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Putting prevention into practice (Green Book)

Appendix 2

A quick guide to putting prevention into PRACTICE

Framework

Consultation

Practice

The community and the health system

Key strategies

Principles

Implementing prevention activities within a structured framework has greater impact than individual activities

Implementation strategies are evidenced based and outcomes focused

Strategies address sustainability and maintain a commitment to a quality culture


Adopt a patient centred approach

Be systematic


Be systematic and use a whole of practice (ie. a population health) approach

Incorporate strategies to identify and address health inequality that are evidence based, feasible, sustainable, adaptable and congruent with the practice philosophy


Focus on what GPs and the practice are interested, competent, and prepared to do

Address health inequalities


Designated coordinator for prevention



Division of general practice representation on community based partnership groups planning health promotion and disease prevention programs





The practice nurse has a key role in prevention




Work as a team




IM/IT system




Ready access to prevention guidelines and prevention material




Automated patient register(s)




Recall and reminder systems




Identify patient prevention needs and interests




Use and manage prevention materials effectively

Receptivity

Implementation is enhanced when GPs, staff and patients believe prevention is important, they can do it, understand the benefits, and have the skills, time and resources


Consider benefit from the patient and the GP perspective

Negotiate strategies


Ensure implementation strategies are transparent, respectful and congruent with practice goals and staff views

Ensure you have adequate resources

Measure and celebrate successes


Build community partnerships based on an assessment of what is achievable

Clarify your understanding of the role, expectations and responsibilities of the general practice and other health professionals and agencies

Provide opportunities for joint activities and/or training where there is an overlap of roles and tasks

Ability (capacity)

Implementation is enhanced when GPs have knowledge, skills, beliefs, attitudes, time and the organisational infrastructure


Use motivational interviewing techniques

Assess your capacities

Ask about and facilitate patient’s abilities and capacities. Address any shortfalls or difficulties


Be consistent

Ensure staff have the knowledge, skills and abilities to undertake prevention

Have policies and guidelines

Use information management systems including registers and reminders

Use health promotion information

Consider alternate delivery mechanisms


Build community partnerships based on practice team strengths and practice goals

Be involved in your local division of general practice

Coordination

Implementation strategies should be planned and structured within the practice


Assess complexity of patient health concerns and the benefits of sharing care


Have a plan

Clarify roles, tasks and responsibilities

Encourage good communication among all team members

Discuss prevention at team meetings and planning sessions


Link prevention activities across the practice and the wider community

Incorporate strategies to reduce disadvantage

Targeting

At risk, priority and/or eligible populations


Decide where best to direct time and resources to achieve outcomes

Consider patient preferences and understanding, national campaigns

Consider using the Patient Prevention Survey

Use the ‘less is more’ approach


Assess patient and practice prevention needs, and set agreed prevention targets for priority populations and groups based on need


Identify partner organisations that share an interest in specific target populations

Consider access for patients

Consider (or enhance) contribution to local health policy development, programs and planning

Iterative process

Have a cyclical planning process that measures progress and ensures adaptation


Set review appointments for patients with complex care needs

Use flow sheets, patient held records and other tools to monitor progress


Ensure the practice has a plan, implement (do) and review process

Provide adequate time for reflection and team meetings

Use feedback to improve implementation

Reflect on strategies, challenges and achievements

Review progress at practice management and/or team meetings

Develop strategies to overcome barriers


Use PDSA cycles Identify existing information on local health needs and priorities

Participate in national quality improvement initiatives

Changes are measured The practice celebrates successes

Collaboration

Work with local, regional and national programs and organisations to improve preventive care within the general practice


Prioritise prevention activities with the patient

Use opportunities as they arise in the consultation


Delegate tasks based on competency within and outside the practice

Use the ‘less is more’ approach


Maximise use of other health professionals and agencies (eg. Quit line)

Effectiveness

Use evidence base implementation processes and strategies

Make the best use of limited resources


Be strategic in assessing and prioritising the most appropriate intervention for the patient

Make best possible use of referral options

Use evidence based strategies


Use evidence based strategies

Embed prevention activities within practice routine


Link practice programs with regional, state and national health promotion activities

Reflect on best use of the practice’s time/contribution in community programs and service delivery

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