Standards for general practices (4th edition)

including Interpretive guide for Aboriginal and Torres Strait Islander health services

Standards for general practices 4th edition
Interpretive guide to the RACGP Standards for general practices (4th edition) for Aboriginal community controlled health services

Standard 1.2 Information about the practice

Our practice provides sufficient information to enable our patients to make informed decisions regarding their care.

Criterion 1.2.1

Practice information

Our practice provides patients with adequate information about our practice to facilitate access to care.

Indicators

► A. Our practice information sheet is available to patients and is accurate and contains at a minimum:

our practice address and telephone numbers
our consulting hours and arrangements for care outside our practice’s normal opening hours, including a contact telephone number
our practice’s billing principles
our practice’s communication policy, including receiving and returning telephone calls and electronic communication
our practice’s policy for the management of patient health information (or its principles and how full details can be obtained from the practice)
the process for the follow up of results
how to provide feedback or make a complaint to the practice including contact details of the local state or territory health complaints conciliation body.

► B. Our practice team can demonstrate how we communicate essential information to patients who are unable to understand our practice information sheet.

► C. If our practice has a website, the information is accurate and contains at a minimum the information included in our practice information sheet and meets the advertising requirements of the MBA Code of Conduct.

Explanation

Key points

Providing written information about the practice is important as it informs patients about the range and cost of services provided by the practice, such as:

what clinical services are available at the practice
how to obtain medical care within and outside normal opening hours
billing principles, such as bulk billing, accounts settlement, representative or approximate costs for treatment
communication policies, including the use of electronic means (eg. SMS and email)
patient health information management policy (eg. how to obtain a copy of the health information kept by the practice)
the process for follow up of results (eg. who will contact whom and by when)
how to provide feedback and complaints to the practice (eg. a contact number for the person responsible for dealing with feedback and complaints).

Format of the information sheet

A photocopied, typed or electronically generated information sheet is acceptable. The information on the practice information sheet is important to all patients and the practice needs to find alternative ways to provide or discuss this information with patients who are unable to read or understand it. Pictorial representations or a simple language version of the information may be helpful.

Where a practice serves defined ethnic communities, it is appropriate to make written information available in the most common languages used by the practice population.

Font style and size can be an issue for people with vision limitations. Vision Australia has produced legibility guidelines which practices may find useful. The guidelines are available at www.visionaustralia.org.au/info.aspx?page=785.

Providing feedback or making a complaint

Practices are encouraged to be open about the way patients can provide feedback or make a complaint. It may be useful to state that the practice is receptive to feedback and will always endeavour to resolve any complaints directly, but where a matter can not be resolved, the relevant health complaints commissioner can be contacted by the practice or by the patient for advice and possible mediation.

Practice websites

Where a practice has a website, it needs to ensure the information is regularly updated to reflect changes in the practice. Information on the website needs to be accurate and contain, at a minimum, the information included in the practice information sheet.

Advertising within practice information

Information provided by the practice (eg. practice information sheet, health promotion information or ‘tailor made’ health information magazines) may contain local advertising. The practice should include a disclaimer that the inclusion of advertisements is not an endorsement by the practice of these services or products.

All advertising needs to comply with the mba Code of Conduct on advertising including:

Making sure that any information you publish about your medical services is factual and verifiable
Making only justifiable claims about the quality or outcomes of your services in any information you provide to patients
Not guaranteeing cures, exploiting patients’ vulnerability or fears about their future health, or raising unrealistic expectations
Not offering inducements or using testimonials
Not making unfair or inaccurate comparisons between your services and those of colleagues. The MBA Code of Conduct is available at http://goodmedicalpractice.org.au.

Criterion 1.2.1

Practice information

Our practice provides patients with adequate information about our practice to facilitate access to care.

In a nutshell

Your health service gives to its community and patients all the information that they need in order to use its services effectively. This can be in writing, such as a notice or information sheet, or a combination of writing and pictures or diagrams. It can be communicated verbally if that works better. Whichever form the information takes, it needs to be clear and easily understood so that patients understand how your health service works and how they can use its services.

Key team members

Practice manager
All clinical staff
Reception staff

Key organisational functions

Practice information sheet
Patient communication
Communication policies
Billing policies and functions
Patient health information management policy
Follow-up management processes
Patient complaints process and protocol

Indicators and what they mean

Table 1.5 explains each of the indicators for this criterion. Refer to Criterion 1.2.1 Practice information of the Standards for general practices for explanations of some of the concepts referred to in this criterion.

Table 1.5 Criterion 1.2.1 Practice information
Indicators	What this means and handy hints
▶ A. Our practice information sheet is available to patients, and is accurate and contains at a minimum: our practice address and telephone numbers our consulting hours and arrangements for care outside our practice’s normal opening hours, including a contact telephone number our practice’s billing principles our practice’s communication policy, including receiving and returning telephone calls and electronic communication our practice’s policy for the management of patient health information (or its principles and how full details can be obtained from the practice) the process for the follow-up of results how to provide feedback or make a complaint to the practice including contact details of the local state or territory health complaints conciliation body.	The information sheet you provide patients to inform them about your health service and how you communicate with them should be up to date, accurate and at the very least contain the following information: your health service address and telephone numbers your opening hours and your after-hours arrangements, including a contact telephone number any costs and fees charged for services. This includes information about how costs and fees can be paid, and an idea of the approximate costs for common types of treatment information about how your service normally contacts and communicates with patients. This can include a description of the roles of your Aboriginal liaison officers and cultural brokers – who they are, how they work and how they normally contact patients any situations when your service may contact patients by phone or electronically your health service’s policy for managing patient health information how your health service follows up with patients about their results. This can also include your Aboriginal liaison officers and cultural brokers – who they are, how they work and how they may contact you what patients can do if they are not happy with your service. If your health service has a policy of dealing with complaints internally, it is important you let patients know about the process you will follow when you receive a complaint. You will need to provide the name and contact number of the person in your organisation who has authority to deal with complaints (for example, the health service manager). Contact numbers also need to be provided for external organisations that patients can contact, such as the state or territory health ombudsman. You will also need to explain that feedback and complaints are confidential.
▶ B. Our practice team can demonstrate how we communicate essential information to patients who are unable to understand our practice information sheet.	If the patients in your health service cannot read your information sheet, your staff need to be able to demonstrate they know of alternative means of explaining essential information. This could include explaining the information to patients orally and checking that they understand. For example, if patients from a number of language groups visit your service, the practice information sheet would be available in those languages. Or your staff would be able to explain things orally, through an interpreter if needed. If your service uses an interpreter, your staff need to know how to use the interpreter service. You could also provide some information through a mixture of diagrams, symbols and simple English (or another language). You may also want to consider the size of the letters and words for people who may have a problem with vision.
▶ C. If our practice has a website, the information is accurate and contains at a minimum the information included on our practice information sheet and meets the advertising requirements of the MBA Code of Conduct.	Any business that provides a regulated health service needs to meet the guidelines for advertising under the Health Practitioner Regulation National Law 2009 (see Medical Board of Australia (MBA) Code of Conduct at www.medicalboard.gov.au/Codes-Guidelines-Policies.aspx). Any information provided on your health service website needs to be in the public interest, and to be factual, honest, accurate, clear, verifiable and not misleading. It needs to contain information that is consistent with your health service information sheet. Your website may also contain: a clear statement of the services offered contact details of the health service including email and telephone numbers the gender of the practitioners the hours the health service is open and how to access care after hours advice on the availability of wheelchair access to the health service information about the fees that are charged and/or bulk-billing arrangements.

Case study

Below is a description of the ways in which an Aboriginal community controlled health service can ensure it provides the right information to its patients to enable them to access care. Not all of these good practices are required by the Standards, but they illustrate the many practical and creative things that ACCHSs can do to ensure they deliver services of high safety and quality to their community.

The health service understands that some patients might not feel comfortable coming to the service. To ensure these patients have access to the service, some of the information it provides is in visual or graphic form, to communicate the message that every community group can feel they belong here. The waiting room has paintings and other artwork from community groups, to help patients know that everyone is welcome. The receptionists are friendly and helpful, so that new patients feel glad they have come to the service. (An example of a helpful receptionist is one who provides patients with relevant information, if they can.)

Staff emphasise to patients the importance of attending a scheduled appointment. If patients have concerns about the appointment, they are encouraged to talk about their concerns so that they can be dealt with. If a patient has difficulty getting to the health service for the appointment, staff will try to arrange transport – with the service’s driver, or with a neighbour, perhaps. If staff are unable to arrange transport, they will arrange a home visit instead.

The health service’s information sheet is clear, up to date and provides information in community languages about staff members, opening hours, services provided, how to provide feedback, after-hours arrangements and contact details. The information sheet contains many pictures and diagrams and a larger font version is available for those with vision impairment.

Staff members orally explain details about the service to patients who cannot read the information sheet. This could include explaining the different staff members who work in the service and what their roles are, and telling patients when and how the service will contact them and for what reasons. Reasons could include follow-up of investigations and recalls for primary health activities – for example, immunisations, health assessments or care-plan activities. Because there is a lot of information, staff members are happy to go through it again later if any patient forgets or didn’t understand it properly the first time.

In addition to the information sheet, the service publishes a newsletter each quarter, in community languages. This newsletter details what outreach and specialist clinics are being held, where and when, and who to contact to arrange access to these. The newsletter also includes features that coincide with national health promotions – for example, diabetes week or pink ribbon or domestic violence awareness campaigns. If new staff members join the team, a feature is run including a brief introduction of the staff member, their role and how to contact them. In some cases, the service enters the above information on a whiteboard in each waiting area, instead of publishing a newsletter.

The staff member responsible for maintaining the website reviews it regularly, and updates it with details of any new staff members or changes in services as these occur.

The waiting room contains a brochure on patient health information management. This brochure explains that patients’ health records are generally kept in an electronic format only available to the staff members directly providing care to a patient or helping to organise their care. It tells patients that, with their permission, their health records will be used to send them reminders about coming to the service for immunisations, health checks, diabetes cycle-of-care activities and Pap smears (if applicable). The brochure also explains how patients can provide feedback or complaints to management, or the state or territory health complaints ombudsman.

All staff, including reception staff, have a responsibility to answer patients’ questions and to take time to explain things if patients don’t understand. Before staff assume that what they have said has been properly communicated, they will check the patient has understood. Staff also know that sometimes the information sheet is not enough, and that they may need to explain to patients what they need to do to access the service in the most effective way.

Showing how you meet Criterion 1.2.1

Below are some of the ways in which an Aboriginal community controlled health service might choose to demonstrate how it meets the requirements of this criterion for accreditation against the Standards. Please use the following as examples only, because your service may choose other, better-suited, forms of evidence to show how it meets the criterion.

Maintain an up-to-date service information sheet that contains all the required information.
Provide brochures and/or signs in the waiting room, written in community languages, showing: