DEALING with adverse events may not be the most inviting topic for any group of professionals, but one of the three finalists for the Australian Divisions of General Practice (ADGP) GP Engagement award, the West Vic Division of General Practice in rural Victoria, has found a way to engage GPs on this issue.

Since 1994 West Vic has been running a clinical risk-management program funded by the state health department.The aim is to improve the quality and safety of patient care by providing GPs in small rural hospitals with a peer-review process that monitors adverse patient events and highlights educational opportunities for doctors.

GPs participate in the program by having their records screened by peers, reviewing other doctors' medical records, attending quarterly reference panels, and sharing recommendations with all rural hospitals so that adverse events can be avoided. Some 16 hospitals are involved in theprogram. 3800 records have been screened by 35 GP reviewers and 110 GPs have received recommendations.

The division is proud of the project,which has been rolled out across rural Victoria, West Vic senior projects manager Jane Measday says."There's something within the program that really responds to GPs' needs."It affirms GPs in their practice, and encourages them to look at quality issues and [to improve] the standard of care in a true peer review and non-punitive environment that encourages them to be honest and open with each other.

"The program looks into adverse events, not bad doctors", Ms Measday says. "It's systems that let people down, and we try to look at where those systems break down, and improve them.

In NSW, the Northern Sydney Division of General Practice has adopted a whole practice approach to getting GPs, practice nurses and staff involved in its activities.The division used the chronic disease management initiative as an excuse to adopt this approach to 'engagement'.

The result? More GP involvement and better communication with nurses and practice staff. The number of direct services to GPs has risen by 61% in the past year, and thedivision's continuing professional development (CPD) activities have broadened and become more interactive. As a result, more GPs with a greater variety of backgrounds and skills are getting involved.

Since reaching out to practices, there has been an increased interest in all of thedivision's programs, division CEO Sally Maspero says."We're working with a lot more GPs,and seeing more than we have before," Ms Maspero says. "The hope is that once that [cooperation] becomes entrenched, those GPs will start to participate in division program planning.

"We were really able to do it through the new grant for chronic disease management,as well as a National Prescribing Service contract and Home Medicines Review contract. With those, we were able to increase our staff and broaden the services we had been providing to GPs."As a result of the program, the division hosted 47 CPD activities between July 2002 and June this year, an increase from 32 in the previous year.  GP attendance rose from 187 in 2001-02 to 320 in 2002-03.

Practice staff are also included in many events, including professional development opportunities and attending working groups and meetings.I n fact, the Northern Sydney division runs quarterly practice staff network meetings, monthly practice nurse education meetings, and whole practice education focused on chronic disease management topics such as the asthma 3+ program.

"It's been wonderful," Ms Maspero says. "We have great uptake by practice staff and we also have a practice nurse network going as well. There's been a lot of enthusiasm, and the practice staff and practice nurses are delighted to be involved and have some activities directly addressed to them.

"The Southern Tasmanian Division of General Practice has established strategic priorities to ensure that 'GP engagement' is central to the way it develops and delivers services. As a result, the division involves GPs from a board level through to designing and rolling out programs. GPs are involved in governance roles, with eight elected GP directors working alongside two independent directors. Employment is offered via three GP staff positions linked to improving the relevance and quality of the division's services to GPs.

"All the programs we deliver are guided by GPs," acting division manager and senior project officer Judy Broad says."Our strong priority is to engage an increasing number of GPs, and we try tomake sure we get different doctors involved each time."Communication is fundamental to thedivision's commitment to engaging GPs,with the division delivering a number of email groups including an information dissemination email list, a peer chat group, apractice staff list, and special interest groups.

As with the Northern Sydney division, the Southern Tasmanian division takes a whole-practice approach, delivering a range of services on issues such as accreditation, practice nurse training, practice staff networking and maintaining a locum register.By supporting practices and understanding their needs, the division has become a "relevant and important partner to GPs", Ms Broad says.

The division also actively pursues engagement between GPs and other services providers."It's an area that we put great store by," Ms Broad says. "We believe that, to deliver quality services to the range of GPs and practice staff, we have to not only understand our population but also have a fairly flexible and proactive approach togetting GPs involved. We listen to what our GPs and practices are saying they want"  MO

Subscribe to Page