The practice nurse at Adelaide City General Practice (GP) took on the responsibility of creating and running a flu vaccination clinic. The aim was to free up doctor appointments and to proactively vaccinate patients early in the season. By using a flu vaccination template, generously supplied by Regency Medical Centre, Adelaide City GP were able to change the process of how they vaccinated their patients against the flu, which led to an increase in productivity and income, and an expansion of the practice.
Location: Adelaide City General Practice, Adelaide, South Australia.
Practice: 5 GPs, a practice nurse, receptionist, practice manager, nutritionist, physiotherapist, podiatrist and psychologist.
Patients: 5,786 active patients on their database.
Goal: To free up GP appointments by introducing a nurse-led clinic.
Prior to joining the APCC Program, the practice had 12,183 patients on file which after thorough data cleansing of the patient register, has been reduced to 5,768 patients. They joined the Program in August 2008 to establish systems for chronic disease management.
With the arrival of the flu season, Adelaide City GP was looking at their options to be proactive and vaccinate their patients before many contracted the flu. The practice team attended a meeting held by their Division, GP Partners Adelaide, where the practice manager of Regency Park Medical Centre presented the process of his practice’s flu vaccination clinic. Adelaide City GP recognised the value of the flu vaccination clinic and decided to introduce their own clinic.
Adelaide City GP had recently employed Danielle as their practice nurse, through the GP Plus program*. Part of Danielle’s role was to establish a flu vaccination clinic. Through the Division, the practice team was able to obtain sample letters, brochures, and notices about introducing a flu clinic, and Regency Medical Clinic generously supplied Adelaide City with example documents they had used when setting up their clinic.
Before any promotion about the clinic could begin, Danielle and the practice GPs had to decide on a system that would ensure the clinic was efficient. In previous years flu shots were opportunistic and given out during normal scheduled appointments. The aim of the flu clinic was to prevent the increase in cold/flu appointments that occurred during winter by proactively vaccinating those most at risk, and to also reduce the amount of full appointment slots being taken up for vaccinations.
To be eligible for the flu vaccination clinic, the GP’s decided patients had to have:
- seen a GP within the practice in the last three months
- been vaccinated before without any issues/reactions
- no known egg allergies
- not had any major reactions to any previous vaccinations of any kind
- a chronic disease, and/or
- be over 65 years of age.
The next step was to mail out a letter to all patients who were over 65 years of age and/or on the chronic disease registers, which amounted to 180, informing patients about the new flu clinic. The clinic was scheduled to accommodate 12 appointments per day (10 minutes each, 2 hours total) for 3 days of the week.
The appointment time slots filled quickly. Before their appointment, patients were required to fill in a consent form. After they were vaccinated, each patient received a take-home, colour coded fact sheet, which detailed possible side effects and how to recognise them as being a reaction to the vaccination. The practice team recorded a total of 165 flu shots for the 2009 season.
Introducing the flu vaccination clinic had a number of positive outcomes for Adelaide City GP. Some were unexpected, and highlighted to the practice team where other opportunities lie for continuous improvement.
- Doctors’ appointments were freed up during winter for more chronic issues as the majority of high risk patients were vaccinated early, via the clinic.
- Greater appointment capacity for the doctors as they had a decrease in flu-related acute appointments.
- Patients were introduced to the new practice nurse, her role, and had the chance to get to know her.
- Patients’ feedback was very positive as there was little waiting time, no cost and when running ahead of schedule, the nurse also checked and recorded blood pressures.
- The practice nurse was highly productive and took ownership of the flu vaccination clinic.
- The practice received financial benefits of approximately $1,700 through Medicare.
- The initial networking event at GP Partners Adelaide highlighted to the practice team the value of networking and learning from other practice’s experiences.
- The practice is now expanding, including the addition of two extra consulting rooms (up from two), an increase in reception hours and the addition of another practice nurse for two days per week.
Adelaide City GP intends to run the flu clinic at the beginning of each flu season. They will also be charging a gap fee of $5, which will increase practice income and can be invested back into the practice to further develop services and improve patient care. The practice team is now in the process of establishing a chronic disease management program, and is hoping to employ another nurse at the practice.
By introducing a flu vaccination clinic to patients in the high risk category (those over 65 years of age and those with a chronic disease), Adelaide City General Practice was able to free up doctor appointments during the peak flu season, as well as vaccinate patients early. The flu clinic gave the new practice nurse the opportunity to take ownership of her role, meet the patients and encouraged more networking to share ideas and introduce positive changes. Adelaide City General Practice now share details of their flu vaccination clinic with other practice teams at training sessions held by GP Partners Adelaide.
* GP Plus Program: The GP Plus Practice Nurse Initiative is a general practice program funded by SA Health and implemented in partnership with the metropolitan Divisions of General Practice. For more information please visit:
“As a new practice nurse, starting in a new career, the APCC Program was truly a great way to learn and network… My mind now boggles with the many things we can do to improve our patient care” – Danielle, Practice Nurse, Adelaide City General Practice