What is Quality Improvement?

The RACGP Standards for general practices (4th edition) (the Standards) describes Quality Improvement as an activity undertaken within a general practice where the primary purpose is to monitor, evaluate or improve the quality of health care delivered by the practice (RACGP standards for general practices 4th edition).

The Standards recommend practices engage in quality improvement activities that review structures, systems and processes to aid the identification of required changes to increase the quality of healthcare delivery and safety of patients.

Quality improvement is the process where an opportunity to change practices occurs as a result of learning. Professional advice and a growing body of evidence demonstrate quality improvement activities lead to positive change in practices, particularly when involving a whole practice team approach. Activities the College recognises as inherently QI are:

  • Supervised clinical attachment (SCA)
  • Plan, do, study, act (PDSA)
  • Clinical audit
  • GP research
  • Evidence based medicine journal club (EBMJC)
  • Small group learning (SGL).

 

How is NWMPHN involved?

In 2016, NWMPHN delivered more than $200,000 in grants to 22 general practices. Preference was given to practices that incorporate the following into their applications:

  • Use a team based approach.
  • Target disadvantaged members of the community.
  • Are innovative, evidence-based and sustainable.
  • Have clear objectives and evaluation measures.
  • Have an ongoing benefit for the community.
  • Consider consumers in the planning, implementation and evaluation of the Plan.
  • Have not previously participated in incentivised Quality Improvement activity (i.e. APCC) or can describe how their choice of topic varies from previous activity.

Projects funded cover one of the following priority areas:

 

Grant rounds

Round 1 completed – 31 December 2016.
Round 2 completed - April 2017.

 

Case studies

 

A better plan for patient care

New treatment plans that put the patient’s needs and goals first are having a positive impact on care at one general practice in West Melbourne.

The new plans use motivational interviewing and health coaching approaches to create and record health goals that are meaningful and achievable for patients, taking account of barriers and challenges specific to their circumstances.

A quality improvement grant from North Western Melbourne PHN provided the opportunity for Practice Nurse Maria Hussey from Premier Health Partners to redesign the treatment plan templates to make them more patient focused.

“All the patients involved have said the care plan has really been able to give them some control and a real sense of what they need to do,” Ms Hussey said.

 

Holiday clinics a healthy connection for refugees and asylum seekers

School holiday clinics for young children and their families are helping connect refugee and asylum seeker communities in Fitzroy with the health services they need.
cohealth on Brunswick St Fitzroy started the school holiday sessions in April 2016, part of an innovation program funded by North Western Melbourne PHN.

One in every 10 patients at cohealth Fitzroy identifies as a refugee or asylum seeker, and with appointments for large family groups difficult to accommodate outside of school hours the school holiday program enables non-urgent health screening at a convenient time.
Nurse Jeanette George from cohealth said the holiday sessions “helped staff build relationships with local families and identify children who could benefit from early intervention services and follow up visits”.

 

New program helps reduce pressure on VCE students

Hundreds of VCE students in Caroline Springs had a less stressful time this year thanks to a new youth mental health program offered by local medical centre Active Medical.

Helped by a $3000 grant from North Western Melbourne PHN, Active Medical delivered a mindfulness and meditation session to over 300 students from nearby Lakeview Senior College, as well as an evening discussion with Active Medical clinical staff for both students and their parents.

Practice Manager Raphael Sammut said there was an overwhelmingly positive response to the sessions, both from the students and for the practice itself.

“In the following weeks we saw a lot of students come in, and it was clearly linked to the sessions that we did,” Mr Sammut said.

 

Tracing program helps improve hepatitis B care and testing

A Hoppers Crossing health centre is leading the way in tracing and protecting people in refugee communities who may be at risk of contracting hepatitis B.

Supported by a grant from North Western Melbourne PHN, IPC Health Nurse Vicki Muscat and her team traced 420 people who were close contacts of 122 local Karen people known to be hepatitis B positive.

Most were already immune but around 12% were unprotected and just under 8% were already chronically infected with hepatitis B.

As well as giving close contacts the opportunity to be vaccinated or begin receiving treatment, Ms Muscat said the contact tracing program has also helped keep the original group of patients engaged with the health centre.

“It can be very hard to get people living with chronic hepatitis B to go to the GP and to get regular reviews,” Ms Muscat said. “The project has really helped build the connection between the patients and the centre and encourage them to come in regularly for testing and review.”

 

Resources

Putting prevention into practice - RACGP Green Book
QI&CPD FAQs for 2017-19 triennium
Improvement Foundation - QI training

For more information about Quality Improvement contact Natalie Eykman on (03) 9347 1188.