Evidence based goal-setting for patients with multiple chronic conditions
Evidence based goal-setting for patients with multiple chronic conditions - health goal generation and negotiation for MACS referred patients
Living with chronic disease can be challenging. Some examples of chronic disease are:
Often, these conditions need to be managed for a lifetime, so it is important to try to maintain independence and stay as healthy as possible.
The Multidisciplinary Ambulatory Consulting Service (MACS) operates chronic disease management clinics across Central Adelaide Local Health Network (CALHN).
CALHN MACS aims to provide a responsive, multidisciplinary and person centred, chronic disease management service to people with multiple chronic and complex conditions.
We work in partnership with the referring general practitioner (GP) to provide coordinated care for patients that ensures optimal health outcomes and reduces hospital admissions.
The CALHN MACS team includes senior doctors (consultants and senior registrars) who specialise in different areas of medicine, a registered nurse, a chronic heart failure nurse and a pharmacist.
CALHN MACS clinics provide a single point of contact for patients, in addition to shared care and support for GPs. Patients benefit from a multidisciplinary team care which can provide medication optimisation, disease management education, goal setting and home medicine reviews. Clinics are most suitable for patients with:
This service may not be appropriate for patients living within nursing homes.
For referral details or more information on CALHN MACS clinics please telephone (08) 7074 2701 or view the CALHN MACS web page.
CALHN MACS clinics can provide you with access to a team of health care professionals who will work through your health concerns and problems with you.
The team may include senior doctors (consultants and senior registrars) who specialise in different areas of medicine, a registered nurse, specialist nurses, and a pharmacist. Your individual needs will be assessed by the team and, in consultation with you and your general practitioner (GP), they will develop a management plan.
By attending the clinic you will benefit from:
The aim is to keep you well, improve your quality of life and keep you out of hospital.
Talk to your GP or specialist to see if you are eligible to attend a MACS clinic.