Respiratory and sleep thoracic medicine outpatient service at CALHN

The Central Adelaide Local Health Network (CALHN) Respiratory and sleep (thoracic) medicine service delivers a multi-disciplinary inpatient, ambulatory and outreach specialist respiratory and sleep service for standard and complex disorders.

Referrals to the department are triaged by a senior consultant. Appointments will be allocated based on urgency, complexity and need for specialist input, and will depend on the detailed written and faxed information provided in the referral.

Outpatient contact details

Royal Adelaide Hospital (RAH)

From Monday 10 December 2018, Chest Clinic Services previously located at 275 North Terrace (Cystic Fibrosis, Lung Transplant and Tuberculosis) will be relocating to the (RAH.

Fax (for referrals): (08) 7074 6248

Appointment enquiries, new cases and review or change of appointments: Chest Clinic - Telephone (08) 7117 2900

The Queen Elizabeth Hospital (TQEH)

Fax (for referrals): Outpatients (08) 8222 7244

Appointment enquiries and new case appointments: Outpatients - Telephone (08) 8222 6998 or (08) 8222 6374

Review or change of appointments:

  • Outpatients - Telephone (08) 8222 7020
  • 4a Respiratory Unit Outpatients - Telephone (08) 8222 6670

Appointment locations

Royal Adelaide Hospital (RAH) Chest Clinic

Department of Thoracic Medicine
3D Chest Clinic or 3E Wing 2
(Cystic Fibrosis, Lung Transplant and Tuberculosis)
Port Road, Adelaide SA 5000

Telephone: (08) 7117 2900

Fax: (08) 7074 6248

The Queen Elizabeth Hospital (TQEH)

Respiratory Medicine Unit
Level 4A Outpatient Department
28 Woodville Road,
Woodville South SA 5011

Telephone: (08) 8222 6670

Fax: (08) 8222 6041

Services

State-wide programs

  • SA tuberculosis program (at RAH only)
  • SA adult cystic fibrosis program (at RAH only)
  • SA lung transplantation program (at RAH only)
  • SA specialised interventional pulmonology programs (at RAH only)

General respiratory and sleep programs – at RAH and TQEH

  • COPD
  • Respiratory failure, upper airway and other sleep disorders
  • Lung cancer and other malignancies
  • Asthma
  • Pleural disorders
  • Interstitial lung disorders
  • Occupational lung disorders
  • Pulmonary vascular disease/pulmonary hypertension
  • Complex lung disease related to other organ transplantation
  • Rare lung disorders

Services and clinics

  • Ambulatory and community clinics for diagnosis and management
  • Inpatient admission and consultation
  • Lung function laboratory
  • Sleep disorders and ventilatory failure Investigation and treatment Service (VFITS)
  • Thoracic procedures
  • Pulmonary rehabilitation
  • Home oxygen

Rural outpatient clinics

Services are also provided to patients referred from rural and remote areas in SA/NT.
Off-site clinics are located in:

  • Whyalla
  • Port Augusta
  • Alice Springs
  • Coober Pedy
  • Riverland (Berri and Barmera)
  • Ceduna
  • Port Lincoln

Indigenous clinics

  • Pika Wiya
  • Nunyara
  • APY Lands
  • Yalata
  • Oak Valley
  • Tjuntjuntjara

Respiratory and sleep outpatients

Although many respiratory and sleep conditions require supervision from a physician long term, wherever possible, the objective of a respiratory or sleep 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.

This particularly applies to lesser priority conditions which may have a longer waiting time for an appointment and for which specialised drug therapies and/or disease monitoring are not indicated.

Children

Children are usually managed by paediatricians with referral to the Women’s and Children’s Hospital or a paediatric respiratory and sleep physician as required.

RAH on site bulk bill consultants

  • Professor Paul Reynolds
  • Dr Arash Badiei
  • Dr Sally Chapman
  • Dr Dien Dang
  • Professor Mark Holmes
  • A/Prof Chien-Li Holmes-Liew
  • Dr Emily Hopkins
  • A/Prof Hubertus Jersmann
  • Dr Judith Morton
  • A/Prof Phan Nguyen
  • Dr Richard Stapledon (TB only – no charge)
  • Dr Vanessa Tee
  • Dr Michelle Wong
  • Dr Aeneas Yeo

TQEH on site bulk bill consultants

  • Dr Jonathan Polasek
  • Dr Andrew Fon
  • Dr Sanaz Lehman
  • Dr Anil Roy
  • Dr Zafar Usmani
  • Dr Antony Veale

Thoracic medicine priorities, including referral process

Thoracic Medicine priorities are based on clinical urgency

Immediate priority

Respiratory emergencies with threat to major organs.

Acute respiratory disease where admission is required.

Direct to an Emergency Department.

Examples of immediate priority

  • Acute or rapidly progressive shortness of breath or respiratory failure
  • Major haemoptysis
  • Acute asthma
  • Acute pneumothorax
  • New lung opacity in a clinically unstable patient
  • Suspected or proven tuberculosis

Referral process for immediate priority

If life-threatening, the patient should be sent to the nearest emergency department.

Otherwise, must be discussed with the thoracic registrar or the on call medical registrar if after hours, via switchboard on (08) 7074 0000 (RAH) or via (08) 8222 6000 (TQEH). Then fax a referral marked URGENT to (08) 7074 6248 (RAH) or (08) 8222 7244 (TQEH) or send with the patient if urgent assessment arranged.

RAH Cystic Fibrosis Service - Telephone (08) 7117 2900 between 8.00 am to 5.00 pm or the thoracic registrar/on call medical registrar if after hours, via RAH switchboard on (08) 7074 0000.

Urgent priority

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

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

Examples of urgent priority

  • New lung mass in a clinically stable patient
  • Significant or progressive dyspnoea
  • Severe sleepiness/ fatigue or suspected sleep related disorder impacting on patient or community safety
  • Unstable asthma
  • Other urgent issues
  • For Cystic Fibrosis (CF) (RAH only): potential new diagnosis

Referral process for urgent priority

Monday to Friday, 9.00am to 5.00 pm: Fax referral marked URGENT to (08) 7074 6248 (RAH) or (08) 8222 7244 (TQEH).

After hours: Thoracic registrar or medical registrar on call via switchboard (08) 7074 0000 (RAH) or (08) 8222 6000 (TQEH).

For Cystic Fibrosis (CF): 8.00 am to 5.00 pm: contact Cystic Fibrosis Service on (08) 7117 2900 to make an urgent appointment.

After hours: call CF registrar or consultant on call via RAH switchboard on (08) 7074 0000

Semi urgent priority

Requires specialist management but unlikely to deteriorate rapidly.

Examples of semi-urgent priority

  • Obstructive airways disease – (asthma/ COPD with ongoing symptoms)
  • New interstitial lung disease with ongoing symptoms
  • Suspected sleep disorder in a high-risk patient

Referral process for semi-urgent priority

Fax referral to the RAH on (08) 7074 6248 or TQEH on (08) 8222 7244.

Early assessment may be facilitated by addressing the referral to a respiratory or sleep consultant by name as this provides additional assessment opportunities.

Intermediate priority

Condition is unlikely to deteriorate quickly.

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

Examples of intermediate priority

  • Patients with stable respiratory conditions and able to function in the community
  • Suspected sleep disorder not impacting on patient, public safety or cardiovascular risk

Referral process for intermediate priority

Fax referral to the RAH on (08) 7074 6248 or TQEH on (08) 8222 7244.

Non-urgent priority

Low priority

Examples of non-urgent priority

  • Long standing cough with normal radiology
  • Snoring, no sleepiness, no heavy machinery/ heavy vehicle use or driving difficulty, no relevant co-morbidities
  • Respiratory or sleep conditions already under the care of other physicians, for which there is no active issue.

For CF: Non urgent issues

Referral process for non-urgent priority

Fax referral to the RAH on (08) 7074 6248 or TQEH on (08) 8222 7244.

Low priority for appointment

Patient may not be seen for a considerable period. Alternative specialist options may be obtained by phoning (08) 7117 2900 (RAH).

For CF: Phone (08) 7117 2900 between 8.00 am to 5.00 pm.

Referral process

All referrals including those urgently requiring consultation must be in writing.

Immediate referral process

Where consultation is same day urgent, the thoracic registrar or the on call medical registrar if after hours should be contacted via the RAH switchboard on (08) 7074 0000 or TQEH switchboard on (08) 8222 6000 to discuss the patient. 

A written referral marked urgent should then be faxed to the RAH on (08) 7074 6248 or the TQEH on (08) 82227244 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 immediately.

Less urgent/ non-urgent referrals

Cases will be triaged by a senior consultant and appointments will be allocated based on urgency, complexity and need for specialist input, and will depend on the detailed information provided in the referral. Non-urgent referrals will be allocated to the next available appointment, and may incur a wait. The waiting time for appointment will vary and be dependent on the demand for this service and the medical urgency of the patient’s condition. Respiratory and sleep problems which are not considered high priority (see eligibility and referral criteria) may wait a longer time for an appointment.

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

Alternate care options and health information for low priority conditions while waiting for an appointment

Please consider other options – advice concerning alternative respiratory or sleep physician input can be provided upon request (please note that patients may not be bulk billed) – please fax a written request for information on alternative referral sources to (08) 7074 6248 (RAH) or (08) 8222 6041 (TQEH) if required.

If multiple referrals/ appointments regarding the same presenting complaint are made, please cancel those which are not required, to enable the remaining appointment slots to be utilised efficiently.

Features indicative of potentially serious pathology

  • Haemoptysis
  • Severe or rapidly progressive shortness of breath
  • Suspected tuberculosis or tuberculosis exposure
  • Radiology finding of: lung mass/ lung opacity/ suspected malignancy
  • Sleepiness at risk of endangering self or others

Referrals for outpatient appointments from the emergency department will be accepted:

  • If related to the primary reason for presenting to the emergency department
  • If not related to the primary reason for presenting, referrals must be discussed with and accepted by the thoracic registrar – name of registrar must be written on referral.

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

Post discharge guidelines and information

Patients whose medical condition has stabilised or resolved and for whom no further appointment has been made will be formally discharged. If assessment is required again, a new referral should be faxed to the RAH Chest Clinic on (08) 7074 6248 or TQEH respiratory outpatients on (08) 8222 7244.

Respiratory and sleep clinical information sheets

The following information sheets about presentations commonly seen in respiratory and sleep outpatients provide the minimum information required for assessing a referral and advice about pre-referral management strategies.

If you wish to refer a patient who does not meet criteria, or you wish to discuss a patient prior to referral, please phone the thoracic registrar through the RAH switchboard on (08) 7074 0000 or TQEH on (08) 8222 6000.