Integrated Chronic Disease Management (ICDM)

The Integrated Chronic Disease Management (ICDM) program aims to support people with Chronic Disease to have a better quality of life and experience fewer complications. 

The ICDM Clinical Nurse Consultant helps clients to be active in their own care by setting realistic goals and providing education, advice and support for ongoing self-management. This may include identifying other health professionals, support groups, rehabilitation programs and community resources to help clients achieve their goals and gain a deeper understanding of managing health conditions.

The ICDM team provides education, advice and support for ongoing self-management of chronic disease to help people prevent further deterioration in their health. 

The process involves taking a detailed history, including medical and social factors. The Clinical Nurse Consultant (CNC) helps clients learn to manage their health and develop a self-management plan. The CNCs have an extensive knowledge of resources and support available in our region and can link clients into these.

Referrals
Clients can be referred either by their GP, Allied Health Professional, Nurse or self-referral.

Complete the Referral Form below or self-refer by phoning Access: 5671 3333.

Admission Criteria
The service is available to people residing in the catchment area of Bass Coast Health with a chronic disease who would benefit from health coaching and goal setting. 

Exclusions apply to people at high risk of hospital admission in the next four weeks. They can be redirected to the Hospital Admission Risk Program (HARP) via phoning Access: 5671 3333.

Availability

• Wonthaggi, Tuesday and Thursday, 8am to 4pm. Phone 5671 3343
• Cowes, Thursday and Friday, 8am to 4pm. Phone 5671 2100.