HARP Chronic Disease Management Partnerships in Health

HARP Chronic Disease Management – Partnerships in Health

HARP CDM is a collaboration between Melbourne General Practice Network, Royal District Nursing Service, Doutta Galla Community Health Service, Merri Community Health Service and the Royal Melbourne Hospital. The over all aim of the program is reduce the number of avoidable hospital admissions.

The HARP Diabetes Co-Management Service is managed out of the Melbourne General Practice Network.  In order to address a gap in GP access to diabetes care for their patients, the pilot project was an initiative of the Diabetes Alliance Group (a representative group of Divisions of General Practice across Melbourne). After four successful years the program was mainstreamed into HARP CDM-Partnerships in Health, joining services targeted at heart failure, pulmonary rehabilitation, psychosocial issues, falls prevention and diabetes foot services among others.

As part of the HARP CDM - Partnerships in Health program, Diabetes Comanagement Service places Registered Nurse Credentialled Diabetes Educators (RN-CDEs) within General Practice on a regular basis to manage and monitor the care of patients with complex diabetes. The RN-CDE’s make recommendations on insulin prescription, oral medications, referrals to other health providers where necessary and develop and maintain systems within the general practice to care for complex diabetes patients.

The RN-CDE’s provide education and support to the GP’s and practice staff and act as a liaison between the GP and other health care providers for eligible patients.

As part of the Diabetes Co-Management Service, community clinics have been set up at Doutta Galla Community Health Service and Merri Community Health Service in order for patients to receive care outside of the General Practice. The involvement of an endocrinologist from the Royal Melbourne Hospital allows patients to receive specialist care in a community setting. Communication with GP’s is at the core of the program and all recommendations are forwarded directly to the GP.

To view the HARP Chronic Disease Mangement website click here

For more information

Please contact:

Alan McCubbin
Diabetes Co-Management Team Leader
Phone: (03) 9347 1188
Email: alan.mccubbin@mgpn.com.au