CURRENT PROGRAMS AND PROJECTS

Practice Works Clinic Support Program

Practice-Works has been developed as an ongoing clinic support program which includes a range of activities in four service areas:

• Accreditation
• Information technology
• Practice management
• Practice workforce

By providing in-clinic assistance, training and networking opportunities for GPs and practice staff, this program is facilitating continuous quality improvement within General Practices. Activities include GP Business Advantage professional development program, structured Information Technology (IT) training, practice staff network, and accreditation survey rehearsal visits.

GPs and staff have readily accepted this program, and no significant problems have been experienced in its implementation. The practice staff network, which provides training opportunities otherwise unavailable in the local area, has been an aspect of the program that has been particularly well received.

Better Practice in Diabetes Care Program

This program aims to improve the quality of diabetes care in General Practice, and to improve the health outcomes of people with Diabetes/Cardiovascular Disease (CVD). The program aims to identify Type 1 and Type 2 diabetes early, and prevent Type 2 diabetes.

Initially, the program objectives will be to assess the local needs of GPs in diabetes. Next, to assist GPs to improve their care for people with diabetes. This will be threefold, to equip GPs in early identification, diagnosis and management of diabetes. Also, to establish systems for recording the process and outcomes of care, recalling patients with diabetes, promoting GP networks with other allied health and community service providers for optimal coordination and continuity of care, and aassisting with clinical practice audits comparing actual practice against best practice guidelines.

To date, the program has achieved a Patient Satisfaction Survey of People with Diabetes, Diabetes Patient Record Audit and a Clinical Audit.

Resources to General Practitioners in pilot include a Blood Glucose Monitor, posters for waiting rooms, and a GP

Information Kit encompassing:

• Guidelines for the Detection, Diagnosis and Management of people with Diabetes,
• Instructions on the Clinical Audit,
• Patient Information resources,
• GP Information resources, and
• Instructions on claiming medical Benefits Schedule (MBS) Items.

Also, the Division has developed report pads for Podiatrists, Dieticians and Diabetes Educators for feedback to GPs after a consultation with a person with diabetes. Currently, the Division is conducting six-monthly Audit linked Continuing Medical Education (CME) Activities, as well as monthly Diabetes Executive Group Meetings and three monthly Diabetes Reference Group Meetings.

The program has helped GPs to put in place structures of a best practice management of people with diabetes, and to coordinate the care of GPs with other health services.

Immunisation Program

The program aims to increase the role of GPs in immunisation through the provision of updated information and skills. As well as increasing the efficacy of immunisation management, the program is targeting community misconceptions regarding the necessity for and safety of immunisation. Also, it is providing practical support to GPs in improving practice immunisation rates, and increased communication between GPs, La Trobe and Baw Baw Shires and other key stakeholders related to immunisation.

So far, all practices have received between two - ten visits with a majority of GPs assisted to meet immunisation best practice standards re schedule, administration and contraindications. Practices have received assistance with education of correct vaccine storage and management with provision of cold chain audits and datalogging. The Division is conducting a successful community awareness campaign regarding the importance of immunisation. Other achievements of the program include the majority of GPs registered with and, reporting information to, the ACIR, a greater number of Divisional members benefiting from the GP II payments, and the liaison with allied health providers to improve coordination of immunisation information and skills within the Division area. Also, data cleaning services provided have shown an improvement of 7 - 10% of immunisation rates within the clinic.

Information Technology Program

The program aims to encourage and enable effective use of Information Technology (IT) throughout the Division as part of an overall communication system. To date the program has:

• Increased the knowledge and awareness of computers amongst GPs and practice staff.
• Improved GP access to medical software.
• Facilitated access to medical and computer information, including training courses.
• Reduced the paperwork and time involved in transferring patient notes between practices and with pathology services.
• Improved and maintained the computer skill levels of clinical and non-clinical staff.
• Provided stronger links are being built between GPs, health service providers and the Division.

Doctors for Farm Health Program

The program aims to improve the rate of detection for health issues such as skin cancers, cardiovascular disease and diabetes for farming families through activities such as at Farm World, and Lardner Park Field Days in March each year. The program means that farmers and farming families have had improved access to GP services. As a result, there has been earlier detection of skin cancers, high blood pressure and diabetes or 'at risk' status, and those detected as at risk have been referred to their own GP.

Adolescent Health Program - 'The Clinic'

This joint 18-months pilot project is conducted between the Division, the West Gippsland Health Care Group and the Directorate of Education through the State Government's 'Turning the Tide' initiative.

'The Clinic' operates between 3:30 pm and 5:30 pm each Monday afternoon and provides services from local General Practitioners, Community Health Nurse, Youth Worker, Drug and Alcohol, and Youth Housing. It aims to create a supportive environment in which young people can present their health concerns, have them heard and acted upon, in partnership and where their health choices and behaviour can be improved. Such a program takes some time to be accepted and accessed by young people. In excess of 100 young people have used the project with 30% making return visits. The Division's involvement in the pilot will cease on 30 June 2000. However, the program will continue under the auspice of the West Gippsland Healthcare Group.

Health Promotion Program

The aim of the program is to involve GPs in addressing topical and local health needs, as required, and encourage GPs to work together with other local health service providers in health promotion, screening and education. The Division has built a close working relationship with both the Latrobe Community Health Service and the West Gippsland Health Care Group in conducting community-based health promotion activities.

Division GP members provide monthly health promotion articles for local newspapers and deliver talks to schools, community organisations and other groups on various health issues including sex education, depression, women's health and men's health.

Locum Program

The program commenced in February 1998 and aims to assist GPs to take annual and Continuing Medical Education (CME) leave, and cover sick leave. One full-time locum GP is employed/contracted to the Division at any one time and is made available to GPs/practices by a booking system. The service has been heavily subsidised, but the Board has made a conscious decision to provide the service on a 'cost neutral' basis in 2001.

Since the inception of the program, the locum has been fully booked up to six months ahead. Four locums have been used during this time, two by direct employment and two through Global Medical staffing. The service has proven very popular, with approximately 40 % of GP members having directly used the service. This has enabled them to take well-earned rests from their practices and has been of particular benefit to sole practitioners.

Continuing Medical Education Program

The program, which is in addition to the Practice Works program educational activities, aims to provide relevant, responsive, effective and quality Continuing Medical Education (CME) programs to member (and other) GPs and practice staff within the Division.

When planning education events, consideration is given to local health needs identified through the Division's needs assessment. Each of the educational dinners held in 2000 have been very successful with an average of 20 - 25 GPs in attendance. Topics have included sports injury, skin rashes, cognitive behaviour, pain management, ADD & ADHD, paediatric emergencies and travel medicine.

The annual conference was also highly successful with attendance by 32 GP members and GP Registrars. Four concurrent clinical skills workshops were held each day over the weekend conference. These workshops covered removal of lesions, application of acupuncture in General Practice, ECG assessment, reading x-rays, joint injections, minor eye procedures, interpretation of pathology results, and common fracture management and plastering. The Division has also supported and assisted pharmaceutical companies in conducting educational dinners.

Community Liaison Program

The program aims to have consumer feedback integrated into the planning, policy and service delivery areas of the Division through establishment of a Consumer Reference Group. A Consumer Reference Group comprising five community representatives and two GPs has been established and is in its infancy. The CRG will make a positive contribution to the future direction of the Division.

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