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Partnerships in Health
Chronic Disease Management (HARP)

Description:
The aim of the program is to ensure clients, who frequently present to the Royal Melbourne Hospital, are adequately receiving their care needs in the community. It is designed to ensure people receive the right care in the right place. HARP CDM is an interim service which completes a comprehensive care needs assessment, and specialist assessment where required, and develops a care plan with the client and family as to how their care needs are best met. This often involves linking with other community services, liaising with other family members, health care professionals and doctors.

HARP CDM represents a partnership between Melbourne Health (including the Royal Melbourne Hospital), Doutta Galla Community Health Service (DGCHS), Moreland Community Health Service (MCHS), Royal District Nursing Service (RDNS), and the Melbourne General Practice Network (MGPN).

The HARP CDM Program comprises of various service components including a central intake, Heartwise (chronic heart disease service), Melbourne Easy Breathers (chronic respiratory service), and Medication Management Service, Asthma educator, Cardiac Coach, Falls Prevention, generic & psychosocial intensive service coordination, Diabetes foot service and Diabetes co-management service

Clients are allocated to a key worker within the service area most appropriate to their needs. Services are provided in clients’ homes, general practices and on the campuses of the partnership agencies.

Fees
There is generally no charge for this service. Small fees apply for some services such as group involvement and the diabetes foot service.

To REFER To this service please CLICK on this link: HARP-CDM AT ROYAL MELBOURNE HOSPITAL

People who have complex needs and or significant complications as a result of chronic disease including, but not limited to; heart disease, chronic respiratory disease and diabetes who:

  • have presented to or been admitted to the Royal Melbourne Hospital (or other nearby hospital (not mandatory for diabetes services)
  • are at imminent risk of hospitalisation
  • live in the catchment areas (the Cities of Moreland, Moonee Vally, and Melbourne, and the suburb of Broadmeadows)

To view HARP CDM's Website please click here

 

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