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Purpose

The purpose of the Open Arms – Veteran & Family (Open Arms) Clinical Liaison Pathway is to ensure a streamlined process for actioning proactive outreach response to clients identified as being at elevated risk to themselves, to others or from others, or have been otherwise identified as requiring assertive support. It spells out the roles and responsibilities of different parts of Open Arms in a collaborative response and supports National consistency of care for clients.

This process outlines responses to reach-out requests from the Minister and Secretary’s Office, Department of Veteran Affairs, and to notifications of death and other significant events requiring action and visibility. Additional actions that may occur to support clients, families and staff in response to a death or other significant event can be found in the following policies and procedures:

- 300 Organisational Risk Management Policy
- 200-04 Clinical Risk Management Policy and Procedure
- 203-02 Responding to Self-harm and Suicidal Behaviours; and
- 202-09 Clinical Event Investigation Procedure

The purpose of reporting welfare checks, child welfare report and attempted suicides is to provide additional support to the region or Client Assist when required, to alert the Executive of a situation with the potential for needing additional attention, to monitor the frequency of these events within Open Arms and support the review of system issues.

The Open Arms Clinical Liaison Pathway involves Regions, National Office, Client Assist and where appropriate DVA Triage and Connect working together to support vulnerable clients in a timely manner with the central point of communication being the Clinical Liaison inbox, which is monitored by the Assistant Director Client Assist and Assistant Director Clinical Liaison.

Clinical Liaison Pathways

There are multiple sources of reach-out requests and notifications that come through to the Clinical Liaison inbox. However, the main pathways into Clinical Liaison are as follows:

Referral Type

Description or Details

The Minister and/or The Secretary

Requests for reach-out

Defence NOTICAS and FATALCAS

Defence Notifications are provided to DVA by Defence of current ADF member casualties and fatalities, as part of the Support for Wounded, Injured or Ill Program (SWIIP) enabling support through early engagement. These are shared with Open Arms and other relevant DVA sections, including Triage and Connect and the Veteran Support Office.


 If the individual is a client of Open Arms, Open Arms will initiate an immediate reach out to the client or family to offer support. If the individual is not known to Open Arms, Open Arms will wait until a reach out request comes from Triage and Connect.

DVA

Requests for reach-out, notifications of deaths, incidents of concern for awareness

Open Arms: National Manager (NM), Open Arms Regions

Notifications of deaths, notifications of attempted suicide, notifications of child welfare reporting, incidents of concern for awareness



The Clinical Liasion flowchart below outlines these pathways in more detail. Also, specific guidance for each of these referral types is provided in the following task cards:

  • 203-04/02 Clinical Liaison Pathway – Minister’s Office
  • 203-04/03 Clinical Liaison Pathway – Secretary’s Office
  • 203-04/04 Clinical Liaison Pathway - DVA 

Clinical Liaison Flowchart


Consent and Confidentiality

Refer to:

  • 101 Client Information, Rights and Records Policy
  • 101-02 Privacy and Confidentiality Procedure

A key aspect of the Clinical Liaison Pathway is that Open Arms Clinicians seek to gain consent from clients to share information outside of Open Arms as a standard part of reach out requests. This should be completed in a clinically sensitive manner and documented in feedback to the Clinical Liaison inbox using the reach-out request templates (refer to Appendix 4).

If a significant level of risk of harm to self or others is present in the situation then consent is not required to share personal details in the enlistment of appropriate support for the person/s at risk.

Issues Requiring Immediate Visibility or Support

If the Regions or Client Assist require urgent DNM, NM or ANM assistance or support for a particular client or situation then please phone the relevant person directly on their mobile phone. If not answering, additional options include landline, skype, text, contacting their EA/Coord support or contacting another member of the executive team.

The Assistant Director Clinical Liaison (ADCL) will monitor the CL inbox and other avenues of information on a daily basis and will alert to the DNM situations such as:

  • Current adverse or client specific media coverage
  • Complex scenarios, including situations that may escalate rapidly
  • Clients who have recently been visible
  • Significant threat to self or others


Daily Clinical Liaison Summary

The Daily Clinical Liaison Summary provides a brief snap-shot of current issues requiring awareness by the Executive team and is stored in TRIM location: 2003477 “Strategic Management – Reporting – Open Arms – Daily Clinical Liaison Summary”.



Requests for Reach-out – Known to Open Arms

All reach-out requests will be included in Daily Summary sheet sent to NM, ANM and DNM at Close of Business.

Reach-out request from Minister’s Office (MO)/Secretary’s Office (SO):

MO/SO lodges reach-out request through PDMS and emails details to: OPENARMS.CLINICALLIAISON@dva.gov.au and CC OPENARMS.COORD@dva.gov.au

COORD:

  • Ensure contact details are obtained
  • Clarification of reach-out, what is the specific request for Open Arms to action
  • Clarification of due date for response (this step should not delay the request for reach out)
  • Email OPENARMS.CLINICALLIAISON@dva.gov.au if any additional details or changes to tasking have occurred with the following format for subject heading: “For REACHOUT: Due DD/MM: Surname, First Name”. Security mark as Sensitive.

Assistant Director – Client Assist (ADCA) monitoring Clinical Liaison inbox:

  • Review of status of client in VERA, including current/previous episodes of care, risk status, (including any safety flags) and attachments
  • Delegates to ADCC in relevant region for reach-out:

1) Phone call to ADCC alerting to incoming reach-out request.
2) Email reach-out request to ADCC (CC Regional Director) using following format for subject heading: “FOR REACHOUT: Due DD/MM Surname, First Name”. Security mark as Sensitive. NB: If ADCC is unavailable, contact Regional Director to clarify relevant staff member to action reach-out. See Appendix 4 for reach out request template.
3) Record initial details of the reach out in the daily tracker TRIM location: 2003477.

Region:

  • Evaluate reach out request in the context of the clinical knowledge of the situation
  • If reach out is NOT required, email OPENARMS.CLINICALLIAISON@dva.gov.au with the reason ASAP (e.g. has already had contact with Open Arms that day, has asked not to be contacted any more by Open Arms)
  • Otherwise, complete reach-out as soon as practical and appropriate, ensuring where possible that consent has been clarified regarding sharing of information back to MO/SO
  • Provide clinical care as appropriate to the situation
  • Document any client interactions or attempted contacts in VERA according to usual clinical best practice record keeping
  • Email OPENARMS.CLINICALLIAISON@dva.gov.au with outcome of reach-out attempts by 3pm, completed or not. Security mark as Sensitive, using reach-out request template provided in the original email. NB: If the reach out request is initiated after 3pm, feedback will be required by 3pm the next business day (unless advised otherwise).

Assistant Director Clinical Liaison:

  • Actively follow-up with region regarding reach out request if response not received by 3pm or clarification is required
  • Actively follow up with DVA business areas if required
  • Prepare summary words for clearance and send through to Deputy National Manager with the following format for subject heading: “FOR CLEARANCE: Due time DD/MM: Surname, First Name”. Security mark as Sensitive.

Deputy National Manager:

  • Review actions taken
  • Review words for clearance
  • Email OPENARMS.COORD@dva.gov.au with approved words for clearance to MO/SO and CC email to NM.

COORD:

  • Ensures clearance words are in appropriate format
  • Ensure ADCL and DNM aware of upcoming deadlines relating to MO replies
  • Lodged through PDMS.

Requests for Reach-out – Not known to Open Arms

All reach-out requests will be included in Daily Summary sheet sent to NM, ANM and DNM at Close of Business.

Reach-out request from Minister’s Office (MO) / Secretary’s Office (SO):

MO/SO lodges reach-out request through PDMS and emails details to: OPENARMS.CLINICALLIAISON@dva.gov.au and CC OPENARMS.COORD@dva.gov.au
COORD:

  • Ensure contact details are obtained
  • Clarification of reach-out, what is the specific request for Open Arms to action
  • Clarification of due date for response (this step should not delay the request for reach out)
  • COORD email OPENARMS.CLINICALLIAISON@dva.gov.au if any additional details or changes to tasking have occurred with the following format for subject heading: “For REACHOUT: Due DD/MM:

Surname, First Name”. Security mark as Sensitive.

Assistant Director – Client Assist (ADCA) monitoring Clinical Liaison inbox:

  • Review of status of client in VERA, including current/previous episodes of care, risk status, (including any safety flags) and attachments.
  • Delegates to Client Assist Clinician for reach-out using the following format for subject heading: “FOR REACHOUT: Due DD/MM Surname, First Name”. Security mark as Sensitive. See Appendix 4 reach out request template.
  • Follows-up reach-out request with assigned Client Assist clinician and records initial details of the reach out request in the daily tracker TRIM location: 2003477.

Client Assist:

  • Complete reach-out request taking note of due date and ensure consent has been clarified regarding sharing of information back to MO/SO
  • Provide clinical care as appropriate to the situation
  • Document any client interactions or attempted contacts in VERA according to usual clinical best practice record keeping.
  • Email OPENARMS.CLINICALLIAISON@dva.gov.au with outcome of reach-out attempts by 3pm, completed or not. Security mark as Sensitive, using reach-out request template provided in original email.

Assistant Director Clinical Liaison:

  • Prepare summary words for clearance and send through to Deputy National Manager with the following format for subject heading: “FOR CLEARANCE: Due time DD/MM: Surname, First Name”. Security mark as Sensitive.

Deputy National Manager:

  • Review actions taken
  • Review words for clearance
  • Email OPENARMS.COORD@dva.gov.au with approved words for clearance to MO/SO and CC email to NM.

COORD actions:

  • Ensures clearance words are in appropriate format
  • Ensure ADCL and DNM aware of upcoming deadlines relating to MO replies

Reach Out Requests co-actioned with DVA.

All reach-out requests that also involve DVA require an initial phone call.
The ADCA will delegate the reach-out request and phone Assistant Director T&C Escalations or Assistant Director T&C Operations to ensure visibility (If either of these staff members are unavailable please contact the Director T&C to advise of appropriate staff member).

If Open Arms are requesting an official detailed response from DVA to include in our cleared response to the Minister, the ADCA needs to advise COORD of this, with the information we are specifically seeking from DVA. Open Arms COORD will then liaise with the relevant DVA COORD area to have this actioned.

Any MO/SO request where a DVA business area are taking the lead, Open Arms will still actively follow-up the individual and/or family members to ensure all possible support is being offered.

Requests for Reach-out – from DVA

All reach-out requests will be included in Daily Summary sheet sent to NM, ANM and DNM at Close of Business.

Reach-out request from DVA (CCS, T&C, WASP)

Business area emails reach-out request to OPENARMS.CLINICALLIAISON@dva.gov.au using the DVA support request form and selecting “reach-out request” (See Appendix 4). Business area also calls Client Assist on-call phone if the request is urgent

Assistant Director – Client Assist (AD-CA) monitoring Clinical Liaison Inbox:

  • Ensure contact details are obtained
  • Clarification of reach-out, what is the specific request for Open Arms
  • Clarification if any required due date for response (this step should not delay the request for reach out)
  • Clarification if there is consent to share information between DVA and Open Arms
  • Review of status of client in VERA, including current/previous episodes of care, risk status, (including any safety flags) and attachments.

Individual Not Known To Open Arms:

  • AD-CA delegates to Client Assist Clinician for reach-out using the following format for subject heading: “FOR REACHOUT: Due DD/MM Surname, First Name” and include the completed support request form provided by DVA. Security mark as Sensitive. See Appendix 4 reach out request template.
  • AD-CA follows-up reach-out request with assigned Client Assist clinician and records initial details of the reach out in the daily tracker TRIM location: 2003477.

Client Assist:

  • Complete reach-out request taking note of due date and ensure consent has been clarified regarding sharing of information back to DVA business area
  • Provide clinical care as appropriate to the situation.
  • Document any client interactions or attempted contacts in VERA according to usual clinical best practice record keeping.
  • Email OPENARMS.CLINICALLIAISON@dva.gov.au with outcome of reach-out attempts by 3pm, completed or not. Security mark as Sensitive, using reach-out request template provided.
  • Report back to relevant DVA business area using DVA Feedback Template provided in Appendix 4

Individual Known To Open Arms:

Assistant Director – Client Assist (AD-CA) monitoring Clinical Liaison inbox:

1) Phone call to ADCC alerting to incoming reach-out request
2) Email reach-out request to ADCC (CC Regional Director) using following format for subject heading: “FOR REACHOUT: Due DD/MM Surname, First Name” and include the completed support request form provided by DVA. Security mark as Sensitive. NB: If ADCC is unavailable, contact Regional Director to clarify relevant staff member to action reach-out. See Appendix 4 reach out request template.
3) Record initial details of the reach out in the daily tracker TRIM location: 2003477.

Region:

  • Evaluate reach out request in the context of the clinical knowledge of the situation.
  • If reach out is NOT required, email OPENARMS.CLINICALLIAISON@dva.gov.au with the reason ASAP (e.g. has already had contact with Open Arms that day, has asked not to be contacted any more by Open Arms).
  • Otherwise, complete reach-out as soon as practical and appropriate, ensuring where possible that consent has been clarified regarding sharing of information back to MO/SO.
  • Provide clinical care as appropriate to the situation.
  • Document any client interactions or attempted contacts in VERA according to usual clinical best practice record keeping.
  • Email OPENARMS.CLINICALLIAISON@dva.gov.au with outcome of reach-out attempts by 3pm, completed or not. Security mark as Sensitive, using reach-out request template provided in initial request.
  • Report back to relevant DVA business area using DVA Feedback Template provided in Appendix 4.

After-Hours Support Call Requests

For DVA Business area:

After 4.30pm DVA Business area emails OPENARMS.CLINICALLIAISON@dva.gov.au, using the DVA support request form and selecting “after-hours support call” (See Appendix 4). Business area also calls Client Assist on-call phone if the request is urgent.

Assistant Director – Client Assist (AD-CA) monitoring Clinical Liaison Inbox:

  • Ensures contact details are obtained
  • Clarification of after-hours support call request, what is the specific request for Open Arms
  • Clarification if DVA business area requires feedback from Open Arms
  • Clarification if there is consent to share information between DVA and Open Arms

Individual Not Known To Open Arms:

  • AD-CA delegates to Client Assist Clinician for after-hours support call request using the following format for subject heading: “FOR AFTER HOURS SUPPORT: Surname, First Name” and include the completed support request form provided by DVA. Security mark as Sensitive. Include the support request form sent through from DVA.
  • AD-CA follows-up Support Call request with assigned Client Assist clinician.

Client Assist:

  • Complete after-hours support call request taking note of information provided by DVA. Ensure consent has been clarified regarding sharing of information back to DVA business area.
  • Provide clinical care as appropriate to the situation.
  • Document any client interactions or attempted contacts in VERA according to usual clinical best practice record keeping.
  • Report back to relevant DVA business using the DVA Feedback Template provided in Appendix 4

Individual Known To Open Arms:

  • Review of status of client in VERA, including current/previous episodes of care, risk status, (including any safety flags) and attachments
  • AD-CA delegates to Client Assist Clinician for after-hours support call request using the following format for subject heading: “FOR AFTER HOURS SUPPORT: Surname, First Name” and include the completed support request form provided by DVA. Security mark as Sensitive. Include the support request form sent through from DVA.
  • AD-CA follows-up Support Call request with assigned Client Assist clinician.

Client Assist:

  • Complete after-hours support call request taking note of information provided by DVA. Ensure consent has been clarified regarding sharing of information back to DVA business area (if not, attempt to obtain consent from client to provide feedback to DVA wen actioning after hours support call).
  • Provide clinical care as appropriate to the situation.
  • Document any client interactions or attempted contacts in VERA according to usual clinical best practice record keeping.
  • Report back to relevant DVA business area, by emailing the DVA Feedback Template (see Appendix 4).
  • Copy in relevant ADCC from relevant Region for their awareness. Using the following format for subject heading: “FEEDBACK AFTER HOURS SUPPORT: Surname, First Name”. Security mark as Sensitive.

For Region:

The Open Arms Client Assist Support Call is designed to complement the support provided by the regular Clinician by extending the level of care when needed. The Client Assist Support Call can consist of a simple check in with the client to assess wellbeing and risk, to as far reaching as brief intervention. The Client Assist Intake Clinician will listen and respond to clients who are;

  • Distressed or in crisis
  • At risk of suicide or self-harm
  • At risk of harming someone else
  • At risk of family domestic violence
  • Isolated and need to stay connected
  • Require additional support to maintain therapeutic goals

The Client Assist Intake Clinician will assist to decrease the level of distress, improve the callers’ ability to cope and develop a plan to manage until they are able to engage with their usual counselling Clinician. The Intake Clinician will also link clients to crisis services or activate the duty of care response as required.

If your client requires our assistance at times when you are not available, please do not hesitate to request a Client Assist Clinician contact your client. Please find the revised After Hours Support Call procedure below.

If a client is identified as requiring a support call outside of usual business hours;


Notifications

Notifications of Issues/Incidents of Concern for Awareness

The Regions or Client Assist may become aware of issues which National Office should have visibility of. If non urgent, these can be notified via an email to the Clinical Liaison inbox.
If an issue requires immediate visibility, such as a security incident, the DNM or NM should be notified via phone call, then an email to the Clinical Liaison inbox with CC DM/NM/ANM.

In addition to the specific situations outlined below, notifications could include:

  • Complex situations that may escalate rapidly
  • Clients who have recently been visible and additional actions are now being taken
  • Significant threat to self or others
  • Minor Security incidents
  • Adverse local media coverage, particularly about individual clients
  • Repeated callers
  • Clients acting inappropriately on Open Arms social media

The Assistant Director Clinical Liaison will then collate the above information and include in the daily summary sent to the NM, DNM and ANM at Close of Business.

Notifications of Welfare Checks

All notifications of welfare checks will be included in Daily Summary sheet sent to NM, ANM and DNM at Close of Business.

Further details about actions in the context of a welfare check can be found in the responding to self-harm and suicidal behaviour procedure (under development).
Region or Client Assist (within 60 minutes of actioning welfare check):

  • Notify DVA Security team if required
  • Email OPENARMS.CLINICALLIAISON@dva.gov.au with
    • relevant details of the situation
    • any outstanding actions that the Region or Client Assist will be following up.

See Appendix D for template

  • Document in VERA

Assistant Director Clinical Liaison:

  • Provide support to the region as necessary
  • Include in Daily Summary to NM, DNM and ANM

Notifications of Child Welfare Reporting

All notifications of Child Welfare Reporting will be included in Daily Summary sheet sent to NM, ANM and DNM at COB.

Further details about actions in the context of a child welfare report can be found in the Assessing and Responding to Violence Procedure (under development).

Region (within 60 minutes of completing child welfare report):

  • Email OPENARMS.CLINICALLIAISON@dva.gov.au with
    • Brief summary of the report made
    • support being provided to the client and their family
    • any support being provided to Open Arms Staff/OPCs
    • any outstanding actions that the region will be following up.

See Appendix D for template.

  • Documentation in VERA

Assistant Director Clinical Liaison:

  • Provide support to the region as necessary
  • Include in Daily Summary to NM, DNM and ANM

Notifications of Attempted Suicide

All notifications of Attempted Suicides will be included in Daily Summary sheet sent to NM, ANM and DNM at COB.
Further details about actions in the context of a welfare check can be found in 203-02 Responding to Self-harm and Suicidal Behaviours.
Region (within 60 minutes of receiving notification):

  • Email OPENARMS.CLINICALLIAISON@dva.gov.au with
    • client details
    • support being provided to the client, their family and affected Open Arms staff or OPCs
    • any outstanding actions that the region will be following up.

See Appendix D for template.

  • Documentation in VERA

Assistant Director Clinical Liaison:

  • Provide support to the region as necessary
  • Include in Daily Summary to NM, DNM and ANM
  • Email the Assistant Director Quality Improvement with the initial notification and any additional relevant details

Notifications of Deaths

  • Notifications of death are emailed to CLINICALLIAISON@dva.gov.au . OPENARMS.CLINICALLIAISON@dva.gov.au forwards all death notifications, together with subsequent HIBs, to the Open Arms Client Safety Unit, at OPENARMS.CLINICALQUALITYANDPOLICY@dva.gov.au
  • Notifications of death are received via email from DVA or from the Regions.  All notifications of death are to be included in Daily Summary Sheet.  Notifications are also sent to the Open Arms Client Safety Unit where a decision is made as to whether this death is included in an Adverse Event Review.

Regions

  • Use the following format for subject heading “DEATH NOTIFICATION: Surname, First Name”. Security mark as Sensitive. Use death notifications template (see Appendix 4) to include relevant information about actions taken including relating to family, staff and OPCs.
  • Complete requested next-of-kin/family reach-outs in a manner appropriate to the specific sensitivities of the situation.

Assistant Director – Client Assist (ADCA) monitoring Clinical Liaison inbox:

  • Identifies if client was a current client of Open Arms and if so, checks for Next-of-Kin contact information;
  • If required, email request to the relevant Open Arms region to attempt a reach-out (sensitive to timing) to next-of-kin/family members to offer Open Arms support service

If informed by the Regions:

  • Informs DVA of death notification by emailing NOTIFICATIONS@dva.gov.au , including date of death, date death was reported to Open Arms (and who by), possible cause, and estimated date of last contact with Open Arms;

If informed by DVA:

  • Replies to DVA indicating if client was known to Open Arms and if so, the estimated date of last contact. Also request contact details for Next of Kin.
  • Email Assistant Director – Quality Improvement with the original notification and any additional relevant details.
  • Update the Daily Summary sheet

Assistant Director – Clinical Liaison:

  • If the client is known to DVA, then DVA will prepare a Hot Issues Brief and will require input from Open Arms.
  • Prepare draft words for Hot Issues Brief input including information about the client’s history of engagement with Open Arms and the date of last contact.
  • Progress draft words for clearance to DNM to be sent to DVA within 60 minutes.
  • If the client is not known to DVA, contact DNM (SMS or phone call) with relevant details to ascertain whether a Hot Issues Brief for Open Arms is required.

Assistant Director Clinical Quality Improvement (Information Management):

  • Client’s name added to the Current Adverse Incident Spreadsheet.
  • If client has an archive file, request lodged with Records Services for retrieval and digitisation of file.
  • Check that all session notes are entered within client’s Vera file. If not, liaise with Regional ADCO (if in-centre clinician) or ADCOG (if OPC) to obtain missing notes.
  • Collate VERA record.
  • Add message to VERA Individual Profile page to indicate that a death notification has been received.
  • Add Date of Death under Demographics tab in VERA.

Within 48 hours of notification

Documentation in VERA

All documentation in VERA should be in line with best clinical practice and Open Arms policies and procedures.  This includes uploading key correspondence relating to the client’s welfare.



APPENDICES can be accessed through the document download link below.




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