July 22, 2022

Western Health released a new procedure around Additional Care Resources (formally known as specialling) in June 2022 which is now in use.

This procedure aims to guide the clinical assessment and decision making processes around Additional Care Resources in order to support patients to remain independent, maximise their well-being and improve outcomes, while reducing the risk and incidence of deterioration or harm to themselves and others.

Impact of changes on ED

Better defined processes around requesting and approval of additional care resources
Staff working in Additional Care Resources roles are empowered, via encouragement to be actively engaged in care of patient
More consistent language
More consistent review of need for additional care resources can help prompt escalation of any ongoing issues

Summary of key changes


Change	Current procedure	New Procedure
Terminology	Specialling (behavioural or clinical)	Additional Care Resources
Resourcing	Assigned to condition or diagnosis	Assigned for patient or staff safety
Handover	Verbal handover	Written – handover form
Approval process	Inconsistent approval process – inequitable access to resources	Consistency – equitable access to resources

NEW Additional Care Resources Handover and Patient Care Planning form

All Additional Care Resource Staff should receive a handover prior to starting their shift, and be given a copy of the paper handover form by the person providing handover.

The Additional Care Resource will actively engage in handover, and implementation of the patient care plan. This would usually involve filling in the handover form and discussing with the person providing handover.

Each shift, the need for an additional care resource will be reviewed by the NIC, and a new handover form should be completed.

When to request Additional Care Resources

There are three reasons you may need Additional Care Resources.

1. Patient Safety

discuss individual needs
complete risk assessments
encourage family and carers to get involved when appropriate
consider the need for appropriate referrals
ensure correct handover

2. Staffing Safety

assess other staffing resources in ED
identify what skill level is required

3. Operational Support

consider staff allocation according to patients’ needs
are there co-horting options to share the additional care?
are there other services that can provide you with assistance?

How to request an Additional Care Resource

Post approval, the additional care resource is requested via HEWS, or if a security guard is required, via directly request via the Security Supervisor, please email: WH-SecuritySupervisors@mh.org.au

Additional Care Resources will be reviewed and approved on a shift by shift basis.