Effective prevention usually requires teamwork within the practice as well as links with other (clinical and nonclinical) services.
Prevention and health promotion are among the core responsibilities of GPs and PNs.3 Through a range of strategies, GPs and PNs have the potential to influence patients to:
GPs and PNs may also pursue prevention through health advocacy or lobbying within their discipline.
The preventive approach incorporates opportunistic and planned interventions from the perspective of the whole practice as well as for the individual practitioner and patient. It may include auditing medical records to identify those who are missing out, using special strategies to support patients with low literacy, and being proactive in following up patients who are most at risk.8 External help (eg from PHNs) is often needed to support practices in these types of activities. PHNs are able to help in a range of ways, including de-identified data reviews.
The RACGP has developed a resource on Secondary use of general practice data. This resource provides support to decide whether it is appropriate to release de-identified healthcare data at the request of an external organisation.
PHN case study
A couple purchased a retiring GP’s practice. They were new to the business and sought assistance from us, their local PHN.
We assisted them in recruiting a PN by advertising on the PHN website and in monthly newsletters. We provided in-practice training for the PN who had come from a hospital setting – educating the nurse on the cycles of care, using recall reminder systems and maintaining practice protocols such as cold-chain.
We provided software installation and training to the practice, which enabled them to audit their aspects of their practice. With this software, we provided the practice with a report and supported them over the next 12 months in improving their recording of risk factors, patient data entry, and identifying patients with missed diagnoses and billing opportunities. Additionally, this process served as a continuing professional development (CPD) opportunity in quality improvement for the GPs, who now often frequent our free CPD nights.
The business owners felt this help was invaluable.
– Alessandro Luongo, Clinical QI Coordinator, South Western Sydney PHN
Measures to improve access to preventive healthcare by Aboriginal and Torres Strait Islander peoples are especially important, given their higher burden of disease and the barriers that exist to preventive healthcare. More information is available in the National Guide.
Collaboratives case study
Health and Wellbeing North Ward is a multi-skilled and integrated medical practice offering primary care alongside other allied health providers. As a collective, it focuses on the proactive identification and treatment of risk factors before disease appears, and on patient-centred management of existing conditions.
The practice has a large Aboriginal and Torres Strait Islander community in its area. To provide holistic and culturally aware care, the practice employs a specialist Aboriginal and Torres Strait Islander healthcare worker. Having a dedicated staff member for this community allowed the practice to:
- run regular day clinics to address chronic condition management
- offer consistent appointments for the local Aboriginal and Torres Strait Islander population and the local school that educates Aboriginal and Torres Strait Islander children from the broader area
- provide home visits to those with access and/or language barriers
- offer Medicare-rebatable healthcare plans for chronic and mental health conditions through their multidisciplinary set-up.
Patients responded very positively toward the extra care. Patient feedback surveys showed a 95% positive reaction, and practice numbers grew by 38% over two years. The care fostered a sense of loyalty and community among patients, with follow-up appointments kept and measurable improvements in health outcomes.
– Adapted from Improvement Foundation Australia. Australian Primary Care Collaboratives Program, Case study: Health and Wellbeing North Ward, ‘Multi-skilled, holistic agency adopts “wellness” philosophy’. Adelaide: Improvement Foundation Australia, [no date].
Teamwork within an Aboriginal and Torres Strait Islander health service – Health checks
Patients aged 18 years and over are identified and screened for cardiovascular risk, chronic diseases and smoking via the Medicare Health Assessment for Aboriginal and Torres Strait Islander People (Medicare Benefits Schedule [MBS] item 715).
Suitable clients are invited to participate in after-hours exercise group sessions with a personal trainer, twice a week for two hours. Sessions include advice and education on diet and healthy eating, with the aim to decrease body mass index (BMI), increase health literacy and provide better management of chronic disease. Smoking cessation support is also offered and promoted.
– Fiona Thompson, Clinical Services Manager, Pangula Mannamurna Aboriginal Corporation
Visit 'Key Aboriginal and Torres Strait Islander organisations' for a list of useful contacts