Day Program Restructure

Organisation / Service

SA Statewide Eating Disorder Service

SEDS has been running an intensive Day Program since 2016. The Day Program complements the Inpatient Program at Flinders Medical Centre, one of the two main tertiary hospitals in South Australia. As a Public Health Service SEDS strives to meet its obligation to provide more intensive services than what is available through Private or NGO providers. Comprehensive, whole of service reviews are conducted bi-annually and these have allowed the service to accurately measure impacts of minor to moderate amendments to the Program as well as to inform literature publications on a regular basis. Following the last review in August 2023 it was decided to conduct a comprehensive review of the Day Program Structure on the foundation of the following principles:

1. Clinical/Efficacy- Any changes would need meet or exceed current clinical outcomes for attending participants. There will be greater clarity around admission length and goals of care. Following extensive liaison with other Day Program Providers the Program will offer admissions in three, four-week blocks separated by a one-week consolidation period that will include individualised interventions. This will replace the current open, ongoing group structure.

2. Operational – The new structure will provide an opportunity for expanding clinical services and allow staff greater capacity to undertake ongoing Quality Improvement activities. It is acknowledged that the service is under resourced despite the increased demand over the past 4 years.so there is an obligation to maximise quality services within available resources and facilitate revenue generating additional initiatives.

3. Staff wellbeing- The new structure will promote self-care and wellbeing within the staffing cohort. SEDS is fortunate to have an exceptionally skilled and passionate workforce but under the current labour-intensive structure there is clear evidence that running the Program with the current resources is unsustainable. 

With Divisional Project support the change process is well under way. An extensive literature review and stakeholder consultation have been completed. Formal presentation of recommendations will be conducted in late March 2024. Before operationalisation every therapy module used in the Program will be reviewed and updated. Consolidation week activities will be finalised as well as creating new weekly and annual timetables.

National Strategy Standards and Actions

Treatment

Standard 4: Treatment models and practices are effective and evidence-based.

Action 4.1: Treatment services to provide a model of care for eating disorders that is effective and evidence-based.

Action 4.3: Treatment services to routinely collect data to evaluate outcomes and inform service and sector continuous quality improvement.

Standard 8: Treatment is affordable.

Action 8.1: Government and health services to ensure that all public mental health services provide eating disorder services consistent with the needs of their regions. 

Community-based intensive treatment

Standard 1: People can access a community-based intensive treatment option delivered close to home or virtually (e.g., day programs, intensive outpatient programs, outreach support).

Action 1.1: Commonwealth, state/territory governments and regional planners to support additional community-based intensive treatment options, due to significant gaps for step-up and step-down treatment. 

Action 1.2: Researchers, in conjunction with service providers and people with lived experience, to co-produce further research into existing and innovative high intensity community treatment models, including models which meet the needs of underserved and higher risk groups.