Ideas for Improvement

Practices involved in the APCC Program are generating hundreds of bright ideas for improvement to try out in their practices. Here, practices 'share generously' some of these ideas. Clink on the links below to be taken to each ideas section. 

Are you an APCC practice? Do you have a bright idea that worked in your practice that you'd like to share with others? Click here to send us your idea. (Remember to include your practice name and state)

Build the practice team

Change your business

Be systematic and proactive in managing care

Involve patients in delivering & developing their care

Identify effective links with key local partners

 

Build the practice team

  • Provide cultural awareness training for your staff.
  • Create a weekly practice staff newsletter to keep everyone ‘connected’.
  • Document changes in roles and processes to embed new systems.
  • Orientate new staff in the practice to the APCC program and get their feedback. They will have some great ideas to share! But, don’t forget to evaluate it!
  • Make it easy for the practice staff by providing data submission calendars and resources to the practices can help make their Collaborative journey smoother.
  • Try to resolve IT related issues early. If you can resolve issues early, practice motivation is more easily maintained.
  • Explore the barriers and find ways to overcome them. The barriers in reality may be quite small but may seem huge while at the coal face.
  • The carrot is mightier than the stick! Demonstrating the benefits is a lot easier (and a lot more pleasant) than reminding staff of contractual obligations.
  • Spend time with those staff who are resistant to change. If you can engage these staff early, barriers can be quickly overcome and progress is much easier to make.
  • Keep an eye out on the Rural Health Education Foundation website for upcoming education programs for GPs and practice nurses. Podcasts are now available for many of the PHEF programs. For a list of available programs, visit: http://www.rhef.com.au.
  • Encourage your clinical and non-clinical staff to participate in professional development activities, for example:
    • Practice Managers Certificate IV and Diploma;
    • Computer courses;
    • All CDM, EPC and Practice Nurse MBS item number training;
  • Develop training skills in some staff so they can educate other staff at the practice about the Collaboratives and 'systems' thinking. 

 

How healthy is your team?

Use the Team Health Check questionnare to survey your team then collate the results in the Health Check spreadsheet to assist with the collation and presentation of feedback.

 

Change your business

  • Consider using templates, for example:‘12 minute’ slips to keep appointments to time;
    • ‘12 minute’ slips to keep appointments to time;
    • ‘Encounter’ slips for patients to list the issues they wish to discuss with their GP. This will be handed to the GP at the beginning of the appointment;
    • ‘Fit-in’ slips so patients understand their GP will only deal with the urgent matter at that time;
    • ‘Follow up’ slips with priority ratings to assist reception to enter a timely next appointment;
    • ‘Patient history update’ slips – include ‘stopped smoking’, ‘started smoking’, etc.
  • Script/referral emails to streamline communication between GPs and front desk.
  • Change last 3 appointments in each session to 10 minute appt instead of 15 minutes, for recall appointments as most recalls only need shorter appointments.
  • Develop a 4 week trial of 10 minute recall appointments for an hour at end of each session with one GP to free up GP time.
  • Use a ‘buddy system’: Each GP will be allocated a practice nurse to work in the room beside the GP to commence the GP Management Plan (GPMAP) or Team Care Arrangement (TCA) with the patient and organise referrals points as needed. The patient will then see the GP for completion of the GPMP/TCA.
  • Use a triage flowchart so staff can quickly assess patients needs.
  • Develop a schedule of times for practice nurse tasks so reception can allocate adequate amounts of time e.g. 20 minutes for a dressing, 45 minutes for GPMP preparation.

Be systematic and proactive in managing care

  •  Identify patients on chronic disease registers who smoke and send a recall letter with a Lifescripts smoking assessment form attached for a follow up consultation.
  • Source CHD resources from Heart Foundation with the aim of improving and standardising patient information and distribute these to CHD patients.
  • Prevent leg amputations and improve shared antenatal care: Purchase a venous doppler that can double up as a foetal doppler and records results directly into clinical software.
  • Put a system in place to ensure that all patients seen over a 2 month period have a weight, height and BMI documented in their clinical record.
  • Create templates in clinical software to include the goals/recommendations of national guidelines (i.e. Diabetes Management in General Practice 2008?09, Red Book, Heart Foundation)
  • Roster a rural locum to return on a monthly basis to run CHD clinics.
  • Implement a “red sheet” diabetes summary for every diabetic patient using ‘team centric documents‘ from the Doctors’ Control Panel (DCP). Doctors will be encouraged to use the “red sheets” and be prompted to improve their management of diabetic patients utilising the diabetes cycle of care.
  • Improve cholesterol level control on diabetic patients. Identify the number of patients with cholesterol > 4mmol/l and non recorded. Use this information to remind doctors about the importance of cholesterol control and to develop patient education.

Involve patients in delivering & developing their care

  • Advise patients with consistently high BP to get a home BP monitor. Ask the patients to measure and report their physical activity levels and monitor for improved BP control
  • Establish an insulin support group to improve the care of patients with poorly controlled diabetics.
  • Design a patient survey to be circulated to all patients so that information around a number of issues can be collected.

Identify effective links with key local partners

  • Practice team obtained pedometers and skipping ropes from the Division to get all staff skipping and walking. The aim is for practice member act as mentors for the local community.
  • Obtain Pedometers from local reps to issue to patients in order to get them involved in the 10,000 steps program.
  • Making CDM more understandable to patients by developing hand held records and more detailed recall letters.
  • Align care planning for a particular disease group with promotion events for that disease run by local health, newspapers, national bodies etc.
  • To encourage our CHD patients to be more active. Implement regular exercise regime for CHD patients and any others who wish to join. Contact local council and get posters and information re walking programs in local area.
  • Introducing the food portion plate for diabetic patients to assist in weight management BSL’s.
  • Hold regular meetings with Allied Health Providers employed/contracted to your surgery to improve communication and integration. 

Last Updated 05 June 2014