Health Monitor

Service overview

The Health Monitor team are a telephone-based service of nursing and allied health staff with broad clinical assessment and community care coordination experience. The team contact eligible consumers via text message and / or phone within 48 hours of discharge. 

Health Monitor aims to ensure discharge plans are implemented as intended, whilst providing support for emerging post-discharge issues. People requiring ongoing, more intensive or in-home support, are referred to other community-based services. Phone based interpreting services can be utilised for phone calls if required.

The Health Monitor team may explore the following areas:

  • Current illness/recovery
  • Medications
  • Planned follow up appointments
  • Formal supports currently in place or referred to
  • Social supports
  • Any other concerns

Based upon any issues or concerns identified, Health Monitor will undertake necessary actions, including advice, short term care coordination, escalation to home visiting services, further referrals to additional community services, coordination/confirmation of follow up appointments, GP liaison, explore transport services and/or liaise with home medical unit as required.

Team members

  • Registered nurses
  • Physiotherapy
  • Occupational therapy
  • Podiatry
  • Administration support

Service delivery

  • Phone based service
  • Participation is voluntary
  • Six days a week within business hours - 9am - 4.30pm (closed on Sunday)
  • Number and frequency of calls determined with clients following an initial assessment
  • Contact duration up to two weeks

Eligibility Criteria

Currently patients aged 50+ who are discharged from the Emergency Department or General Medicine Units and all clients discharged from the Hepatobiliary Surgical Unit.

The Health Monitor team does not currently accept referrals.

Contact details

Phone enquiries on 9231 2777 (Monday - Saturday).