Deakin Rural Health

Primary Health Care

APHRCI Centre of Research Excellence 2015 Extension: Towards Building Better Primary Health Care

The APHCRI Centre of Research Excellence (CRE) 2015 Extension, Towards Building Better Primary Health Care, builds on work from the CRE for Primary Health Care Microsystems.

It consists of three separate projects; (1) developing a model to test the Primary Care Patient Measure of Safety questionnaire; (2) developing a collaborative manual for multimorbidity, and (3) undertaking a pilot of a telephone intervention for women who have had gestational diabetes.

1) The Primary Care Patient Measure of Safety (PC PMOS) tool was developed during the reporting period in collaboration with international partners Dr Sally Giles and Dr Jane O’Hara from the Greater Manchester Patient Safety Translational Research Centre and the Bradford Institute for Health Research. This tool is a 50 item questionnaire for patients to complete and provide feedback on a range of factors that contribute to potential safety incidents in the primary care setting. It is the first tool of its kind in Australia, and was developed using patient experience data from participants in the GGT region.

A paper reporting on PC PMOS has been accepted by BMJ Quality and Safety and a model to validate PC PMOS in Australian general practices has been developed and ethics approval granted.

2) Multimorbidity is one of the biggest challenges now facing primary care as it can lead to fragmented care and polypharmacy, with a disproportionate increase in medication interactions and medication errors. A collaborative-care model has been developed in which practice nurses act as the case managers and work with patients to ensure that clinical decisions include patient priorities and goals. This model also incorporates a guide to assist GPs to reduce any inappropriate medications being prescribed.

A draft manual with training guides has been created and a pilot to test the model in a single practice has been developed and run, following ethics approval.

3) TeleMAGDA is an adaptation of the Victorian Life! lifestyle-modification program using telephone coaching rather than group participation. Negotiations have commenced with BUPA Health Dialog for an NHMRC partnership grant application (November 2015).

APHCRI Centre of Research Excellence for building quality, governance, performance and sustainability in primary health care through the Clinical Microsystem Approach

The Department was awarded an Australian Primary Health Care Research Institute (APHCRI)-funded Centre of Research Excellence (CRE) in 2011 for building quality, governance, performance and sustainability in primary health care through the Clinical Microsystem Approach. This Centre of Research Excellence in Primary Health Care Microsystems (CRE) would investigate improved models in regional governance and e-health, effective multidisciplinary teamwork and primary care performance and accountability across two research streams.

Stream 1: based in the University of Queensland, investigated quality, governance and sustainability in maternity share-care.

Stream 2: located in the Department’s Warrnambool office, was to examine safety and quality of primary healthcare. There is an estimated 1.5% of patients are expected to experience an adverse event, and over 11% to experience an adverse event from prescribed medication/prescription errors. More than half of these are considered preventable. In the GGT, this Stream 2 would address the need for Australian general practices to improve patient safety as they cope with the increasing complexity of chronic disease management, multimorbidity and polypharmacy.

The research teams comprised expertise in general practice, nursing, allied health and other specialties with an aim to identify best practice quality and safety procedures and how these could be best implemented in a general practice setting.

A manual suitable for a Collaborative on Patient Safety was completed in partnership with the Improvement Foundation, which manages the Australian Primary Care Collaboratives program. The manual has been endorsed by the Australian Government Chief Medical Officer, who has written the foreword. Considerable knowledge exchange between the Department of Health, the Improvement Foundation and the researchers has taken place as well as deep involvement of national and international experts.

A Patient Measure of Safety (PMOS) questionnaire that was designed in the United Kingdom (UK) to measure a patient’s perception of factors relating to (clinical) safety and used in UK hospitals has been adapted by CRE to measure patient safety in Australian general practices.

This work will continue in the CRE 2015 Extension: Towards Building Better Primary Health Care which builds on developments from the CRE for Primary Health Care Microsystems through three separate projects.

The Centre of Research Excellence in Primary Health Care Microsystems was a collaboration between the GGT UDRH and the Universities of Queensland and New South Wales, and worked closely with the Australian Commission on Safety and Quality in Health Care, Australian General Practice of Accreditation Limited, Improvement Foundation Australia, Australian Practice Managers Association, Australian Practice Nurses Association, the Chronic Illness Alliance and the Royal Australian College of General Practitioners.


Primary Health Care Research Evaluation and Development (PHCRED) program

The Australian Government Department of Health and Ageing-funded program aimed at building research capacity amongst primary health care workers.

Primary Health Care Research Evaluation and Development (PHCRED) Bursaries: Australian Government Department of Health and Ageing (PHCRED Strategy)-funded research projects and evaluations based on primary health care priorities for the Greater Green Triangle region and aimed at building research capacity amongst primary health care workers.

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