February 2018 No Images? Click here Practice tips: assessing practice readinessParticipating practices have made the commitment to start their transformative journey to a Health Care Home. A key question for the practice is: “Where do we start?” Practices may have a vision for the type of Health Care Home they would like to be. At times however, the changes required may seem challenging. The first step in this journey is to assess practice readiness and identify opportunities for improvement. The Health Care Homes Assessment (HCH-A) tool has been developed to help practice teams understand their level of readiness. PHN practice facilitators can support practices through this process, help identify areas for improvement and translate these into practical activities within a practice action plan. This action plan then creates a roadmap, and guides practices to identify outcomes. The steps in the HCH-A tool are simple and include a valuable self-reflection activity that generates a whole-of-practice discussion to better understand how each practice really works. Tips for completing the HCH-A:
Clinical champion: Vinita Deshpande, clinical consultant pharmacistWhere do you work?“I work at Mt Druitt Medical Centre with Dr Kean-Seng Lim and a great team of GPs, practice staff, practice nurse, dietician, exercise physiologist, psychologist and counsellor. I have been here since April 2017. “We are [currently] looking at our patient database and trying to focus on a specific population of patients who might benefit from some sort of pharmaceutical intervention. For example, patients who are on long-term opioids or benzodiazapines. These classes of drugs are not meant to be used long-term, so we’re trying to make sure that we’re giving people alternatives, trying to reduce their dose and to work out if we can give them alternate ways of managing their pain. “We also do opportunistic interventions, for example with people who are post-hospital discharge. People on inhaled medications for COPD or asthma, as they can benefit from having someone check their device technique. I also do spirometry so that we can reduce their dose of inhaled corticosteroids if they have improved.” What’s the demographic at your practice?“We have a multicultural demographic made up of both young families and older people. We have some extended families coming to the practice, so the parents, children and grandchildren all come to the practice. My patients are generally in the over 60 age bracket.” What are you doing differently with your Health Care Home patients?“We are following up on them more, trying to make sure we get some data more regularly, their blood pressure, their weight, blood glucose monitoring and being in more regular contact with them to see how they’re managing.” What do you like about working in a GP clinic?“I’ve always wanted to work in primary care as a pharmacist, and I became an accredited pharmacist for that reason. I enjoy the one-to-one patient contact and the problem-solving that’s involved in that. “My main motivation is patient care. My role at the practice is all about trying to optimise a person’s care ― looking at it from the point of view of medication optimisation or trying to address some of the concerns that the patient may have brought up themselves. “I also like my role in clinical governance and data management as this ties in well with optimal patient care. Finding the gaps and or looking for ways to improve what’s already there so that we are not missing anything. It’s a way of taking my role one step further.” What skills do you bring to the practice?“I can look much more closely at what’s happening with the medication, look at renal function in terms of drug doses ― that’s a big one ― and what medications a person might be taking that the GP doesn’t know about. That could be an over-the-counter medication, or they’ve gone and seen another GP and been prescribed something. “I can spend some time with them and talk to them about their concerns with compliance issues or anything they may not have brought up with their GP. That might be maintenance treatments for COPD and asthma, which they may not be using every day because they find it laborious or don’t know how to do it correctly.” Encouraging patients to be as pro-active as they can is an important part of Health Care Homes. How do you approach patient motivation?“You’ve got to use motivational interviewing techniques ― that’s my technique. For example, if I’m trying to get people to quit smoking, I’ll try to focus on their reasons for smoking or for a previous quit attempt. That’s the way to motivate people in any aspect of trying to change their health behaviour ― get them to elicit their reasons first and then roll with that, and give them more information to help them.” After you’ve seen a patient, do you meet with the GP?“We’ve got a really good system whereby I will see the patient first, I will write notes up and then in the last ten minutes of my consult, the GP will come in. We might decide for example that we need to change them to a different anti-depressant because after talking to the patient at length, we find that they are having too many side effects from their current anti-depressant.” Practices to enrol patients over twelve monthsThe department expects that participating practices will continue to enrol Health Care Home patients over the coming year. This will give practices time to adjust their process and business systems for the Health Care Home model. It also recognises that it may take time for practices to contact potentially eligible patients, tell them about Health Care Homes, and make sure that people who are eligible to enrol are comfortable with the new model. Full enrolment is expected to be achieved by 30 November 2018. This will give all patients a minimum of 12 months of Health Care Homes services. The department will monitor patient enrolment. Animation now onlineAn animation about Health Care Homes is available on the consumer and health professionals’ webpages. The animation targets prospective patients with little knowledge about Health Care Homes. Practices can use it to introduce Health Care Homes to patients, their carers or families. The Health Care Homes handbook and compliance and assurance toolkit are now also available on the department's website. Bookmark these pages for easy access |