IF eNews February 2015


In this issue:

Improving Healthcare International Convention – Earlybird Registrations and Abstract Submissions Now Open
Quality Improvement Training Recommences for 2015
How does quality improvement deliver results and value in the health sector?
Top tips for team building from the APCC Practice Nurse and Practice Manager Lead Waves
Thousands of patients tested and diagnosed with chronic kidney disease by health services in the APCC Cardiovascular and Chronic Kidney Disease Wave
qiCommunity webinars and discussions
Closing the Gap: Measure and Act “It’s really a duty of care…”
New – Primary Health Networks Innovation Collaborative
Outreach Management System


Improving Healthcare International Convention Earlybird Registrations and Abstract Submissions Now Open

With the healthcare environment facing continuous change and resource pressure, there is now an increased need to improve integration and unite all aspects of primary, community and hospital healthcare to bring about systemic improvements.

At IF’s inaugural Improving Healthcare International Convention, you will have the opportunity learn about the latest solutions and take away practical ideas that will enable you to re-think service delivery to meet the challenges of providing the highest quality health care in today’s changing health system.

Hosted in Melbourne on 16-18 November 2015, the Improving Healthcare International Convention will consist of a day of master classes and workshops, and two days of keynote and concurrent presentations.

Front line staff, technology specialists, clinicians and quality improvement experts from all healthcare sectors will come together to discover how to implement innovative, cutting edge, practical solutions that will help to:

  • Connect the elements of the health system to improve communication
  • Increase efficiency across health providers
  • Embed quality improvement methods and leadership in organisations
  • Successfully inspire, implement and measure change
  • Engage patients as part of the healthcare team to improve health outcomes and quality of life
  • Utilise the latest technologies to rethink the way healthcare is delivered.

Learn from the Best
The program will feature over 40 presentations, including the latest innovative solutions from the following world class quality improvement (QI) experts:

Paul Plsek, Quality Management Consultant, Atlanta, US
An internationally recognised consultant on innovation in complex organisations and author of ‘Creativity, Innovation, and Quality’; Paul’s work can be described as ‘helping organisations think better.’ With over 20 years’ experience in the field of QI, Paul is recognised for his pioneering efforts in bringing modern QI techniques to healthcare organisations. Additionally he is also the Chair of Innovation at the Virginia Mason Medical Center (Seattle, US) and the Director of the NHS Academy for Large-Scale Change (UK).

Dr John Ovretveit, Director of Research, Karolinska Institute, Stockholm, Sweden
John’s work is based on the belief that organisation and management can bring out the best and worst in people, and that the right organisational design is critical for effective healthcare. A theme underlying his work is how practical research can contribute both to better care for patients and to ‘healthy work organisation’.

Neil Jordan, General Manager, WorldWide Health at Microsoft, Seattle, US
As chief strategist for Microsoft’s health industry initiatives worldwide, Neil helps define Microsoft’s vision for the future of healthcare and works to ensure that their products, technologies and partner solutions will make it a reality.

Paul Grundy, Director, IBM Global Healthcare Transformation, New York, US
In his role at IBM, Paul develops and executes strategies that support IBM’s transformation initiatives in the healthcare industry. Additionally, Paul is President of the Patient Centred Primary Care Collaborative (PCPCC). The PCPCC is dedicated to advancing an effective and efficient health system built on a strong foundation of primary care and the patient-centred medical home. The PCPCC, through its five Stakeholder Centres, works to transform the US healthcare system through delivery reform, payment reform, patient engagement and employee benefit redesign.

Marjorie Godfrey, Co-Director, The Dartmouth Institute Microsystem Academy, New Hampshire, US
Marjorie is a leader in designing and implementing improvement strategies that target the interface between the clinical microsystem and patients, families and care teams. Her primary interest is engaging inter-professional healthcare professionals in learning about and improving local healthcare delivery systems with a focus on patients, professionals, processes and outcomes.

Be Involved
Showcase your innovative QI solutions at the Convention. Presentation submissions are now open, visit the Convention website at www.ihic.improve.org.au to find out more.

Register Now
Register now for the early bird special at www.ihic.improve.org.au and save over $200 off the standard price.

We look forward to seeing you there!


Quality Improvement Training Recommences for 2015

Following the amount of interest in the quality improvement training sessions delivered by IF via webinar in 2014, a schedule of training sessions on a range of topics has now been released for the next few months. These sessions are cost effective and easy to access through online software GoToTraining. Upcoming sessions for March are listed below, just click through to register and pay online.

Improving business systems and patient flow
March 3 @ 12:00 pm – 1:00 pm CDST
This webinar is focused on the provision of patient-centred, timely and efficient care. In other words, can we provide our patients with the care that they need, when they need it? This session will provide you with the first steps.

Further steps in improving patient flow
March 10 @ 12:00 pm – 1:00 pm CDST
Once you have an understanding of your business and of patient flow, you can start to make subtle changes to the way your practice operates, enabling efficiencies. PREREQUISITES: WEB008 (Improving business systems and patient flow)

Leading change and effective communication
March 18 @ 12:00 pm – 1:00 pm CDST
We all support improvement, it’s change we don’t like! This session will take you through the fundamental aspects to help lead change in your organisation and your team as well as that ever present challenge – communication.

For a full list of upcoming webinars and more information visit the events page on the IF website.


How does quality improvement deliver results and value in the health sector?

With quality improvement (QI) indicators a key requirement for the upcoming Primary Health Networks, the value of QI continues to remain a critical component in improving outcomes in the healthcare sector.

The Australian Primary Care Collaboratives (APCC) Program is one of Australia’s leading quality improvement programs in primary healthcare, and this year reaches its ten year milestone. The results that participating practices and health services have achieved over the past decade are quite impressive:

  • More than 347,000 patients with diabetes and more than 223,000 patients with coronary heart disease now have improved health outcomes.
  • Over 35,000 people with diabetes have their blood sugar recorded within recommended limits
  • More than 34,000 people with diabetes now have their cholesterol recorded within recommended targets
  • 34,000 more people with diabetes now have their blood pressure recorded within recommended limits

Over the past 10 years, practices and health services in the APCC Program have worked to improve health outcomes for more than 400,000 of their patients. The good news is that the APCC continues to deliver improvements to patient outcomes.

These improvements deliver value for money, with better health outcomes, at less cost to the health system. The APCC program has delivered substantial savings to the health sector as it is estimated that the investment of $1 in primary care saves taxpayers over $12 in hospital costs.

Why read all about it when you can see it? Hear about the results, how the APCC works, and listen to participants as they talk about the improvements they made as a result of their involvement. To view the video click here.


Top tips for team building from the APCC Practice Nurse and Practice Manager Lead Waves.

The Australian Primary Care Collaboratives (APCC) Program Practice Nurse (PN) Lead Wave and Practice Manager (PM) Lead Wave recently joined forces to host their first learning workshop. Facilitated by APCC Clinical Advisor Dr Andrew Knight, a key aspect of this workshop was to discuss the APCC Foundation Principle – Build and Maintain the Team.

Over the years, experience has shown you will be more successful in implementing sustainable change if your whole team is engaged and participates in the improvement journey.

Jenny Brandon, a PN and PM at Gracemere Medical Centre in Qld, Implementation Lead for the PN Wave and Brett McPherson, PM at Collins St Medical Centre, Vic, Implementation Lead for the PM Wave, generously shared their team building experience at the workshop. Here, we give you six of the best team building tips from Jenny, Brett and other APCC participants.

1. Engage the team
Effective teams have members who feel committed to agreed goals. Explain reasons behind what your organisation is doing and inform everyone about your progress. Team members will engage more with the process if they understand why it is important and can appreciate the anticipated benefits for patients and the practice or health service.

Get the whole team involved in developing and implementing ideas for change. Staff members will feel that their input is valued.

Identify your champion/s. You may not get everyone engaged at the start. Make small changes using the support of those who are on board. Celebrate and share success and good ideas and promote them across the team. You’ll find that people will be drawn in by the success of others.

2. Create teams within teams
Not everyone needs to be involved in everything and it may be difficult to get everyone to attend whole of team meetings. Consider having ‘micro-teams’ working on various projects and feeding back to the broader team.

3. Share information
Effective teams communicate well. Good communication saves time, money and eliminates duplicated work. To enhance communication in your practice try email or intranet updates, a communication book and face to face meetings between the whole practice team or amongst micro-teams. Noticeboards have been used in many practices to post updates or display graphs so the team can share improvements, celebrate progress and the achievement of milestones.

Share your successes and your failures. Effective teams will regularly reflect on what they are doing. They will look at where they are and reflect on what’s working and what’s not. They will ask themselves “What should we do more of?” “What should we do less of or stop doing altogether?” “What have we achieved, and how does this compare to what we expected to achieve?”

Sometimes having whole of team meetings can be difficult. Nurses, reception staff, and GPs can have their own team meetings and include a representative from other micro-teams to provide input and updates. Micro-teams can also post updates on the intranet, in the communication book, on the noticeboard or leave updates in the tea room. This approach provides opportunities for everyone in the team to keep informed of the work that’s being done.

4. It’s often the process not the people
Problems are usually with the process rather than the people. Practice managers and nurses can influence that and that’s why they become key to the change process and improving outcomes.

At Brett’s practice, Collins Street Medical Centre, they focus on getting the process right. Testing things on a small scale first; reflecting, refining and adapting before rolling out for broader use.

5. Invest in your resources
Staff will need to allocate time to plan and undertake new tasks or initiatives. You may need to invest in additional wages, technology, or other resources to improve processes, efficiencies and patient outcomes in the medium to long term. Brett sees allocation of ‘protected time’ to staff as an investment in the practice’s future.

6. The Chocolate Frog strategy
Recognising your team’s efforts and value to the organisation can produce great outcomes. Small acts of recognition, gratitude and celebration contribute significantly towards staff morale.

You won’t believe what people will do for a chocolate frog…

Try holding a competition and offer a small prize like a chocolate frog as a weekly incentive. Jenny’s practice tried a number of different strategies to encourage staff to complete diabetic risk assessments (DRATs), without much success. What worked the best in the end? From a baseline of just one or two DRATs a week, a regular weekly prize of a chocolate frog generated an influx of more than 20 completed DRATs each week. It’s been so successful they now take the same approach for other targets too, again with great success.

This is just a snapshot of the great ideas put forward by Andrew Knight, Jenny Brandon, Brett McPherson and other webinar attendees.

To listen to the whole webinar, you can open the webinar in qiConnect at: https://my.improve.org.au/programs/apcc/PNLW/Pages/APCC_PN_Lead_Wave_Learning_Workshop_One.aspx

If you are not registered to qiConnect, simply fill in the online registration form here to gain access.


Thousands of patients tested and diagnosed with chronic kidney disease by health services in the APCC Cardiovascular and Chronic Kidney Disease Wave

In Australia, CKD currently accounts for approximately 10% of deaths and, in 2010, it was estimated that CVD was responsible for 31.7% of deaths. Combined, these diseases cost the individual and the health system enormously both in terms of the economic burden and impact on individuals’ quality of life. Early identification and evidence based management of CKD is therefore crucial to keeping these conditions under control.

The APCC Cardiovascular Disease (CVD) and Chronic Kidney Disease (CKD) Wave, is now in its eleventh month with 59 participating practices with many of those demonstrating some great improvements, with a focus in this update on the CKD work being done.

Participants are currently directing most of their efforts towards the proactive identification and management of patients that are at risk of developing CKD whilst assisting patients in implementing self-management strategies. Early identification of CKD enables proactive intervention by both the patient and healthcare professionals using lifestyle modification techniques (such as increasing exercise, lowering alcohol consumption, eating better and stopping smoking) which are proven to lower risk, combined with ongoing clinical testing.

Through the identification of patients at risk of developing CKD, targeted screening using eGFR and ACR testing has resulted in 5000 patients being tested for the disease since the beginning of the Wave in February 2013. Early CKD doesn’t have any symptoms, so the condition must be actively tested for in order for it to be diagnosed.

The focus on screening has resulted in 4200 patients with CKD being correctly diagnosed and recorded in practice clinical systems.

Subsequent intervention strategies are also leading to better management of the disease. Positive repercussions are being evidenced through an improvement in patient numbers who have their blood pressure recorded within a healthy range (<= 130/80 mmHg). Since starting the program, an additional 2000+ patients diagnosed with CKD now have their blood pressure recorded within a healthy range.


qiCommunity webinars and discussions

The Improvement Foundation’s qiCommunity continues to grow with over 2,100 members involved. This community has been established to support healthcare professionals and organisations to work together and share resources that help implement and sustain effective quality improvement activities.

IF would like to thank everyone who was involved in the 2014 qiCommunity webinars. You can find resources and podcasts from the 2014 webinars on the qiConnect Resources page.

IF looks forward to bringing you the series for 2015, the first of which was held on 24 February 2015 – ‘Top Tips for engaging the practice Team in Improvement’. A recording of the webinar will be available on the qiConnect resources page soon. We look forward to you joining us at the next webinar “Improving business systems and patient flow” on 3 March.

If there are topics you are interested in hearing more about or information you would like to share, we are keen to hear from you. Please email suggestions to qicommunity@improve.org.au

Discussion Forum:
If you want to find out how other general practices health services are tackling an issue and get input from your peers, we encourage you to visit the qiCommunity Discussion Forum. Recently added posts include:

Health Assessment Procedure: Does anyone have a written procedure for undertaking health assessments that they would be willing to share? I am new to General Practice and have been in post 7 weeks. We are a large general practice and the current model for conducting health assessments is very complicated and not written down.

Setting up Allied Health Professionals within a medical clinic: We are a small rural clinic hoping to set up an Allied Health Service for one day per week on rotation between 4 professionals. Our Medicare Local is assisting with initial funding but we wish to make it a sustainable service. Has anyone experienced this and if so do they have any tips on the administrative process

If you would like to be a member of the qiCommunity or get access to qiConnect – IF’s Web Portal, visit the IF website and complete the online qiConnect access form and get connected.


Closing the Gap: Measure and Act “It’s really a duty of care…”

With over 23 years’ experience working in mainstream general practice in Australia, and in recent years working with Bullinah Aboriginal Health Service, Dr Davies brings a wealth of experience to her role as the Improvement Foundation’s (IF) Closing the Gap: Measure and Act’s Clinical Lead.

Dr Davies’ involvement in both areas of the health system, combined with her participation in IF’s quality improvement programs, enables her to provide valuable insights into how IF’s Closing the Gap: Measure and Act initiative provides a useful framework for health improvement for Aboriginal and Torres Strait Islander patients.

Dr Davies says these often disenfranchised clients have much higher rates of psychological stress, heart disease and diabetes, and IF’s initiative to set closing the gap as the priority will be beneficial.

“The main message for the mainstream practices is reminding them that most Aboriginal and Torres Strait Islander patients attend mainstream services, so therefore if we want to close the gap we need to do that in our own practices. That’s the first step.

We’re shocked by the data nationally but we have the ability to act on that gap within our own services locally. It’s really a duty of care that we should be doing that.”

Listen or read Dr Davies’ full interview on qiConnect. If you have not yet registered for qiConnect click here to complete registration.

Closing the Gap: Measure and Act is an Improvement Foundation initiative. IF is inviting general practices around Australia to collect, submit and measure data on key indicators that could lead to better health outcomes for Aboriginal and Torres Strait Islander peoples.

If you missed out on this webinar, visit our events page to find out what is coming up and register for future events.

Visit the Closing the Gap: Measure and Act page on the IF website for more information about this initiative.


New – Primary Health Networks Innovation Collaborative

It’s been a very busy few weeks for our Medical Local colleagues across Australia as the tendering process for the Primary Health Networks (PHN) came to a close on 27 January 2015.

IF engaged with a number of potential tenderers to support their bid with the offer to sign onto our PHN Innovation Collaborative. Visit the PHN Innovation Collaborative page on the IF website to find out more about this project.

We wish all our colleagues submitting an application all the best and we look forward to our next quality improvement journey together.


Outreach Management System

For providers such as medical specialists, general practitioners and Allied Health Professionals working in urban, regional, rural and remote Queensland, the Outreach Management System has assisted in the coordination and delivery of services to visiting patients.

Over the past two years the improvement Foundation (IF) in partnership with CheckUP worked closely to build a monitoring and reporting system for Outreach services. The system was designed to improve the submission of reports and generate automatic invoices, coordinate visits and communicate between fund holders, providers and regional coordinators in a secure environment.

Since early 2015 IF has been in communication with the Rural Health West (RHW) and the Rural Workforce Agency Victoria (RWAV) regarding the expansion of this system to the Western Australian and Victorian providers. For more information or if you would like a free demonstration of the Outreach Management System, please contact Amy Markey on (08) 8422 7408 or email amy.markey@improve.org.au

February 24, 2015

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T: 08 8100 8700 | TOLL FREE (within Aust): 1800 771 522 | E: enquiries@improve.org.au

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