Published on 6 June 2022

There’s a new clinical procedure for requesting and approving Additional Care Resources. Previously known as specialling the revised procedure aims to guide clinical assessments and the decision-making process around Additional Care Resources, while providing a standardised approval process.

We understand that intervention is sometimes necessary and the Additional Care Resources are available to ensure the safety and well-being of our patients, our staff and visitors.

What's Changing?

The below table clearly outlines changes to the current procedure.

 

Change

Current procedure

New Procedure

Focus

Emphasis on 1:1 ‘specialling’

Focus on providing safe care

Terminology

Specialling (behavioural or clinical)

Additional Care Resources

Resourcing

Assigned to condition or diagnosis

Assigned for patient or staff safety

Handover

Verbal handover

Written – handover form

Approval process

Inconsistent approval process

– inequitable access to resources

Consistency – equitable access to resources

Clinical Psy Nurse

Required for behavioural

Required for mental health patients

How is it changing?

  • When to request ACR

    There are three reasons you may need Additional Care Resources.

    1. Patient Safety

    • discuss individual needs
    • complete risk assessments
    • encourage family and carers to get involved
    • consider the need for appropriate referral
    • ensure correct handover

     

    2. Staffing Safety

    • does the patient require a transfer to a higher acuity ward
    • assess other staffing resources on the ward
    • identify what skill level is required

     

    3. Operational Support

    • consider staff allocation according to patients’ needs
    • what discharges and transfers may be taking place
    • are there co-horting options to share the additional care?
    • are there other services that can provide you with assistance?
  • Who can request Additional Care?

    If you think your patient will benefit; team leaders should consider what type of additional staff member should provide the care/supervision that their patient needs. This includes allowing a unit staff member to care for the patient and the additional resource supporting the ward.

    Prior to requesting additional care staff, team leaders should consider other options available to them such as reallocating staff or request a medical review of patient needs.

  • How to submit a request for Additional Care Resources

    Follow the shift request process in the workforce module of HeWs 

    1. Select the appropriate rationale and staff skill group required – Support (HCW) or Nurse (RN, RM, EN).
    2. Complete approval detail form with reasons for resource request and full name of approver.
    3. Prior to saving, please check all details are correct.

    Requests for Nursing, Midwifery and HCW/PCA are to be submitted via the Health-e Workforce Solutions (HeWs) platform.

    If you require assistance from security, your request should be made directly with the Security Supervisor, please email: WH-SecuritySupervisors@mh.org.au 

    Additional resources will be reviewed and approved on a shift by shift basis.

  • Approval Process

    The below table outlines the process from assessment through to approval.

Important Documents

In March 2020, the ACCC and EMA Divisions commenced a major review of the current Western Health Patient Observation (Specialling) Procedure in response to increasing requests for additional staff support within the organisation. This approach has been in collaboration with the Nursing and Midwifery Directorate, the aim of the review was to better understand the processes and use of additional care resources from request, approval through to use.