1. “Improving physical and mental health outcomes for adults living with severe and chronic mental health in Lismore through the integration of acute, primary and social care services.”
A partnership project ( ) between people with a lived experience of severe mental health, the Northern NSW LHD, the North Coast Primary Health Network, general practices, pharmacists and social care organisations in the Lismore local government area.
- Alison Renwick, Operational Support Mental Health, Northern NSW Local Health District
- Monika Wheeler, Acting Director – Integration (NNSW), North Coast Primary Health Network
- Sandra O’Brien, Integrated Care Coordinator - Mental Health and Drug & Alcohol, Northern NSW Local Health District
Slide 1: Title Slide with the 'name' of the project, location, organisational partners involved, names and roles of attending delegates
Slide 2: The Key Issue that the Integrated Care Program is seeking to address (i.e. the problem statement) (For Who and Why?)
Slide 3: The Core Aims and Objectives of the Integrated Care Project / Program (What?)
Slide 4: The Proposed Approach / Options Being Considered for the Implementation of the Integrated Care Project (How?)
Slide 5: Key issues the delegates wish to learn more about during their summer school experience

2. The problem
People living with severe mental illness die years earlier than the general population, mostly due to preventable conditions such as cardiovascular and respiratory disease. These people are more likely to have co-morbidities, though these are less likely to be treated and managed.
Mental health issues were rated by Lismore community members as their top health concern in 2016.
Staff working in acute and primary care in Lismore report there is limited integrated between inpatient pyshiatary hospital care, community mental health, general practice and social care supports.
Slide 1: Title Slide with the 'name' of the project, location, organisational partners involved, names and roles of attending delegates
Slide 2: The Key Issue that the Integrated Care Program is seeking to address (i.e. the problem statement) (For Who and Why?)
Slide 3: The Core Aims and Objectives of the Integrated Care Project / Program (What?)
Slide 4: The Proposed Approach / Options Being Considered for the Implementation of the Integrated Care Project (How?)
Slide 5: Key issues the delegates wish to learn more about during their summer school experience

3. The aims and objectives
Improve physical and mental health outcomes for adults with chronic and severe mental health in Lismore.
Person: Improve patient experience of care so that it is timely, holistic, culturally appropriate, integrated and effective.
Clinicians: Improve clinician satistifaction in providing timely, holistic, culturally appropriate, integrated and effective care.
The system: Improve communication and enhance team based approaches to care through the integratation of primary health care, community mental health, Accident and Emergency and inpatient pyschiatric hospital services (Flexible, Assertive, Community Treatment Model of Care).
Slide 1: Title Slide with the 'name' of the project, location, organisational partners involved, names and roles of attending delegates
Slide 2: The Key Issue that the Integrated Care Program is seeking to address (i.e. the problem statement) (For Who and Why?)
Slide 3: The Core Aims and Objectives of the Integrated Care Project / Program (What?)
Slide 4: The Proposed Approach / Options Being Considered for the Implementation of the Integrated Care Project (How?)
Slide 5: Key issues the delegates wish to learn more about during their summer school experience

4. The method
Initiation - Identify the project brief, key stakeholders and key personnel (complete). Convene workshop with key stakeholders to discuss concept (complete).
Diagnostic - Undertake research, literature review and collate baseline data, develop detailed project plan including scope and model, develop relationships with stakeholders and confirm Executive buy-in.
Solution design - Convene Steering Committee, convene co-design workshop to test and amend the scope and model of project, develop documentation, guides and processes to facilitate implementation of solutions in general practice, pharmacy, community health, acute health, social care organisations, conduct pre survey of all patients, carers, clinicans and others involved in project
Implementation - Implement change ideas as per co-designed model of care
Evaluation - Conduct patient, carer, clinician and other stakeholder post interviews, write final report including performance against performance measures and future recommendations
Slide 1: Title Slide with the 'name' of the project, location, organisational partners involved, names and roles of attending delegates
Slide 2: The Key Issue that the Integrated Care Program is seeking to address (i.e. the problem statement) (For Who and Why?)
Slide 3: The Core Aims and Objectives of the Integrated Care Project / Program (What?)
Slide 4: The Proposed Approach / Options Being Considered for the Implementation of the Integrated Care Project (How?)
Slide 5: Key issues the delegates wish to learn more about during their summer school experience

5. Summer school learning aims
How do you develop a shared vision for small projects within the context of competing organisational reforms?
How do we measure the success of organic change?
How do we transcend one off projects to whole of system change?
Slide 1: Title Slide with the 'name' of the project, location, organisational partners involved, names and roles of attending delegates
Slide 2: The Key Issue that the Integrated Care Program is seeking to address (i.e. the problem statement) (For Who and Why?)
Slide 3: The Core Aims and Objectives of the Integrated Care Project / Program (What?)
Slide 4: The Proposed Approach / Options Being Considered for the Implementation of the Integrated Care Project (How?)
Slide 5: Key issues the delegates wish to learn more about during their summer school experience