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Northern Rivers GPs lead the way |
 The winning Hippicratics celebrate their win after performing songs composed by singer songwriter Dr Michael Pelmore and other members of the team, describing what they have done to improve their general practice.
The crowd could not get enough of a group of local GPs and practice staff, whose stage performance of “Our Journey”, a series of songs describing their achievements, won them the most innovative and creative story award at the National Primary Care Collaboratives workshop held in Melbourne in September.
Eight practices from the Northern Rivers are part of the national program that aims to improve general practice and ultimately patient outcomes. The program has been adapted from a successful British model that continues to produce significant results.
“We are implementing some innovative programs to improve our patient’s health here on the Northern Rivers,” said division chair Tony Lembke, whose Alstonville practice is participating in the program.
“The Collaboratives program gives us a mechanism to share our achievements with other practices so that we don’t keep reinventing the wheel. And of course we get to find out about the great ideas that other practices have already tested and refined.”
Six of the eight local practices attending the national workshop gave presentations on specific quality improvements made to their practices. Innovations by the Nimbin Medical Centre and Family Medical Ballina were awarded two of the top three awards.
Nimbin Medical Centre has come up with strategies to manage patients with heart disease proactively and Family Medical Ballina has improved patient access by re-assigning clinical work (see case study).
“These are small, simple innovations but they have a big impact on how we practice and that has positive effects on the health of our patients and the service we can give them.”
Eight more general practices are about to join the second phase of the program, with another eight to come on board early next year. Almost half the practices in the Northern Rivers area will have been involved in the program by its conclusion in 2008.
“The opportunity to work with our local colleagues has broadened our approach to achieving the best possible health in this region. It is an exciting program,” Dr Lembke said.
CASE STUDY
Improving access
Family Medical Ballina
How they did it using the PDSA process (Plan Do Study Act)
Aim
To review the spread of nursing duties to determine if restructuring of available appointments would enable the provision of chronic disease management within available hours.
Plan
Practice manager to monitor the spread of nursing duties over a three week period in August and compare the number of patients seen to the nurse hours available (38).
Do
Information was collated in the last week of August from register of patients in the treatment room and reviewed with the practice nurse.
Nursing duties divided into venipuncture and pathology testing, INRs, ear syringing, dressings and ROS, vaccinations and injections, spirometry, ECGs and Dopplers, minor surgery, general nursing care.
Study
Wednesdays and Thursdays are the quietest days reflecting fewer doctors practising on those days. However, patient-free time is used by the sister for nursing administration duties such as ordering stock.
Mondays are extra busy due to weekend follow-up. No childhood immunisations on this day would balance the load with other days.
The relatively even spread of duties and patients over three weeks reflected an efficient use of nursing services. However, no blocks of time were available for chronic disease care.
Act
- Undertake a review of the additional nursing hours needed to manage chronic disease care.
- No childhood immunisations to be done on Mondays.
- The current system of patient bookings with the nurse needs no immediate restructuring as the patient load is generally evenly spread.
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