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Multidisciplinary Ambulatory Consulting Service (MACS) outpatient services in Central Adelaide

The Central Adelaide Multidisciplinary Ambulatory Consulting Service (MACS) clinic provides inpatient and outpatient services for patients living in the Central Adelaide Local Area Health Network (CALHN) with multiple and complex chronic conditions who are at risk of hospitalisation or require optimisation of medication and care. MACS is a non-diagnostic clinic. Priority care is provided to:

  • patients requiring complex medical management with multiple specialist input
  • those at risk of frequent presentation to hospital emergency departments
  • those requiring medication optimisation
  • patients transitioning from paediatric chronic care management to an adult facility.

Contact details - outpatients

  • Clinic fax (for referrals): (08) 7074 6247
  • Appointments: appointment enquires and new case appointments: (08) 1300 153 853
  • Review / change of appointments: (08) 1300 153 853

Appointment location - outpatients

Royal Adelaide Hospital (RAH)

  • Level 3 Outpatients 
    RAH, Port Road, Adelaide SA 5000
  • Clinical Pharmacology Department (clinic referral and triage hub):
    Level 3, RAH, Port Road, Adelaide SA 5000

Staff and clinic days

Royal Adelaide Hospital (RAH)

Day / time Doctors attending Referral criteria Conditions seen (but not limited to)
Monday   Multiple and complex medical conditions where care is often shared across many specialties.
Patients requiring medication optimisation.
Patients requiring health/medical optimisation.
Patients requiring further health education and support for effective self-management. Health education and self-management strategies and toolkits provided with ongoing support.
Chronic heart failure
Ischaemic heart disease
Hypertension
Diabetes
Atrial fibrillation (AF)
Deep vein thrombosis (DVT)
Warfarin management (new)
Renal failure
Chronic anaemia
Autonomic dysfunction
Chronic obstructive pulmonary disease
Tuesday am Dr Sepehr Shakib
Professor Anne Tonkin
Dr Liza Phillips
Tuesday pm Dr Rami Tadros
Wednesday  
Thursday pm Professor Anne Tonkin
Friday pm Dr Josephine Thomas
Exclusion criteria
Residents living in high level of care facilities.

Bulk bill clinics: (named referral required)

  • Dr Sepehr Shakib
  • Dr Rami Tadros
  • Dr Josephine Thomas
  • Dr Liza Philips

Conditions by urgency category and referral process

Priority Examples (not an exhaustive list) Referral process
Immediate Decompensated heart failure
Significant oedema
Shortness of breath
Chest pain
Monday to Friday – discussed with the clinical pharmacology registrar via RAH switchboard: (08) 7074 0000
After hours: refer directly to the emergency department
Urgent Heart failure with reported oedema and/or shortness of breath.
New heart failure diagnosis.
Symptomatic autonomic dysfunction.
Monday to Friday – discussed with the clinical pharmacology registrar via RAH switchboard (08) 7074 0000
Referrals faxed to RAH:
(08) 7074 6247
Semi-urgent Overview of symptomatic disease and co-morbidities
Review of symptomatic drug interactions
Post hospital discharge review (for chronic disease admission)
Monday to Friday, 8.00 am to 4.00 pm – discuss with clinical practice consultant: via switchboard (08) 7074 0000 to obtain appropriate prioritisation and then fax referral to RAH:
(08) 7074 6247 (named referral is preferred)
Intermediate Heart failure with no ‘acute’ symptoms but requiring optimisation
Autonomic dysfunction for optimisation
Referrals faxed to RAH:
(08) 7074 6247 (named referral is preferred)
Non-urgent Long standing chronic disease management – maintenance care.
Long standing autonomic dysfunction
Referrals faxed to RAH:
(08) 7074 6247 (named referral is preferred)
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 the size and staffing of the hospital department.

Post discharge guidelines and information

If the patient, or their general practitioner, is concerned about a deterioration in the medical condition, and assessment is required earlier than planned, a phone call to the RAH Clinical Pharmacology Department on (08) 1300 153 853 will allow this to be discussed with one of the clinical pharmacologists.

Patients whose medical condition has stabilized and for whom no further appointment has been made will be formally discharged. If re-assessment is required, a new referral, preferably a named referral (see consultant list), should be faxed to the RAH Clinical Pharmacology Department on (08) 7074 6247.

Clinical information sheets

The following information sheets 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.

Patient information sheets

In addition, a number of patient information sheets have been developed for patient to assist in understanding and manageing autonomic dysfunction conditions. These include:

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