A practice prevention team
'Teams out perform individuals acting alone… especially when performance requires multiple skills, judgments and experiences'. Most of teamwork builds on commonsense ideas like the importance of goal setting and mutual accountability. There is often a natural resistance to moving beyond individual roles and the accountability that goes with that, and this would need to be addressed. Barriers to overcome include fear of being personally disadvantaged in the team, past experiences that haven’t achieved benefits, and the pressure of existing workload. Teamwork involves members from different areas accepting their responsibility for the overall progress in achieving that goal. They:
- share an understanding of the goal and what it means
- understand their role in contributing to achievement of the goal and are confident in their skill levels
- understand the processes for sharing necessary information and problem solving, and know that these processes work for them
- respect and cooperate with each other
- share a supportive environment (good systems infrastructure, support from their division of general practice, accessible and relevant training programs)121-123
Diabetes screening in general practice – using a tickbox!
Diabetes screening in general practice has significant reach in terms of population numbers, as the target group covers all ages and income spectrums. One practice trialled the Diabetes Association 'tickbox' over a 1 month period (patients were 40 years of age and over). Patients filled in the 'tickbox' while waiting, and took it with them into the consultation. Staff marked the clinical records with a red tick when the patient completed the tickbox. At the start of each day, records without a red tick were noted and patients asked, as they attended, to fill in the tickbox. At the end of the trial it was decided to incorporate the tickbox into routine practice with the age limit raised to over 50 years. The diabetes trial was designed, run and reviewed by all staff at the practice.
Elaine Green, Leschanault Medical Centre, Australind, Western Australia www.leschmed.com.au
The 'buddy system'
In order to ensure 'stress free' communication in a rural environment, a practice comprising four full time GPs and one part time GP, two registrars, four part time PNs, three full time and three part time receptionists and one school based trainee instituted a disciplined approach toward communication. Teamwork was the key to the approach, which was called the 'buddy system'. This worked on the principle of 'keep it simple, but cover all bases!' The aim was to have happy, efficient staff and satisfied patients. The buddy system ensured that there was always a person or group that could deal with any tasks arising, thus reducing the risk of things being put to one side, forgotten or misplaced. GPs were paired up, according to procedural interests and rostered days off. Each pair was then matched with a non-GP, full time staff member 'buddy'. Each group was also assigned a part time staff member to cover other issues (eg. days off). The system ensures there is continuity from day-to-day for checking mail, pathology results, writing script requests and handling patient enquiries and requests. The system was advertised through the practice newsletter. Once patients became aware of whom to contact, communication became even more streamlined.
Jo Heslin, Denis Medical Clinic, Yarrawonga, Victoria
- General Practice Divisions Victoria. Better capacity, better care. A resource kit for assisting general practices achieve quality outcomes for chronic disease management at www.gpdv.com.au/gpdv
- Management and Research Centre, University of South Australia. Team kick-start – a planning and organising guide for work teams at www.m-arc.com.au/resources_publications.asp
- Commonwealth Department of Health and Ageing. Making your practice work better, a resource kit for general practitioners. Contact your local division of general practice to obtain a copy