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Post Acute Care Service

The Post-Acute Care Service (PACS) provides a short-term support for adults across the Metro North Health catchment to avoid presentation or readmission to hospital. Patients are referred via Emergency Departments, GPs, QAS or on discharge from hospital. Short-term multidisciplinary interventions are provided to address immediate care needs.

PACS can provide a rapid response within 24 hours of referral by an expert multidisciplinary team.
Priorities for next day support include:

  • Need for once daily medication administration/ monitoring
  • Complex acute wounds/ drains that require management
  • Limited basic ADL/mobility equipment* needed to remain safe at home.
    * Monday to Saturday only. Referrer to contact PACS to discuss.

A Geriatrician works with the service and can provide assessment within two weeks of referral.

Referrals for Geriatrician review may be made to address polypharmacy, recurrent falls or a concern related to a rapid decline in cognition/ delirium.

Referrals are accepted from hospitals to support early discharge and prevent readmission.
GPs and Queensland Ambulance Services can refer directly to avoid hospital presentation or admission. Information on how GPs and QAS can access this service is provided below.

Our services

Services include:

  • Education and support in managing your health condition
  • Check medication compliance and education
  • Catheter care education
  • Education for falls prevention and management of falls risk
  • Chronic disease education and support
  • Home safety assessment and supply/ fitting of loan basic equipment (Monday – Saturday only referrer to contact team to discuss).
  • Recommendations for modifications to the home environment based on a client’s current functional level
  • Nutrition assessment and management
  • Swallowing assessment and management, and high-risk communication
  • Limited, short-term personal care in the home
  • Linkage to services to support patient and carers in their existing care arrangement (for example linking carers to carer support agencies or respite options).
  • Patients with allocated level three and four packages where the service provider is temporarily unable to provide the required care
  • Geriatric assessment and management to recommend safe options for the home environment
  • Short term acute wound management including stoma care (where there is a current wound management plan in place and there has been a medical review of the wound).

Short-term services up to a maximum of 14 days are available after a hospital stay, presentation to an emergency department or by referral from your GP or QAS to avoid hospital admission.

How to access this service

Hospital facilities can refer admitted patients to this service for post-acute care.

Referrals are welcomed directly from GPs and QAS staff for services to prevent presentation or admission to hospital.

Referrals can be made to this service 8:00am to 4:30pm Monday to Friday via:

Central Referrals Unit: 1300 658 252

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