87 Station Road Foster, Victoria, 3960 sghosp@sghs.com.au
Visiting hours 9.30am-11.30am and
5.00pm-7.00pm daily
10.00am to 1.00pm Weekends
(from 6 July 2020)
Note:There will be screening of ALL visitors for COVID19
(please see details under the “Patient” tab below).

Chronic Disease Management

Chronic Disease Management aims to:

  • Help you find out what changes you could make to your life to keep healthy and try to prevent heart, lung or other problems including diabetes and asthma.
  • Assist you to plan for lifestyle changes and to prevent barriers getting in the way.
  • Offer practical advice in planning to quit smoking and providing telephone support if you need it.
  • Offer referrals to programs or services which may assist you in your goals.

The Chronic Disease Management Nurse is a key point of contact within South Gippsland Hospital Community Health Centre to support people who have been diagnosed with a chronic health condition or are at risk of developing a chronic health condition such as diabetes, cardiovascular disease, respiratory disease, or neurological conditions.

If you have been diagnosed with a chronic health condition the Chronic Disease Management Nurse can support you to set goals and implement strategies to maintain and improve your health. During your first consultation the Chronic Disease Management Nurse will complete a comprehensive nursing assessment to assist you to identify goals that you would like to set in relation to your health and support you to develop a person-centred care plan to help you implement strategies to achieve these goals. The Chronic Disease Management Nurse can refer you to appropriate allied health, community health and support services as necessary, and provide you with ongoing support by monitoring your physical health, liaising with other members of your healthcare team and assisting you to review your person-centred care plan as your needs change.

For people who are at risk of developing a chronic condition (specifically type 2 diabetes and cardiovascular disease) the Chronic Disease Management Nurse can assist you to join the Life! program* which is a free Victorian healthy lifestyle program that helps you improve your eating habits, physical activity and stress management. Changing your lifestyle isn’t easy, especially on your own. The Life! program gives you the motivation and support needed to make and maintain positive changes and to live a healthier and more active lifestyle.
(*eligibility criteria applies)

The Chronic Disease Management nurse is available Thursday and Friday 9.00am – 3.30pm and usually completes the initial comprehensive nursing assessment during a home visit. Ongoing support can be provided by further home visits, telehealth consults or visits to the community health centre according to your personal preference.

To self-refer please phone South Gippsland Community Health Centre on (03) 5683 9780

Referrals from GPs other healthcare professionals are welcome and can be sent to South Gippsland Community Health Centre via fax: (03) 5683 9746 or email: sgh.chcreception@sghs.com.au@sghs.com.au

Once your referral is received the Chronic Disease Management Nurse will phone you to arrange a time that suits you for your initial consultation to occur.

Client contribution fees apply for Chronic Disease Management Nurse consultations and are set according to income. This will be discussed during initial phone call from Chronic Disease Management Nurse.

Programs:

Cardiac Rehabilitation:  A program for clients who have had a heart attack, angina, angioplasty [Stent], coronary artery bypass grafts, valve surgery, or people with chronic heart disease.

Each client has an initial appointment with a community nurse and physiotherapist before beginning group rehabilitation. The 9 week program focuses on assessment and education to minimize the risk of future problems, as well as exercise to improve heart health.

Access to the program is usually via referral from your doctor or other health practitioner, however self-referrals are accepted.

Pulmonary Rehabilitation: A program for clients with chronic lung conditions to enable them to increase their exercise tolerance, manage their breathing and live within their limitations.

Each client has an initial appointment with a community nurse and physiotherapist before beginning a group exercise program. The 9 week program focuses on assessment and education to assist you to learn to exercise within the limitations of fatigue and breathlessness.

Access to the program is usually via referral from your doctor or other health practitioner, however self-referrals are accepted.

Health Improvement Programs: A variety of programs to assist and motivate clients to alter their way of life to preventing chronic illness such as heart disease and diabetes.

Quit Smoking Advice: A discussion with a nurse on the best way for you to plan for quitting smoking. Includes follow up by telephone if desired.

Care Coordination: For those needing multiple services to achieve the best outcome and assist them to remain living independently.

For further information or to make an appointment, please phone the Community Health Centre between 9am and 4 pm Monday to Thursday.