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Multidisciplinary care in general Practice: The Teamwork Study

Multidisciplinary care in general Practice: The Teamwork Study. Mark Harris, Centre for Primary Health Care and Equity. Investigators.

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Multidisciplinary care in general Practice: The Teamwork Study

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  1. Multidisciplinary care in general Practice: The Teamwork Study Mark Harris, Centre for Primary Health Care and Equity

  2. Investigators • 1.1 Chief Investigators CIA Professor Mark Harris CIB Dr Judy Proudfoot CIC Professor Justin Beilby CID Professor Patrick Crookes CIE E/Prof Geoffrey Meredith CIF A/Professor Deborah Black1.2 Associate Investigators A/Professor Elizabeth Patterson Dr David Perkins Mr Gawaine Powell Davies Mr Matt Hanrahan Dr Barbara Booth UNSW Research Centre for Primary Health Care and Equity

  3. Room to improve UNSW Research Centre for Primary Health Care and Equity

  4. Opportunity and gap in performance UNSW Research Centre for Primary Health Care and Equity

  5. The need for team care • Good evidence that team care:- • Improves patient adherence to management • Helps patient to achieve and sustain lifestyle change especially diet, physical activity, and weight control and monitoring of their chronic condition • Helps to save GP time • GAP in current treatment: • Not everyone who needs it is getting multidisciplinary care. UNSW Research Centre for Primary Health Care and Equity

  6. Effective teams have: • Small, manageable number of members • Appropriate mix of skills and expertise • Measurable performance goals and specific tasks • Clear roles • Suitable leadership (person with most expertise) • Good communication structures • Collective responsibility for achieving goals • Adequate resources – financial, training, admin, technical UNSW Research Centre for Primary Health Care and Equity

  7. Effective teams processes • Shared, clear purpose and objectives* • Regular communication, problem-solving • High level of participation in team • Emphasis on quality • Support for innovation • Clear leadership (incl. lack of conflict about leadership) * Strongest predictor of team effectiveness UNSW Research Centre for Primary Health Care and Equity

  8. Barriers to teamwork • GP attitudes/lack of knowledge of benefits • Patient attitudes re: nurse care • Lack of knowledge/training of individual staff (eg.PN) • Lack of time • Volume of paperwork • Funding structures (i.e. not enough reimbursement to GP or nurse for nurse tasks) • Lack of support systems (IT etc) • Small business (need for financial viability) • Lack of policies & procedures • Lack of structured communication systems UNSW Research Centre for Primary Health Care and Equity

  9. Facilitators of teamwork • Greater understanding of benefits (patient outcomes) • Systemic changes (IT, protocols & processes, communication) • Item numbers for CDM (including nurse care) • Greater role clarity • Clinical benchmarking • A designated leader in the practice • Different models • GP champions & case studies of success • Support from Divisions & Colleges • Involvement of Divisions with smaller practices (e.g. contract PN) • More physical space UNSW Research Centre for Primary Health Care and Equity

  10. Aims NHMRC study • Evaluate the impact of a practice-based intervention involving non-GP staff (practice managers, receptionists and nurses) • Describe the roles, responsibilities and activities of non-GP practice staff • Investigate what practice factors are associated with greater or lesser involvement of non-GP practice staff • Calculate the cost of the intervention UNSW Research Centre for Primary Health Care and Equity

  11. Intervention Practice based intervention designed to enhance the role of non-GP staff in chronic disease management. Intervention facilitated by research team. Components • Education session • 3 structured practice visits to support practices to put in place systems to create team care • Resources including directories, referral aids, care plan templates, • Telephone support UNSW Research Centre for Primary Health Care and Equity

  12. 3. Evaluation • Interviews with GPs and GP staff, and other providers before and after the study • Patient information (following patient consent) • Survey at 0 and 12 months including SF12 and PACIC • Data from patient records for the past 2 years (HbA1c; cholesterol – HDL, LDL; blood pressure, body mass index, etc.), as well as any referrals they have received for their condition. UNSW Research Centre for Primary Health Care and Equity

  13. More Information • If you would like more information : • Email me • M.f.harris@unsw.edu.au • Visit our website • http://www.cphce.unsw.edu.au UNSW Research Centre for Primary Health Care and Equity

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