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Interpretive guide to the RACGP Standards

for Aboriginal community controlled health services

Standard 1.3 Health promotion and prevention of disease

Our practice provides health promotion and illness prevention services that are based on patient need and best available evidence.

Criterion 1.3.1

Health promotion and preventive care

Our practice provides health promotion, illness prevention and preventive care and a reminder system based on patient need and best available evidence.

Explanation

Key points

General practice as the gateway

General practices are the gateway to healthcare for most of the Australian population and are therefore well placed to play a key role in health promotion, illness prevention and preventive care. General practices also have the potential to coordinate with other health professionals and key agencies to achieve health promotion and preventive care objectives. The holistic approach to care that general practices provide, allows for each patient’s individual circumstances to be considered when providing health promotion, preventive care, early detection and intervention.

Health promotion is distinct from the education and information that GPs use to support their diagnosis and choice of treatment. Such prevention, education and health promotion may be delivered by GPs, general practice nurses or allied health professionals and reinforced through the use of written materials and other resources such as health promotion points in the ‘on-hold’ telephone messaging system or chronic disease self management/education clinics run by GPs or practice nurses.

Take home information

Education about health promotion and preventive care can be provided verbally during a consultation. It is also useful for patients to self select information on a range of health issues that may affect or interest them. The provision of written material is recommended as patients remember only three to four key messages from a consultation. This criterion refers to the many health pamphlets and brochures available from sources such as health departments, non-government organisations, health promotion programs, local community organisations and support and self help groups. Some educational materials are also produced in audio-visual format, which may complement the written material provided by the practice.

Aboriginal medical services often develop culturally appropriate material for their patients.

Practices are encouraged to be selective about the leaflets, brochures and pamphlets they make available, as these may vary considerably in quality and reliability.

Online information for patients

The use of the internet as a source of health information is becoming more common. Practices need to consider the quality of the information available on internet sites before recommending them to patients.

Practices are encouraged to use the checklist in the current edition of the RACGP ‘green book’ Putting prevention into practice: Guidelines for the implementation of prevention in the general practice setting to help determine whether patient education materials, including those on the internet, are of sufficient quality. The ‘green book’ is available at www.racgp.org.au/greenbook.

The HealthInsite website at www.healthinsite.gov.au is another useful resource and information is available in different languages.

A systematic approach to preventive care

Regular consultations are an opportunity for health promotion.

However, this criterion also requires practices to have a systematic approach to health promotion and preventive care for patients, including those with a physical or intellectual disability.

Systems may include patient prevention surveys, use of disease registers, recall and reminder systems and local service directories to assist with referrals to lifestyle modification programs.

Reminder systems need to operate in such a way as to protect the privacy and confidentiality of patient health information. Practices also need to consider their responsibility to their patients if the practice ceases using a reminder system.

Preventive activities need to be based on the best available evidence and where possible incorporate the use of clinical guidelines.

Health risk assessment

Health risk assessment is a key component of preventive care. General practitioners play an important role in the early detection of disease though screening programs such as the cervical and bowel cancer screening programs.

Managing patient information to support preventive care

Members of the clinical team routinely collect information that should be transferred to a patient’s health summary. A complete health summary makes a useful statement of the patient’s main health issues. This contributes to better continuity of care within the practice and when patients seek care in other settings.

Some information may also be transferred to national registers (eg. immunisation data) or state and territory based systems (eg. cervical screening or familial cancer registries) in order to improve care. Where the practice participates in national registers, patients should provide consent for the transfer of related health information to a register or be made aware that they can opt out of such registers. The RACGP new patient form is a useful tool for informing patients about national registers and recording a patient’s consent to the transfer of health information or their decision to opt out of a register. The new patient form can be ordered through RACGP publications.

Practices might also use data collected in the practice’s clinical software or paper based systems (eg. smoking status, diabetes register) to improve the targeting and use of prevention activities (eg. smoking cessation, weight management). They may use collected information transferred from private pathology providers (eg. diabetes screening, cervical screening). This is not only a quality improvement activity (see Criterion 3.1.1 Quality improvement activities); it also provides a check that the practice is identifying all relevant patients for their health promotion and preventive care activities.

Useful resources for the practice

Services providing care outside normal opening hours

The RACGP acknowledges that the provision of information by services that provide care outside normal opening hours about health promotion and illness prevention is likely to be opportunistic.

Standard 1.3 Health promotion and prevention of disease

Our practice provides health promotion and illness prevention services that are based on patient need and best available evidence.

Overview of Standard 1.3

This Standard is about your health service having a consistent and planned approach to the early detection, prevention and management of the major chronic diseases in its community. It is also about your health service’s health promotion strategy – how it provides the community and patients with the best information and evidence about health and how to prevent health problems.

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