An innovative team approach and integration of care across sectors, including general practices, ... more An innovative team approach and integration of care across sectors, including general practices, community health services, allied health professionals and hospitals, can deliver high-quality comprehensive care in disadvantaged areas while providing teaching and research opportunities and community service. Academic general practice departments are committed to supporting and evaluating such models. A governance infrastructure that encourages strong partnerships across health care sectors is essential. With broad health partnership support, bulk-billing is viable in an Australian general practice team model providing health care to the disadvantaged.
This study aimed to explore how a new model of integrated primary/secondary care for type 2 diabe... more This study aimed to explore how a new model of integrated primary/secondary care for type 2 diabetes management, the Brisbane South Complex Diabetes Service (BSCDS), related to improved diabetes management in a selected group of patients. We used a qualitative research design to obtain detailed accounts from the BSCDS via semi-structured interviews with 10 patients. The interviews were fully transcribed and systematically coded using a form of thematic analysis. Participants' responses were grouped in relation to: (1) Patient-centred care; (2) Effective multiprofessional teamwork; and (3) Empowering patients. The key features of this integrated primary/secondary care model were accessibility and its delivery within a positive health care environment, clear and supportive interpersonal communication between patients and health care providers, and patients seeing themselves as being part of the team-based care. The BSCDS delivered patient-centred care and achieved patient engagement in ways that may have contributed to improved type 2 diabetes management in these participants.
Page 1. Research A checklist for comprehensive health assessment for the-over 70's Julie E. ... more Page 1. Research A checklist for comprehensive health assessment for the-over 70's Julie E. Byles Senior Lecturer in Clinical Epidemiology, Centre for Clinical Epidemiology and Biostatistics. The University of Newcastle, NSW ...
To determine the extent to which preventive activities, including the ordering of an oral glucose... more To determine the extent to which preventive activities, including the ordering of an oral glucose tolerance test (OGTT) between 6 and 12 weeks of birth, are integrated into women's primary care postpartum visits after a gestational diabetes mellitus (GDM)-affected pregnancy. Prospective survey and retrospective chart audit of general practices that provide maternity shared care in south-east Queensland, July 2011 to June 2012. General practitioners (n = 38) and medical records of women to whom they provided care (n = 43 women). GPs' awareness and knowledge of GDM guidelines and delivery of postpartum preventive care. The response rate for the survey/chart audit was 47%. All respondents recommended an OGTT between 6 and 12 weeks; a variety of guidelines informed practice; and weight, blood pressure and infant feeding practices were regularly checked. Mental health status and diet and exercise were discussed less consistently. GPs surveyed knew guidelines around the timing and...
To review the available literature to identify the major challenges and barriers to implementatio... more To review the available literature to identify the major challenges and barriers to implementation and adoption of the patient-centred medical home (PCMH) model, topical in current Australian primary care reforms. Systematic review of peer-reviewed literature. PubMed and Embase databases were searched in December 2012 for studies published in English between January 2007 and December 2012. Studies of any type were included if they defined PCMH using the Patient-Centered Primary Care Collaborative Joint Principles, and reported data on challenges and barriers to implementation and adoption of the PCMH model. One researcher with content knowledge in the area abstracted data relating to the review objective and study design from eligible articles. A second researcher reviewed the abstracted data alongside the original article to check for accuracy and completeness. Thematic synthesis was used to in three stages: free line-by-line coding of data; organisation of "free codes" i...
To assess the usability and validity of the Primary Care Practice Improvement Tool (PC-PIT), a pr... more To assess the usability and validity of the Primary Care Practice Improvement Tool (PC-PIT), a practice performance improvement tool based on 13 key elements identified by a systematic review. It was co-created with a range of partners and designed specifically for primary health care. This pilot study examined the PC-PIT using a formative assessment framework and mixed-methods research design. Six high-functioning general practices in Queensland, Australia, between February and July 2013. A total of 28 staff participated - 10 general practitioners, six practice or community nurses, 12 administrators (four practice managers; one business manager and eight reception or general administrative staff). Readability, content validity and staff perceptions of the PC-PIT. The PC-PIT offers an appropriate and acceptable approach to internal quality improvement in general practice. Quantitative assessment scores and qualitative data from all staff identified two areas in which the PC-PIT requ...
To identify elements that are integral to high-quality practice and determine considerations rela... more To identify elements that are integral to high-quality practice and determine considerations relating to high-quality practice organisation in primary care. A narrative systematic review of published and grey literature. Electronic databases (PubMed, CINAHL, the Cochrane Library, Embase, Emerald Insight, PsycInfo, the Primary Health Care Research and Information Service website, Google Scholar) were searched in November 2013 and used to identify articles published in English from 2002 to 2013. Reference lists of included articles were searched for relevant unpublished articles and reports. Data were configured at the study level to allow for the inclusion of findings from a broad range of study types. Ten elements were most often included in the existing organisational assessment tools. A further three elements were identified from an inductive thematic analysis of descriptive articles, and were noted as important considerations in effective quality improvement in primary care setti...
To evaluate the impact of the Royal Australian College of General Practitioners (RACGP)/Royal Aus... more To evaluate the impact of the Royal Australian College of General Practitioners (RACGP)/Royal Australian College of Ophthalmologists National General Practitioner Eye Skills Workshop on Queensland participants reported medium and long term ocular practice pattern. Two questionnaires were administered to all Queensland workshop participants (n = 121), six months and > 12 months following the workshop, to assess self reported ocular practice pattern. The response rate was identical for both the first and second questionnaire with 78 (64%) GPs returning completed forms on each occasion. Results indicate a highly significant increase in the proportion of GPs having access to dilating drops in the practice, using a systematic approach to eye assessment, and using the ocular kinetic perimetry (OKP) chart (p < 0.001), performing paediatric vision testing (p = 0.002) and incising chalazion (p = 0.01) following the workshop. General practitioners also reported a significant increase in...
32 babies with uncomplicated physiological jaundice received home phototherapy from a hospital/co... more 32 babies with uncomplicated physiological jaundice received home phototherapy from a hospital/community team in southern Brisbane. All babies showed acceptable reductions in their serum bilirubin on home therapy, and none required hospital re-admission for phototherapy. Their families were highly satisfied with the home program, and recorded high levels of confidence in their therapeutic responsibilities. Community providers were able to deliver a high quality 24-hour service, integrated with appropriate neonatology support. The cost of delivering the home program was significantly less than a comparable hospital stay.
This paper explores an approach to the implementation and evaluation of integrated health service... more This paper explores an approach to the implementation and evaluation of integrated health service delivery. It identifies the key issues involved in integration evaluation, provides a framework for assessment and identifies areas for the development of new tools and measures. A proactive role for evaluators in responding to health service reform is advocated.
The Brisbane South Centre for Health Services Integration (BSCHSI) initiative used a collocation ... more The Brisbane South Centre for Health Services Integration (BSCHSI) initiative used a collocation strategy to integrate local service delivery across three different health organisations. Physical col- location was combined with validated integration strategies to improve organisational operations among five different work teams involving 90 different individuals. Enhanced communication, increased knowledge of collocating groups, and the development of collaboration and partnerships
An innovative team approach and integration of care across sectors, including general practices, ... more An innovative team approach and integration of care across sectors, including general practices, community health services, allied health professionals and hospitals, can deliver high-quality comprehensive care in disadvantaged areas while providing teaching and research opportunities and community service. Academic general practice departments are committed to supporting and evaluating such models. A governance infrastructure that encourages strong partnerships across health care sectors is essential. With broad health partnership support, bulk-billing is viable in an Australian general practice team model providing health care to the disadvantaged.
This study aimed to explore how a new model of integrated primary/secondary care for type 2 diabe... more This study aimed to explore how a new model of integrated primary/secondary care for type 2 diabetes management, the Brisbane South Complex Diabetes Service (BSCDS), related to improved diabetes management in a selected group of patients. We used a qualitative research design to obtain detailed accounts from the BSCDS via semi-structured interviews with 10 patients. The interviews were fully transcribed and systematically coded using a form of thematic analysis. Participants&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; responses were grouped in relation to: (1) Patient-centred care; (2) Effective multiprofessional teamwork; and (3) Empowering patients. The key features of this integrated primary/secondary care model were accessibility and its delivery within a positive health care environment, clear and supportive interpersonal communication between patients and health care providers, and patients seeing themselves as being part of the team-based care. The BSCDS delivered patient-centred care and achieved patient engagement in ways that may have contributed to improved type 2 diabetes management in these participants.
Page 1. Research A checklist for comprehensive health assessment for the-over 70's Julie E. ... more Page 1. Research A checklist for comprehensive health assessment for the-over 70's Julie E. Byles Senior Lecturer in Clinical Epidemiology, Centre for Clinical Epidemiology and Biostatistics. The University of Newcastle, NSW ...
To determine the extent to which preventive activities, including the ordering of an oral glucose... more To determine the extent to which preventive activities, including the ordering of an oral glucose tolerance test (OGTT) between 6 and 12 weeks of birth, are integrated into women's primary care postpartum visits after a gestational diabetes mellitus (GDM)-affected pregnancy. Prospective survey and retrospective chart audit of general practices that provide maternity shared care in south-east Queensland, July 2011 to June 2012. General practitioners (n = 38) and medical records of women to whom they provided care (n = 43 women). GPs' awareness and knowledge of GDM guidelines and delivery of postpartum preventive care. The response rate for the survey/chart audit was 47%. All respondents recommended an OGTT between 6 and 12 weeks; a variety of guidelines informed practice; and weight, blood pressure and infant feeding practices were regularly checked. Mental health status and diet and exercise were discussed less consistently. GPs surveyed knew guidelines around the timing and...
To review the available literature to identify the major challenges and barriers to implementatio... more To review the available literature to identify the major challenges and barriers to implementation and adoption of the patient-centred medical home (PCMH) model, topical in current Australian primary care reforms. Systematic review of peer-reviewed literature. PubMed and Embase databases were searched in December 2012 for studies published in English between January 2007 and December 2012. Studies of any type were included if they defined PCMH using the Patient-Centered Primary Care Collaborative Joint Principles, and reported data on challenges and barriers to implementation and adoption of the PCMH model. One researcher with content knowledge in the area abstracted data relating to the review objective and study design from eligible articles. A second researcher reviewed the abstracted data alongside the original article to check for accuracy and completeness. Thematic synthesis was used to in three stages: free line-by-line coding of data; organisation of "free codes" i...
To assess the usability and validity of the Primary Care Practice Improvement Tool (PC-PIT), a pr... more To assess the usability and validity of the Primary Care Practice Improvement Tool (PC-PIT), a practice performance improvement tool based on 13 key elements identified by a systematic review. It was co-created with a range of partners and designed specifically for primary health care. This pilot study examined the PC-PIT using a formative assessment framework and mixed-methods research design. Six high-functioning general practices in Queensland, Australia, between February and July 2013. A total of 28 staff participated - 10 general practitioners, six practice or community nurses, 12 administrators (four practice managers; one business manager and eight reception or general administrative staff). Readability, content validity and staff perceptions of the PC-PIT. The PC-PIT offers an appropriate and acceptable approach to internal quality improvement in general practice. Quantitative assessment scores and qualitative data from all staff identified two areas in which the PC-PIT requ...
To identify elements that are integral to high-quality practice and determine considerations rela... more To identify elements that are integral to high-quality practice and determine considerations relating to high-quality practice organisation in primary care. A narrative systematic review of published and grey literature. Electronic databases (PubMed, CINAHL, the Cochrane Library, Embase, Emerald Insight, PsycInfo, the Primary Health Care Research and Information Service website, Google Scholar) were searched in November 2013 and used to identify articles published in English from 2002 to 2013. Reference lists of included articles were searched for relevant unpublished articles and reports. Data were configured at the study level to allow for the inclusion of findings from a broad range of study types. Ten elements were most often included in the existing organisational assessment tools. A further three elements were identified from an inductive thematic analysis of descriptive articles, and were noted as important considerations in effective quality improvement in primary care setti...
To evaluate the impact of the Royal Australian College of General Practitioners (RACGP)/Royal Aus... more To evaluate the impact of the Royal Australian College of General Practitioners (RACGP)/Royal Australian College of Ophthalmologists National General Practitioner Eye Skills Workshop on Queensland participants reported medium and long term ocular practice pattern. Two questionnaires were administered to all Queensland workshop participants (n = 121), six months and > 12 months following the workshop, to assess self reported ocular practice pattern. The response rate was identical for both the first and second questionnaire with 78 (64%) GPs returning completed forms on each occasion. Results indicate a highly significant increase in the proportion of GPs having access to dilating drops in the practice, using a systematic approach to eye assessment, and using the ocular kinetic perimetry (OKP) chart (p < 0.001), performing paediatric vision testing (p = 0.002) and incising chalazion (p = 0.01) following the workshop. General practitioners also reported a significant increase in...
32 babies with uncomplicated physiological jaundice received home phototherapy from a hospital/co... more 32 babies with uncomplicated physiological jaundice received home phototherapy from a hospital/community team in southern Brisbane. All babies showed acceptable reductions in their serum bilirubin on home therapy, and none required hospital re-admission for phototherapy. Their families were highly satisfied with the home program, and recorded high levels of confidence in their therapeutic responsibilities. Community providers were able to deliver a high quality 24-hour service, integrated with appropriate neonatology support. The cost of delivering the home program was significantly less than a comparable hospital stay.
This paper explores an approach to the implementation and evaluation of integrated health service... more This paper explores an approach to the implementation and evaluation of integrated health service delivery. It identifies the key issues involved in integration evaluation, provides a framework for assessment and identifies areas for the development of new tools and measures. A proactive role for evaluators in responding to health service reform is advocated.
The Brisbane South Centre for Health Services Integration (BSCHSI) initiative used a collocation ... more The Brisbane South Centre for Health Services Integration (BSCHSI) initiative used a collocation strategy to integrate local service delivery across three different health organisations. Physical col- location was combined with validated integration strategies to improve organisational operations among five different work teams involving 90 different individuals. Enhanced communication, increased knowledge of collocating groups, and the development of collaboration and partnerships
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