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Infectious Diseases Clinics (IDC) outpatient service in Central Adelaide

Central Adelaide Local Health Network (CALHN) Infectious Diseases Units located at the Royal Adelaide Hospital (RAH) and The Queen Elizabeth Hospital (TQEH) provide inpatient, outpatient and ambulatory services for patients who have been diagnosed with an infectious disease (ID) or who are at risk of an infectious disease.

Services are also provided to patients referred from rural and remote areas.
Children are usually managed by paediatricians with referral to the Women’s and Children’s Hospital.

Depending on the clinical need, adolescents can be managed at the RAH or TQEH with various approvals required.

Referral process

Medical emergency

For any patients who require emergency/immediate assessment, they should be sent directly to the emergency department for further for assessment.

Emergency conditions include:

  • Returned travellers with fever
  • Newly diagnosed HIV requiring admission
  • Malaria

Urgent referrals

  • Where consultation is 'same day' urgent, the infectious diseases registrar should be contacted via the RAH switchboard (08) 7074 0000 or TQEH switchboard (08) 8222 6000 to discuss the patient. 
  • A written referral marked URGENT should then be faxed to:
    RAH: (08) 7074 6247
    or
    TQEH: (08) 8222 7188
    or
    sent with the patient if urgent assessment has been arranged. 
  • If the condition is life-threatening, the patient should be sent to the nearest emergency department.
  • At RAH, there is a rapid assessment (RASS) clinic for relevant clinically urgent matters. The RAH IDC staff will coordinate this style of rapid appointment with the patient or referrer. Next day ad hoc review at TQEH can be arranged as required by contacting the ID registrar (08) 8222 6000.

Contact outpatient details

All other referrals must be in writing and sent or faxed to either the RAH or TQEH. Please refer to contact details below.

Royal Adelaide Hospital (RAH)

Outpatient Department, Level 3, ZoneE.2
Port Road, Adelaide SA 5000

  • RAH fax (for referrals): (08) 7074 6247

Appointment enquiries, review or change and new case appointments

  • RAH Infectious Diseases Clinic telephone: 1300 153 853

The Queen Elizabeth Hospital (TQEH)

Outpatients area (Mondays and Fridays Area 2, Tuesdays Area 4)
Ground floor, TQEH
28 Woodville Road, Woodville South SA 5011

  • TQEH fax (for referrals): (08) 8222 7188

Appointment enquiries, review or change and new case appointments

  • TQEH Infectious Diseases Clinic telephone: (08) 8222 7020 or (08) 8222 6384

Referrals are screened and triaged to an urgent, semi-urgent or non-urgent appointment. The quality of the information provided will influence when an appointment can be made and if there is insufficient information then a request will be made for a new referral before an appointment is given.

Please include in the referral as much information as possible including:

  • history of onset of condition
  • duration of symptoms
  • past medical and surgical history
  • current medication list, and recent treatment or changes
  • records of vaccination /immune status where relevant such as  pneumovax, influenza, hepatitis A, hepatitis B
  • travellers – destination travelled, duration, vaccinations prior to travel and malaria prophylaxis where relevant
  • risk factors – IV drug use, sexual orientation and behavioural risk, type of occupational exposure
  • reports of relevant recent investigations, such as blood tests, imaging studies.
    For recommended tests prior to review for HIV/viral hepatitis, see clinical information sheets below:

    Viral hepatitis Central Adelaide Infectious Diseases outpatients (PDF 111KB)
    HIV Central Adelaide Infectious Diseases outpatients (PDF 204KB)

Non-urgent referrals will be allocated to the next available appointment and may incur a wait. The waiting time for appointment will vary and is dependent on the demand for this service and the medical urgency of the patient’s condition.

Should changes occur to a patient’s medical condition during the waiting time for an appointment, referrers should send updated clinical information and where appropriate, contact the Infectious Diseases registrar via the RAH switchboard on (08) 7074 0000 or TQEH switchboard on (08) 8222 6000.

Services and clinics available

Services provided:

  • outpatient clinical consultations for diagnosis and management
  • inpatient consultations
  • inpatient admission
  • ambulatory outpatient intravenous antibiotic management.

There are many people that attend our clinic that require ongoing specialised assessment, supervision and medication from one of our infectious diseases clinicians, for example human immunodeficiency virus (HIV) management. Other patients may require a period of ID specialist supervision followed by discharge from the clinic, for example hepatitis C assessment and treatment. For some patients, a shared care arrangement is most suitable.

In other conditions, the objective of an infectious diseases outpatient appointment is to provide an assessment of the patient, an opinion regarding the key clinical issues and advice to the patient and the referring practitioner over one to two visits followed by formal discharge from the clinic.

A variety of clinics are held. Patients are seen by a consultant medical physician or an advanced trainee (registrar) in infectious diseases, or a resident medical officer (RMO), and / or a specialist infectious diseases nurse with direct supervision by a consultant.  

Our services / procedures

Conditions

  • Newly diagnosed HIV or symptomatic HIV infection (for symptomatic- call and discuss with on call ID registrar for directions on triage)
  • Newly diagnosed HIV requiring admission (send directly to emergency department)
  • Returned travellers with fever (send directly to emergency department)
  • Malaria (send directly to emergency department)
  • Viral hepatitis (symptomatic-discuss with on call gastroenterology registrar or ID registrar)
  • Hepatitis B, hepatitis C (about to undergo on immunosuppression, chemotherapy, pregnancy, marked change in liver function (LFT’s) 5x upper limit of normal)
  • Patient on IV antibiotics
  • Symptomatic infections, such as UTI with multi-resistant organisms

Post discharge guidelines and information

If the patient or their general practitioner is concerned about a deterioration in the medical condition and infectious diseases assessment is required earlier than planned, a phone call to the RAH switchboard on (08) 7074 0000 or TQEH switchboard on (08) 8222 6000 asking to speak with the ID registrar on call will facilitate appropriate change in treatment or earlier review.

A patient whose medical condition has stabilised or resolved and for whom no further appointment has been made will be formally discharged.

If infectious diseases assessment is required again, a new referral, preferably a named referral (see consultant lists) should be faxed to the IDC on (08) 7074 6247 or the TQEH on (08) 8222 7188.

Infectious diseases priorities based on clinical urgency as displayed below:

Priority Examples
(not an exhaustive list)
Investigations needed prior/what to bring to OPD appointment:
Immediate priority
Direct to an emergency department

Newly diagnosed and
symptomatic HIV infection
or requiring admission

Returned travellers with fever

Malaria

Results if any investigations already performed

Detailed history

Up to date list of medications

See clinical information sheets for HIV/viral hepatitis

Referral process: Must be discussed with the infectious diseases registrar via RAH switchboard on (08) 7074 0000 or TQEH switchboard on (08) 8222 6000.
A written referral marked URGENT should then be faxed to (08) 7074 6247 or TQEH on (08) 8222 7188 or sent with the patient if urgent assessment arranged. If the condition is life-threatening, the patient should be sent to the nearest emergency department.
Urgent (Category 1)

Condition has the potential to require more complex or emergency care if assessment is delayed.

Condition has the potential to have significant impact of quality of life if care is delayed.

Recently discharged hospital patients receiving IV antibiotics

Newly diagnosed HIV infection

Hepatitis B and C patients with the features listed below:

>  about to undergo 
    immunosuppression 
    (for autoimmune disorders
    or rheumatological conditions)

>  those about to
    undergo chemotherapy

>  pregnancy

>  recent acquisition of virus

>  marked change of liver
    function test (LFT)
    from baseline or > 5x 
    upper limit of normal

Symptomatic infections, such as urinary tract infections (UTI) with multi-resistant organisms 

Results of any investigations already performed

Detailed history

Up to date list of medications

For recommended tests prior to review, see information sheets for HIV/viral hepatitis
Referral process: Monday to Friday, 9 am to 5 pm. 
Must be discussed with the infectious diseases registrar on call via RAH switchboard on (08) 7074 0000 or TQEH (08) 8222 6000 to obtain appropriate prioritisation and then a referral letter marked URGENT faxed to RAH (08) 7074 6247 or TQEH 8222 7188.
Semi urgent (Category 2)

Condition is unlikely to require more complex care if assessment is delayed.

Condition has the potential to have some impact of quality of life is care is delayed.

Viral hepatitis with persistently elevated liver function tests

Recurrent skin and soft tissue infections

Recurrent UTI

Parasitic infections

Results if any investigations already performed

Detailed history

Up to date list of medications

See clinical information sheets for HIV/viral hepatitis
Referral process: Referrals should be faxed to RAH (08) 7074 6247 or TQEH (08) 8222 7188.
Early assessment may be facilitated by addressing the referral to an infectious diseases consultant by name as this opens additional assessment opportunities.
Intermediate
Condition is unlikely to deteriorate quickly.


Referral process: Referrals should be faxed to RAH (08) 7074 6247 or TQEH (08) 8222 7188.
Non-urgent
Low priority
Do not usually need to see an ID physician unless there are atypical features.
Referral process: Referrals should be faxed to RAH (08) 7074 6247 or TQEH (08) 8222 7188. Low priority for appointment.

Note

It is important to note these guidelines indicate what is clinically desirable, not what is always feasible in terms of delivery which is dependent on size and staffing of the hospital department.

Referrals unlikely to be offered an appointment

Referrals for outpatient appointments from the emergency department (ED) are generally accepted, but we would encourage that the person’s general practitioner should be involved in all communication and care.  We do accept ED referrals for post exposure prophylaxis (PEP).

Transfer of care from another specialist may be accepted. A referral for continuing care (indefinite referral) from a general practitioner, addressed by name to an infectious diseases physician is preferred.

Referrals from other outpatient clinics at the RAH or TQEH may not be accepted unless specific infectious diseases input is required for the condition for which the patient is already attending a hospital outpatient clinic.

For further information on eligibility and referral processes see the outpatient referral process page.

Alternate care options / health information for low priority conditions while waiting for an appointment or if no appointment is made

  • Not all patients with infectious disease conditions can be offered appointments in the CALHN ID clinics.
  • In most cases, the key to appropriate management is a detailed history and examination. Options for obtaining further information regarding various infectious diseases conditions and to provide guidance for assessment, investigations and management are listed under infectious diseases clinical information sheets located at the end of this web page.

RAH Outpatient infectious diseases clinics

Day Clinic (RAH) Doctors Condition seen
Monday
am
Infectious Diseases Dr Brett Ritchie (M)
Dr Reny Nelson(M)*
HIV, viral hepatitis and general ID
Monday
pm
Infectious Diseases Dr Emily Rowe (M)
Dr Morgyn Warner*
All: HIV, viral hepatitis and general ID
Tuesday
am
Genito-urinary Medicine (GUM) Mahesh Ratnayake (M)
Dr Charlotte Bell (M)
HIV, viral hepatitis and general ID
HIV, Hepatitis C, sexual health
Wednesday
am
Infectious Diseases Dr Jennifer Catford (M) HIV, viral hepatitis and general ID
Wednesday
pm
Infectious Diseases A/Prof David Shaw (M) HIV, viral hepatitis and general ID
Thursday am Infectious Diseases
Sexual Health
Sexual Health Psychiatry
Dr Narin Bak (M)*
Dr Russell Waddell (M)
Dr Andrew Beckwith (M)
HIV, viral hepatitis and general ID
HIV, hepatitis C, sexual health
HIV, hepatitis C, sexual health
Psychiatry HIV, hepatitis C
Thursday
pm
Infectious Diseases
Psychiatry
Dr Andrew Beckwith (M) Psychiatry HIV, hepatitis C
Friday Infectious Diseases
Dr Brendan Kennedy
HIV, viral hepatitis and general ID

Bulk bill clinics (named referral required)

  • (M) above denotes clinicians who provide a Medicare bulk-billed clinical service and prefer a named referral. Gap fees are not charged to any patient seen in the infectious diseases clinics.  
  • * Also see outpatients at TQEH

TQEH Outpatient infectious diseases clinics 

Day Clinic (TQEH) Doctors Conditions seen
Monday am
Area 2
Infectious Diseases Dr Narin Bak (M)* HIV, viral hepatitis
Tuesday am
Area 4
Infectious Diseases A/Prof Ross Philpot HIV, viral hepatitis and general ID
Sexual health
Friday am
Area 2
Infectious Diseases Dr Morgyn Warner*
Dr Renjy Nelson (M)
HIV, viral hepatitis and general ID

Bulk bill clinics (named referral required)

  • (M) above denotes clinicians who provide a Medicare bulk-billed clinical service and prefer a named referral. Gap fees are not charged to any patient seen in the infectious diseases clinic.
  • * Also see outpatients at RAH.

Infectious diseases clinical information sheets

The following information sheets about presentations commonly seen in the infectious diseases outpatients provide the minimum information required for assessing a referral under the headings of: eligibility, priority, differential diagnosis, clinical information and investigations required, pre-referral management strategies and discharge criteria.

 

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