management options are available and accessible in primary care?Period Pain in teens- how can the GP help?In this episode, GP Bianca Forrester speaks with...
2021-04-211h 00Youth Friendly CareTeens seeking help independently, a discussion about the medico-legal and ethical framework guiding primary care cliniciansDraft pre-release pending formal approvals and release.Interviews with Prof Susan Sawyer, Paediatrician and Director Centre adolescent Health at RCH and A/Prof Sandra Radovini, Director Mindful centre, Child and Adolescent Psychiatrist.References and show notes to be developed.This Podcast was recorded "at home" across a few dates in November, 2020Presented by: Bianca ForresterInterviewees: Prof Susan Sawyer, Paediatrician and Director Centre adolescent Health at RCH and A/Prof Sandra Radovini, Director Mindful centre, Child and Adolescent Psychiatrist.Produced by: Bianca ForresterMusic: Space Cadet LullabiesGraphics: Gaal CreativeThe Maze Phase is a production of the University of...
2021-03-2942 minProject ECHO:WVPHN Hub- COVID 19 ECHO networkSeries 4, Session 6: Triaging respiratory illness and fevers in Primary care, Part 2With 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 pri...
2021-03-2521 min
The Maze PhaseEating Disorders in teensEating disorders and disordered eating exist along a spectrum. When considered together, Eating disorders and disordered eating are estimated to affect over 16% of the Australian population. The lifetime prevalence of eating disorders in women is about 8.5% and 2.2% for men and prevalence has been increasing over time. Co-morbidities are common and importantly the mortality rate for people with eating disorders is significantly higher than that of the average population and among the highest for a psychiatric illness.So what is the role of primary care clinicians when it comes to identification, assessment and management of Eating disorders and disordered eating? How...
2021-03-191h 17Project ECHO:WVPHN Hub- COVID 19 ECHO networkSeries 4, Session 5: The shadow of the Pandemic: Triaging respiratory illness and fevers in Primary care, Part 1It’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 COV...
2021-03-1917 minProject ECHO:WVPHN Hub- COVID 19 ECHO networkSeries 4, Session 4: Preparing for the Phase 1b the Vaccine rollout, part 2March 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 ad...
2021-03-1215 minProject ECHO:WVPHN Hub- COVID 19 ECHO networkSeries 4, Session 3: Preparing for the Phase 1b the Vaccine rollout, part 1EOI 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...
2021-03-0535 minProject ECHO:WVPHN Hub- COVID 19 ECHO networkSeries 4, Session 2: Understanding the Vaccine rollout, part 2 Residential Aged CareWell 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 conv...
2021-02-2635 minProject ECHO:WVPHN Hub- COVID 19 ECHO networkSeries 4, Session 1: Understanding the Vaccine rollout, part 1This 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 w...
2021-02-1926 min
Project ECHO:WVPHN Hub- COVID 19 ECHO networkWVPHN COVID-19 Vaccine Rollout Town Hall Session 2: Thursday 11th February, 2021The 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 updateMs Rowena Clift, CEO of Western Victoria PHNCommonwealth Vaccine PlanDr Lucas DeToca , Acting First Assistant Secretary of the COVID-19 Primary Care ResponseIntegration of IT systemsDr Jeff Urquhart , GPLU Barwon Health and Digital health committee member, RA...
2021-02-121h 36
Project ECHO:WVPHN Hub- COVID 19 ECHO networkWVPHN COVAX Town Hall Session 1: Thursday 28th January, 2021The 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 updateMs Rowena Clift, CEO of Western Victoria PHNCommonwealth Vaccine PlanDr Lucas DeToca , Acting First Assistant Secretary of the COVID-19 Primary Care ResponsePublic Health Unit UpdateProf Eugene Athan , Director of the Barwon South West Regional Public Health Unit and director of Infec...
2021-02-051h 42Youth Friendly CareDraft Post production-Episode 9 of the Maze Phase -Medicolegal and ethical considerationsDraft of a Podcast interview between GP Bianca Forrester and Prof Susan Sawyer (Paediatrican) and A/Prof Sandra Radovini (Child and Adolescent Psychiatrist) about medicolwegal and ethical considerations in working with young people in Primary care.
2021-01-2242 minYouth Friendly CareDraft Podcast Ep 8 The Maze Phase Eating Disorders- Part 2This is a draft post production copy of the upcoming Episode 8 of the Maze Phase. GP academic Bianca Forrester interviews Paediatrician Michele Yeo and GP expert in eating disorders, Dr Jenny Conway about best practice approaches to management.Shownotes:Support for familiesNEDC website- https://nedc.com.au/support-and-services-2/families-carers-lived-experience/Butterfly Foundation- https://butterfly.org.au/get-support/how-we-help/Inside out institute- https://insideoutinstitute.org.auResources for familiesFeed your instinct- https://feedyourinstinct.com.auAround the dinner table- feast- https://www.aroundthedinnertable.orgEating disorders families Australia- https://edfa.org.au
2021-01-2232 minYouth Friendly CareDraft Podcast Ep 7 The Maze Phase Eating Disorders- Part 1This is a draft post production copy of the upcoming Episode 7 of the Maze Phase. GP academic Bianca Forrester interviews Paediatrician Michele Yeo and GP expert in eating disorders, Dr Jenny Conway about early recognition, assessment and early intervention.Shownotes:1)Eating disorders Queensland resource “Understanding eating disorders”https://www.eatingdisordersqueensland.org.au/wfheict/uploads/2018/12/Understanding-Eating-Disorders-Booklet-EDA-2017.pdf2) NEDC websitehttps://nedc.com.au/professional-development/health-professionals/3) Jenny mentions Mental Health screening toolsK10- https://www.blackdoginstitute.org.au/wp-content/uploads/2020/04/k10.pdfDass 21, RCADS-headspace clinical toolkit https://headspace.org.au/clinical-toolkit/anxiety/SCOFF: http://www.cedd.org.au/hne/other/scoff_questionnaire.pdfESP- http...
2021-01-221h 17
Project ECHO:WVPHN Hub- COVID 19 ECHO networkSession 8: Innovation through Disruption, Final Session for 2020Welcome 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 a...
2020-11-2756 min
Project ECHO:WVPHN Hub- COVID 19 ECHO networkSession 7: Back to Business as (COVID) usual, Part 3- STI testing weekThe 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 mana...
2020-11-2057 minYouth Friendly CareDepression in teens (Beyond the basics)Through this series we’ve sought to lay the foundations of mental health assessment and basic management in adolescents. In this session, child and adolescent Psychiatrist A/Prof Sandra Radovini provides tips on asking young people about stressors, in both the past and present, that may be contributing to depressive symptoms. She continues to work through the "4Ps of formulation" in Psychiatry by describing common predisposing, precipitating, perpetuating and protective factors for teens experiencing depression and provides an overview of the first steps in medication management.Presenter: A/Prof Sandra RaoviniFacilitator: Dr Bianca Forrester
2020-11-1825 min
Project ECHO:WVPHN Hub- COVID 19 ECHO networkSession 6: Back to Business as (COVID) usual, Part 2- NAIDOC weekAlways 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...
2020-11-1242 min
Project ECHO:WVPHN Hub- COVID 19 ECHO networkSession 5: Back to Business as (COVID) usual, Part 1-Cancer ScreeningSo 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...
2020-11-0616 minYouth Friendly CareAnxiety in teens (Beyond the basics)In this session, child and adolescent Psychiatrist A/Prof Sandra Radovini discusses common stressors and triggers for the common presentation of Anxiety in teens. She takes us beyond the basics and describes the development of a formulation and how this contributes to the development of a tailored management plan.Presenter: A/Prof Sandra RaoviniFacilitator: Dr Bianca ForresterResources Described•Orygen- https://oyh.org.au•Headspace- https://headspace.org.au•Beyond Blue- https://www.beyondblue.org.auCochrane Library- https://australia.cochrane.org/cochrane-library
2020-11-0416 min
Project ECHO:WVPHN Hub- COVID 19 ECHO networkSession 4: Back to school again in Regional Victoria, Part 4· 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 G...
2020-10-3043 min
Project ECHO:WVPHN Hub- COVID 19 ECHO networkSession 3: Back to school again in Regional Victoria, Part 3The 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 g...
2020-10-2344 min
Project ECHO:WVPHN Hub- COVID 19 ECHO networkSession 2: Back to school again in Regional Victoria, Part 2· 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 wit...
2020-10-1649 min
Project ECHO:WVPHN Hub- COVID 19 ECHO networkSession 1: Back to school again in Regional Victoria, Part 1In 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 Physic...
2020-10-0839 min
Project ECHO:WVPHN Hub- COVID 19 ECHO networkSession 10: The Regional Roadmap for re-opening, Part 2As 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 re...
2020-09-1830 min
Project ECHO:WVPHN Hub- COVID 19 ECHO networkSession 9: Housing, crowding and caring, Part 3The 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...
2020-09-1021 min
Project ECHO:WVPHN Hub- COVID 19 ECHO networkSession 8: Housing, crowding and caring, Part 2In 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...
2020-09-0436 min
Project ECHO:WVPHN Hub- COVID 19 ECHO networkSession 7: Housing, crowding and caring, Part 1In 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...
2020-08-2827 min
Project ECHO:WVPHN Hub- COVID 19 ECHO networkSession 6: RACF Outbreak Response Planning, Part 4In 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...
2020-08-2136 min
Project ECHO:WVPHN Hub- COVID 19 ECHO networkSession 5: RACF Outbreak Response Planning, Part 3In 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...
2020-08-1453 min
Project ECHO:WVPHN Hub- COVID 19 ECHO networkSession 4: RACF Outbreak Response Planning, Part 2In 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 CoordinatorIndex:00.00- Introduction and Priorities03.3 0- ID Update 12.30- RACF...
2020-08-0749 min
Project ECHO:WVPHN Hub- COVID 19 ECHO networkSession 3: RACF Outbreak Response Planning, Part 1In 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...
2020-07-3153 min
Project ECHO:WVPHN Hub- COVID 19 ECHO networkSession 2: 23rd July, Lockdown 2.0 Pt2A/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.
2020-07-2327 min
Project ECHO:WVPHN Hub- COVID 19 ECHO networkSession 1: 16th July 2020, Lockdown 2.0In this session, Infectious Diseases Physicians Deb Friedman and Raquel Cowan provide local updates for Geelong and Ballarat. Contact Tracing in Regional Victoria is discussed.
2020-07-1721 min
The Maze PhaseUnderstanding self-harm and suicidal behavioursIn this episode, GP Bianca Forrester and Child and Adolescent Psychiatrist A/Prof Sandra Radovini tackle the tricky topic of self-harming and suicidal behaviours. Sandra describes the key elements of assessment and management for self-harming behaviours themselves and the presence of self-harm as a red flag for suicidal behaviours. They discuss the importance of formal training and support when working with young people who might be experiencing these behaviours. Sandra describes how we might better understand what we can work with and when we need to refer. Sandra also reinforces the the importance of working with supports....
2020-07-1040 min
The Maze PhaseDisruptive behaviour in teensIn this episode, GP Bianca Forrester and Child and Adolescent Psychiatrist A/Prof Sandra Radovini have a conversation about disruptive behaviour in school aged teens. Bianca asks Sandra to help her to organise her thinking about this group of presentations. Sandra frames up this common presentation by describing how “all behaviour has meaning”. So, how do we begin to understand the feelings behind the behaviours? How do we understand these teen’s needs? How do we engage the young person in a collaborative relationship? And how can we as GPs and practice nurses help?Sandra refers to the AMAZE websit...
2020-07-0948 min
The Maze PhaseThe Age of AdolescenceProfessor Susan Sawyer, Paediatrician and expert in Adolescent Health, describes contemporary understandings about the beginnings and endpoints of "Adolescence". She relates her viewpoint piece, published in The Lancet journal in 2018 titled “The Age of Adolescence” which describes how advances in brain imaging and neurobiology have furthered our understandings of biological beginnings and endpoints, how these discoveries might add to our understanding of this time of life. She discusses rights, the law and contemporary social influences and how all of these elements frame our understandings of this time of life and how we might work better with (and for) teens both in c...
2020-07-0540 min
The Maze PhaseDepression in Teens - How can the GP Help?“What is the impact of depression on school aged teens?”GP, Dr Bianca Forrester, continues the conversation with Child and Adolescent Psychiatrist A/Prof Sandra Radovini about mental health problems in teens. In this episode Bianca and Sandra explore the role of the GP in assessing and managing depression in practice. “What predisposes adolescents to depression”? In seeking to understand the young persons experiences in context, for anxiety she poses the question “What are the pressures”? With depression as a presenting problem she poses a different question….tune in to find out....This Podcast was recorded at the PodHub on the 30th Ma...
2020-07-0445 min
The Maze PhaseAnxiety in Teens - How can the GP Help?How can we help teens who are struggling with intense or uncomfortable feelings?In this episode, GP Bianca Forrester speaks with Child and Adolescent Psychiatrist A/Professor Sandra Radovini about best practice approaches to understanding anxiety in school aged teens. They discuss important aspects of assessment and how to understand the adolescent’s problems in context. Sandra asks the key question: What are the pressures? And describes how to explore key areas of the young person’s life. Sandra also provides useful insights into creating an individualised management plan and how to work with the young person’s key suppor...
2020-07-0345 min
The Maze PhaseAdolescent Health care - How can the GP Help?What is Youth Friendly Heath care?We hear a lot about the mental health problems in Australian young people. However, as a group, teens present to primary care less than any other age group and the problems that they present with are often unrelated to their mental health. In this episode, GP Bianca Forrester asks Prof Lena Sanci (Academic Expert in Adolescent Primary care) about the barriers that teens face in accessing the health care services they need, and how we, as health professionals, can help them to overcome some of these barriers.Working with Adolescents- How can the GP...
2020-07-0253 min
The Maze PhaseIntro to the Maze PhaseA 5 minute listen- Introduction to the Maze Phase. A season recorded in 2019 with the aim of providing an overview of common mental health disorders and the assessment and management in primary care. Principles of Youth Friendly care and theories of adolescent development woven into the series. Due to the Bushfires in Australia and now the COVID 19 pandemic, release of the series was delayed. While the series does not specifically deal with the impact of these events on Australian teens, the principles principles put forward in this series remain relevant in practice.
2020-07-0205 min
Project ECHO:WVPHN Hub- COVID 19 ECHO networkSession 3: 16th April, Aged Care Pt2In 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.
2020-04-1616 min
Project ECHO:WVPHN Hub- COVID 19 ECHO networkSession 2: 9th April, Aged Care Pt1In 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).
2020-04-1522 min