Provides a range of coordinated options for clients within the local Townsville Hospital catchment, which includes supporting clients to remain in the community through:

• The timely discharge care for inpatients
• After hospital care service/post acute
• Short-term therapy or group based interventions

Services are multidisciplinary and are provided by Aboriginal & Torres Strait Islander Health Workers, Dietitians, Exercise Physiologists, Nurses, Occupational Therapists, Physiotherapists, Podiatrists, Psychologists, Social Workers, Speech Pathologists, and Therapy Assistants. Centralised Intake Services also manage referrals to Asthma and Respiratory Educators and Diabetes Educators.

Available services:

Service Coordination

• Central Referral Intake (phone 4433 9500) for all referrals where staff will provide assessment and goal oriented care, and/or referral to other appropriate services if required
• Assistance with discharge for Townsville Hospital inpatients and war veterans with complex needs, and facilitate referrals to the most appropriate agency (government or non-government) to support ongoing needs
• Support for clients presenting to the Emergency Department who require community and clinical services on discharge
• Cultural support for Aboriginal and Torres Strait Islander peoples accessing any of the services
• Multidisciplinary team approach, including Community Assessment and Case Management for clients with complex needs and home oxygen clients

Post-Acute Care and Hospital Avoidance
Short term support for those at risk of hospitalisation or who require support on discharge from hospital. Includes:

• Allied Health Rapid Response (from Emergency Department)
• CHIP (Community and Hospital Interface Program) Discharge Coordination
• Community IV Program
• Post-Acute Nursing Care
• Post-Acute Wound Care

Programs/Groups include:

• Breathe Education and Clinical Support Group
• Cardiac Rehabilitation Education and Exercise
• Cooking for 1 and 2 Program
• Hydrotherapy
• Living Strong Program (Indigenous specific lifestyle program)
• Motor Neurons Disease Education and Clinical Support Program
• National Indigenous Pneumococcal and Influenza Immunisation (NIPII) Program
• Pulmonary Rehabilitation Program

Clinical Services (in home or clinic based short-term therapy) include:

• Dietetics – for clients with chronic condition/s requiring dietary input
• Hearing Health Screening – for Indigenous children
• Home Oxygen Therapy Support
• Occupational Therapy – including upper limb and splinting
• Ongoing Needs Identification (ONI)
• Physiotherapy Balance, Mobility/Falls Assessment and Equipment Trials
• Podiatry
• Psychology
• Social Worker/Counselling
• Speech Pathology