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2019 Community Project of the Year Award Winner
Does access to Diabetes Educators in a remote West Australian Aboriginal Medical Service have an improvement on Type 2 Diabetes Control?
Completed in: Roeburne, WA
The Community Project forms part of the population health requirement of the Rural Generalist Fellowship and makes it unique to other rural general practice fellowships. Completed over 6-12 months during your time in a rural community, it is a valuable opportunity to get to know the community and improve health outcomes – including a quality improvement activity undertaken within a general practice with the primary purpose to monitor, evaluate or improve the quality of healthcare delivered by the practice.
I chose a topic that we were struggling with at our remote Aboriginal Medical Service - type 2 diabetes management within our community controlled clinic. In particular, the funding of a regular diabetes educator service, which had been absent for a long period prior to this. Key stakeholders were engaged to ensure it was supported by the board and the wider community, as well as to secure funding for the service.
The project purpose was then to assess the impact of diabetes education in improving the health outcomes of the patients, as measured by clinical qualifiers (HBA1C, BP, urine ACR, Total cholesterol and weight) across the span of the 12 month study period.
At the Aboriginal Medical Service I was working at in Roebourne, Pilbara, Western Australia.
I was a newly fellowed GP and started Fellowship within 2 years of completion of FRACGP. I commenced the project within 6 months of starting Fellowship, which allowed the time needed to plan and complete all stages of the project.
The biggest challenge was working out how my idea for the community issue would come to fruition and translate into a Fellowship project and complete the criteria required. In the planning stages, the challenges were getting the stakeholders involved, having the project accepted by the board and data collection. Having support from other clinic staff and patients helped to motivate me and gave me ideas on how to push forward.
The rewarding part of the project was discovering the improvement in clinical parameters for those patients who had seen the diabetes educator. It was so very empowering to see patients and board members becoming ‘champions’ within the community and fostering community participation in the clinic’s programs and general health engagement. It was rewarding to present the results to the clinic staff who have worked extremely hard in managing the patients, particularly in some circumstances case management and individualised approaches. It was really lovely for the staff to see that their hard work in referring, transporting and supporting patients to the diabetes educator appointments resulted in such improvements.
Completing the project helped my confidence and knowledge in attempting to engage stakeholders, apply models to seek funding, use resources to engage patients, evaluate patient data and outcomes to show changes in study. I guess it empowered me to believe that, with the community and clinic support, you can make a difference if there is a health need or deficiency that needs to be addressed.
Results in the project assessment showed an improvement in both control and study groups, with the most marked improvements in HBA1c, systolic BP and urine ACR in the group that saw the diabetes educator. Perhaps more successful, even than those results, was the impact that this program and the diabetes focus that was brought to attention and fostered within the community. Another fantastic outcome for my project was the future provision of ongoing service and funding for a diabetes educator for the patients are this remote Aboriginal Medical Service. It was also empowering for the community controlled health organisation to follow the process of identifying a health need, through to the positive end point in collective and individual patients’ stories of improvement.
Brainstorm ideas for your project early so you have time to discuss with a mentor and devise a plan. You might already have thought of issues within your practice or community that you want to change. Using something that you’re passionate about will ensure it is something that is likely to be worthwhile - you can fit the project guidelines around this. Don’t feel that you can’t select a topic because it will be hard to fit the required steps of the project. Once you start creating a plan, the criteria and steps can be ‘moulded’ to your project. I almost didn’t do this topic because I thought it would be too hard to get stakeholders involved. Little did I know how keen key stakeholders would be on assisting and that funding grants would become available. Good Luck!
Dr Sophia Gordon is the winner of the inaugural 2019 Community Project of the Year Award. Her innovative project directly contributed to healthcare improvement in remote general practice and positively impacted the town’s community.
The Community Project of the Year award includes a $2,000 cash prize, registration to attend the College's annual conference with return economy flights, accommodation for two nights, an invitation to attend the RACGP National Faculties Evening and acknowledgement at the RACGP Rural Annual Member meeting. The 2019 Community Project of the Year award is sponsored by ANZ Health.
For further details please contact the Rural team on:
1800 636 764
Read the guidelines for completing a rural general practice community project.
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