| Project Objectives / Summary:
The aim of this project was to assess the impact on care planning by GPs through the implementation of a validated population risk screening tool.
The two Divisions carried out the following:
- Detailed review of the Commonwealth Budget initiatives in particular in relation to the Enhanced Primary Care MBS items for care planning, case conferencing and health assessments.
- Literature review and discussions with the Commonwealth Department of Health and Aged Care, the Department of Veterans Affairs (DVA) and Victorian Department of Human Services.
- Conducted focus groups with key GPs from both Divisions seeking views on multi-disciplinary care planning.
- Provided information forums to the wider membership of both Divisions and other health care providers to present findings on the Southern Health Care Network Coordinated Care Trial and initiatives in case management developed by Central Bayside with DVA through projects such as the Health Care Planning Clinical Audit Project.
- Developed and trialed a Readiness for Care Planning Checklist.
Surveyed a number of GPs in each Division and followed up with a telephone questionnaire.
- Exchanged information with other Divisions of General Practice.
Project Collaboration:
Central Bayside Division of General Practice & Dandenong Division of General Practice.
Department of Veterans Affairs.
Local multi-disciplinary Health Care providers.
Key GPs from both Divisions.
Project Outcomes:
The Central Bayside Division, working in collaboration with the Dandenong Division, developed a survey instrument which sought to assist General Practitioners identify their preparedness to begin multi- disciplinary care planning.
The tool aims to identify factors that impact upon a GPs ability to provide care planning. The survey designers hypothesised that for a GP to be 'ready for care planning' they need to have three things in place:
- A practice which has the physical capacity to accommodate care planning activities. This may include use of IT, space for additional health professionals and utilisation of practice nurses.
- A population of patients who require care planning/ care coordination. ie with chronic/ complex illness.
- A GP who is interested in managing the care of complex patients and who wants to implement multi-disciplinary care planning within their practice.
The Readiness for Multi-Disciplinary Care Planning Survey is short and able to be completed by GPs within five minutes. It includes a qualitative scoring system that has been designed to provide survey users with a checklist as to what is requisite to provide comprehensive care planning.
The two Divisions were successful in obtaining funding through Round Two Innovations Funding Pool Program. They developed and completed a project "A Division based strategic framework for the implementation of multi-disciplinary care planning in general practice".
Recommendations:
Due to the objectives of this project (needs analysis & development of survey tools), the more tangible results will come from phase 2 of this project in the NIFP Round 2 project.
Disseminating Project Information:
- Provided each participating GP with a quarterly project update.
- Media used to disseminate information to GPs involved in the project included: Newsletters, Web Page, Personalised Letters, Consultancy Support Services to individual practices.
- Production & dissemination of the "Readiness For Care Planning" tool to all interested Divisions of General Practice.
Lessons / Assessment:
- 21 GPs participated in the project process.
- The uptake of this project by the participating GPs could in part be due to the fact that 90% of participating practices had extensive utilisation of information technology.
- 100% of participating practices utilised the incentive programs linked to this project.
- The survey tools used were succinct & well formatted, requiring minimal time for the GP to complete.
- The content of the survey tools was broad enough to stimulate GP consideration of care planning issues. The survey tools themselves acted as a "behaviour change" catalyst by stimulating GPs to consider changes that they could implement within their own clinical practice as well as changes they could make to their practice environment.
- Prior to the project, over 90% of surveyed GPs saw their role as the coordinator within the multi-disciplinary team & were keen to provide care for patients with complex needs within a multidisciplinary framework.
- Post intervention survey results showed a mixed response to the above issues. It appears that individual GPs' confidence to provide care coordination / leadership within a multi-disciplinary health team was lower than the pre-intervention survey.
- In addition, post intervention surveys revealed that only 38% of GPs were actually providing care coordination services within a MDT context.
- GP feedback showed that the major barriers to their participation in MDCP were:
Time;
Financial remuneration;
Sharing of kudos &/or responsibility of patient care with other members of the MDT.
The value of this project and its timeliness is reflected in the approval of Round Two funding.
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