Quality Improvement

We support learning that improves the quality of healthcare and the safety of patients

Introduction

HNECC PHN is committed to working with and through general practice to enable delivery of best practice outcomes and experiences for patient populations through continuous quality improvement and data driven processes.

We can provide you with practical advice to assist in implementing quality improvement in your practice through our Primary Care Improvement team. We have also developed a number of resources to support quality improvement activity in our region. In the ‘Related Resources’ section on this page, you will find a ‘Quality Improvement Guide and Tools’ overview. This document provides information around how to prepare for quality improvement activities (readiness tool available in the document), how to run a quality improvement activity in your practice, and how to measure the outcomes of the activity effectively. 

Additionally, we are providing ‘Quality Improvement Toolkits’ in specific clinical areas as they become available. These clinical areas have been identified as a high need in the HNECC region, and the toolkits provided will contain information on how to run a quality improvement activity in that specific clinical area. 

  

 

The World Health Organisation’s process for building a strategy for quality of care: 

Other leaders in quality improvement are:

The Royal Australian College of General Practitioners

The Institute of Healthcare Improvement

The Improvement Foundation

 

What is Quality Improvement?

Quality improvement is a system that can be used to regularly review and refine processes in order to improve them, which will in turn impact positively on the care of and health outcomes for your patients.

A quality improvement approach can be used to review structures, systems and processes to enhance patient care, outcomes and safety. Both patient and practice data should be used to determine where quality improvement can effectively occur.

The RACGP defines quality improvement as “An activity used to monitor, evaluate or improve the quality of health care delivered by the practice.”

Examples of how quality improvement can be used in primary care are as follows:

  • Clinical audits
  • PDSA cycles
  • Research and evidenced-based journal clubs
  • Small group education sessions
  • Accreditation processes.

Practice Incentive Program (PIP) Quality Improvement

The Practice Incentives Program (PIP) supports general practice activities that encourage continuing improvements, quality care, enhancing capacity and improving access and health outcomes for patients.

The number and type of incentives available within PIP will change from  1 August 2019 when five of the existing incentives will cease and a new incentive, the PIP Quality Improvement (QI) Incentive will commence.

The QI Incentive aims to recognise and support those practices that commit to improving the care they provide to their patients. Participating practices will be supported to utilise the information they have about their own communities and their knowledge of the particular needs of their own patients to develop innovative strategies to drive improvement. 

As well as demonstrating a commitment to quality improvement, practices will share a minimum set of aggregated data with their local Primary Health Network (PHN), such as the number of patients who are diabetic, the percent who smoke, the cardiovascular risk and weight profile. This information will be collated at the local level by the PHNs to assist in supporting improvement and understanding health needs. There is no requirement for individual patient data, and any measures from an individual practice will not be available to the Department of Health. 

The Royal Australian College of General Practitioners (RACGP), the Australian Medical Association (AMA), the Australian College of Rural and Remote Medicine (ACRRM), the Rural Doctors Association of Australia (RDAA), the Australian Association of Practice Managers (AAPM) and the National Aboriginal and Community Controlled Health Organisations (NACCHO) are all working together as members of the Practice Incentives Program Advisory Group (PIPAG), along with the Department of Health to ensure that this initiative is focused on quality improvement and does not follow other countries in introducing a 'pay for performance' program with perverse incentives.

The Colleges, AMA, RDAA, AAPM and NACCHO are also working closely with the PHNs to ensure the program has strong governance of general practice data.  

With an implementation date of 1 August 2019, the following four Incentives will continue through to 31 July 2019 and then cease:

  1. Asthma Incentive
  2. Quality Prescribing Incentive
  3. Cervical Screening Incentive
  4. Diabetes Incentive

The seven PIP Incentives that will remain unchanged are:

  1. eHealth Incentive
  2. After Hours Incentive
  3. Rural Loading Incentive
  4. Teaching Payment
  5. Indigenous Health Incentive
  6. Procedural General Practitioner Payment, and
  7. General Practitioner Aged Care Access Incentive

Further information on participation requirements will be made available shortly through the Department.

For ongoing and up to date information about the QI PIP from the Commonwealth Department of Health, please go to this link.


Quadruple AIM and Bodenheimer’s 10 Building Blocks for Primary Care

HNECC PHN is committed to the Quadruple AIM which encompasses enhancing patient experience, improving population health, reducing costs and improving the work life of health care providers.

 

Bodenheimer’s ‘10 Building Blocks for Primary Care’ also underpins the success of high-performing primary care.

 

Person-Centred Care

A central component of fulfilling the Quadruple Aim and Bodenheimer’s 10 Building Blocks for Primary Care is to have a person-centred approach.

In a Person-Centred Health System, the person, their families and carers are at the centre of how care and is designed, planned, communicated and delivered. This is because ultimately, it is the values, resources and actions of the person and their carers that are the key determinants of health outcomes.

Every community has differing characteristics and it is ideal for a practice to identify its patient population, particularly if it has a high number coming from priority and diverse populations. These populations might include:

  • Aboriginal and Torres Strait Islander
  • People living with a disability
  • People who identify as part of the LGBTQI community
  • Culturally and Linguistically Diverse (CALD)
  • Migrants including asylum seekers or those on long-term student visas
  • Patients experiencing mental illness
  • Homeless people

Ensuring vulnerable patients are identified and treated equitably is important for identifying disease early and for better health outcomes.

 

Health Promotion

Although General Practices have been practicing health promotion for years, it is now generally agreed that applying a systematic approach to health promotion and illness prevention strategies can influence population health outcomes.

The RACGP Standards for General Practice 5th edition has a criterion (C4.1) directly related to health promotion and preventative care.

 

Health Pathways

HealthPathways is an online health information portal for GPs and other primary health clinicians, to be used at the point of care. It provides information on how to assess and manage medical conditions, and how to refer patients to local specialists and services in the timeliest way.

As HealthPathways is a dynamic collaboration between local primary health care clinicians and the Local Health District there are separate portals for both the Hunter New England and Central Coast regions.

Up to date, evidence-based resources for patients are available on the companion PatientInfo site which is not password protected and freely available to all members of the community.

 

Health Literacy

Limited health literacy is associated with poor health and is a significant problem in Australia. Approximately 40% of Australian adults can understand and apply health information in the way it is usually presented. This means that six out of ten Australian adults are not able to make informed choices about their health, or the care that they receive.

HNECC PHN recognises the importance of clear communication in ensuring safe and high-quality health care, including the need for health consumers being able to access, understand and appropriately act on health-related information. HNECC PHN has developed a Health Literacy Guide to help service providers produce health information that is appropriate for all consumers, including those with low health literacy.

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