CURRENT PROGRAMS AND PROJECTS

Accreditation Program

Throughout the year, the Division has provided a comprehensive support program to assist GPs to become accredited. The Division has provided up-to-date information, practice visits, infection control audits, practice policy and procedure manuals, practice brochure development and education sessions.

This work is supported by two GPs who are trained by Australian General Practice Accreditation Ltd. (AGPAL). These GPs have provided mock surveys and peer support to other practices. With funding from ADGP for an Accreditation Support Project, the Division has been able to enhance its work with its high number of solo GPs and GPs from culturally diverse backgrounds who have particular practice needs, and has developed a model of working with these groups.

The following presentations have been made to members:

• Information evening for Solo GPs on Accreditation
• Infection control for office-based practice
• Accreditation up-date for practice staff
• CPR, triage and first aid for practice staff

Information Technology Information Management Program

Monash Division is committed to helping GPs acquire and use computers for clinical purposes. Local GPs are using the following services:

Information Management/Information Technology Training Service

A comprehensive range ofy interventions. RACGP CME/PD points are allocated for all sessions. A limited range of PD opportunities are also available for practice managers/staff through the Practice Staff Network.

Practice-based Clinical Software and Internet Training for GPs

This onsite training service, piloted by the Division during September-November 1999, has an emphasis on developing hands-on skills related to the use of the Internet and clinical software. Evaluation by participating GPs is overwhelmingly positive.

GP Internet Training Manual

'Using the Internet to Find Clinical Information: from Chaos to Clarity' GPs have an ongoing need to keep up to date. Traditionally, this has been done by reading medical journals and books, and attending continuing medical education meetings. However, it is clear that the Internet will be added to this list which presents GPs with a problem: that of information overload. The Internet is not an easy source in which to find relevant and reliable clinical information. The aim of this manual is to improve the skills of GPs to use this medium for their ongoing clinical information needs. The manual, to be distributed to all Australian Divisions of General Practice, will be available in both paper-based and electronic formats.

Information Management/Information Technology Support Service

An independent 'vendor-free' advisory service intended to streamline the decision-making process associated with computerising or adopting the use of additional information and communication technologies. It is particularly helpful for GPs who are still uncertain where to buy computer software and hardware, and seek unbiased advice.

Information Management/Information Technology Interest Group for GPs

This interactive peer review forum is intended to promote the extended use of computers for clinical purposes - for example, introducing computerised recall and reminder systems.

Information Management/Information Technology Email Bulletin to GPs

This online information service is for GPs who practice within the Monash Division postcode boundaries who have supplied the Division with an email address. Its principal objectives is to stimulate information exchange via email between the Division and Monash Division GPs. The current focus is on Evidence-Based Medicine (EBM).

GP Mentor Scheme

The Division can arrange for interested GPs to visit the practices of those who have already computerised. Several GPs have agreed to provide this 'mentorship' based on their experiences in acquiring computers.

Health Promotion Program

The Health Promotion program aims to promote the adoption of an illness prevention and health promotion approach in General Practice, to support GPs in the adoption of a systematic approach to practice based preventive health strategies, and to promote the role of the GP in health promotion within the local community.

The Division provides:

• Training for either GPs or Practice Staff or both in motivational interviewing.
• Training in the use of reminder/recall systems.
• Provision of waiting room display kits.
• Smoking cessation workshop.
• Workshop on the RACGP "Green Book".
• Participation in the Active Script Program.
• Establishment of a Health Promotion Special Interest Group.

Healthy Ageing Program

This program aims to enhance the quality of life of older people through the development of preventive health activities. Specific activities which the Division has undertaken in this area are:

'Give Yourself A Present on Your Birthday' Project

The 'Give Yourself a Present on Your Birthday' project has been developed by the Division to target people in the 55 to 65 age group, encouraging them to have an annual health check with their GP. The program encourages GPs to take a more proactive role in health promotion and illness prevention with this age group. The resources that have been developed by the Division for this program are:

• A Lifestyle Questionnaire which people in the 55 to 65 age group complete prior to making an appointment with their GP.
• A Personal Health Record, which the patient retains to help them keep track of their own health checks. A key objective of this program is to reach those people in the 55 to 65 age group who have not been having health checks. The program was launched in May 2000 and will be widely promoted in the local community.

Wound Management

The Division offered practice visits by a nurse specialist to promote best practice in wound management. Three practices completed the six-week wound management clinic. Wound management Continuing Medical Education (CME) activities have been conducted and a workshop for practice staff was held.

Falls Prevention

The Division has been involved in the area of Falls Prevention through Falls Prevention CME activities and the provision of Falls Prevention Practice Audits. The Division is also participating in a joint Falls Prevention project, working with local government and other aged care services.

Immunisation Program

The Division has continued to work with GPs, practice staff and local government in promoting immunisation. The Division's activities in this area have included:

• Practice visits to provide information and practice staff training in areas such as the use of ACIR reports and recall/reminder systems.
• Vaccine supply service - the Division established its vaccine supply service in 1997 and the service has continued to provide a valuable back-up service to practices since its inception.
• Logging vaccine fridge temperatures.
• Monthly 'Immunisation Updates' in the Division newsletter.
• Immunisation CME activities and sessions for practice staff on various immunisation issues, including travel medicine, the ACIR and the new immunisation schedule.
• Immunisation history stickers developed by the Division.
• Collaborative activities with local government to increase community awareness of immunisation. The Division is working with three local councils in the promotion of immunisation. A number of joint initiatives have been implemented including education sessions for child care centre staff and immunisation newsletters distributed to parents and child care services.

Ethnic Health Program

The Division aims to ensure that each of its programs considers the needs of ethnic populations and implements strategies where possible. Ethnic health projects in which the Division has been involved in 1999-2000 are thalassaemia, Refugee Health and Drug and Alcohol Abuse:

Thalassaemia Project

The Thalassaemia Project is a joint initiative of the thalassaemia Society, the Thalassaemia Service and the Victorian Clinical Genetics Service (Southern Health Care Network) and Monash Division of General Practice. The project has been funded by the Department of Human Services.

The aim of the project has been to increase the rate of carrier detection for thalassaemia and haemoglobinopathies. The project has also involved studying the effectiveness of different educational strategies in GP genetic education. The project has developed clinical guidelines and educational materials relevant to general practice. The information has been disseminated to GPs via academic detailing and seminars. A total of 50 GPs (across two Divisions) have received academic detailing and 74 GPs have attended seminars, with a further seminar scheduled for June 2000. An evaluation report on the project is being prepared.

Refugee Health and General Practice Development Project

The Refugee Health Project is a joint initiative of four Divisions working in partnership with the Victorian Foundation for Survivors of Torture, Victorian Infectious Diseases Services, Victorian Transcultural Psychiatry Unit and the Department of Human Services. The project has been funded through the Commonwealth Department of Family Services General Practice Innovative Pool.

The project aims to enhance the role of GPs in providing health care to humanitarian entrants and other patients from refugee-like situations. The emphasis is on supporting GPs to contribute to the early identification and management of physical and psychological health problems in new arrivals.

The project is currently establishing a State-wide network of GPs who have a particular interest in refugee health and who seek a platform for professional exchange, peer support and who wish to establish a body to represent their concerns with refugee patients.

Drug and Alcohol Project

The Division has been working with Springvale Community Health Service, Westernport Drug and Alcohol Service and the Indo-Chinese community in the Springvale area to address drug and alcohol issues in this community. The joint Working Party has developed a proposal for a pilot Home Based Withdrawal project in the Indo-Chinese community, which has been submitted for funding consideration.

Other Activities/Resources

• Each year the Division participates in the Springvale Lunar Festival. This year five GPs, two HeartCare nurses and four Division staff participated in the Festival, providing free health checks to over 170 festivalgoers.
• A poster in Vietnamese promoting childhood immunisation has been developed by the Division and distributed through practices, maternal and child health centres, child care centres and pre-school.

Quality Use of Medicines

The primary aim of this program is to support local GPs in their role as prescribers by providing them with independent, consistent and up-to-date information on new and existing drug therapies. The national program is coordinated by the National Prescribing Service, an Australian non-profit organisation that operates at arm's length of the Government and independent of the pharmaceutical industry. Monash & Central Bayside Divisions of General Practice run a joint QUM program, and employ a full-time QUM Program Officer to provide NPS services to our GPs including:

• Academic detailing visits to doctors in their consulting rooms to offer objective up-to-date information on drug therapies.
• CME activities including workshops and clinical audits on select therapeutics.
• Peer-group discussions (eg. case studies, new drugs) involving GPs and pharmacists.
• Ongoing liaison with the NPS national office to provide feedback on local needs to ensure the provision of a relevant and responsive service by the NPS.
• Access to the Quality Prescribing component of the Practice Incentives Program (PIP).

Evidence Based Medicine Project

Evidence Based Medicine (EBM) has arisen out of the profession's need to apply the results of recent, good quality research in clinical practice, together with the explosion in medical knowledge and the advent of the internet and computerised search tools. The aims of this project are to promote EBM to the Division's GPs and to help GPs overcome the barriers to evidence based practice. The strategies used include 'academic detailing' (visiting GPs in their practices on a one-to-one basis) and a series of interactive workshops. An EBM website established on the Division's webpage together with articles in the Division's newsletter and emailed 'EBM bulletins' are other forms of promotional activity undertaken as part of the project. Interested GPs have been provided with resource material including an 'EBM Resource Kit' to help them use the best available evidence in answering questions which arise in clinical practice.

A big challenge is to encourage GPs to look critically at what they do and to insist on evidence to back up their clinical practice. In this way they can make the connection between evidence and effectiveness. There is a large variation in EBM skills and knowledge among GPs and a further challenge is to make the project adaptable enough to offer something to most of the GPs in the Division.

Seventy-two GPs (55% of the Division) received the practice visit and 40 have so far attended two of the workshops. The Division has studied the impact of academic detailing on the knowledge, attitudes and practice of EBM by GPs. This revealed little change in attitude, but an improvement in knowledge and self-reported understanding of EBM. The project has also produced a kit for other Divisions planning to establish an EBM project.

PREVIOUS PROGRAMS AND PROJECTS

• Perinatal Health
• Men's Responsibility Group
• Early Detection of Glaucoma
• Community Liaison
• GP Obstetrics
• Consumer & Community Development
• Stress Management for Chronic Pain
• Counselling in General Practice
• Community Disability Nurse
• Palliative Care
• Dietitians in General Practice
• Youth Access to General Practice
• Health Resources Handbook
• Allied Health
• Community Needs Assessment
• Telephone Interpreter Service
• Women's Health Promotion
• Hospital Referral
• Psychology in General Practice