Better Sooner More Convenient Primary Care - New Zealand Doctor
Better Sooner More Convenient Primary Care - New Zealand Doctor Better Sooner More Convenient Primary Care - New Zealand Doctor
Structure Process Outcomes Facility environment Clinical care Health status Facility systems Relationships Equity Patient experience Cost The following table demonstrates expands on this by identifying which aspects of the quality framework are addressed by the various work plans: Domain Quality activity Work plan Structure – facility environment Cornerstone accreditation of each IFHC Workforce Structure – facility systems QI teams and clinical governance systems in each IFHC Better after hours arrangements Process - clinical care HealthPathways care guidelines Electronic decision support for LTCs MDT Professional development activities Active feedback loops Patient pathways Process - relationships Core general practice teams Facilitated planning sessions MDT teams Shared mental health assessments Integrated health promotion activities Outcomes- health status PHO Performance Programme indicators Long term condition programme indicators Public health indicators Outcomes - equity All access and clinical indicators reported for Māori and rest of population Outcomes – patient experience Measure access delays Develop a community satisfaction questionnaire Outcomes - cost Align clinical and financial incentives Monitor effects of changes to model of care on finances Workforce Acute care HealthPathways Long Term Conditions Workforce Workforce Integration: community based services Mental Health Frail elderly Direct access to diagnostics Core general practice care Integration: community based services Mental health Frail elderly Mental Health Keeping People Healthy Workforce Long Term Conditions Keeping People Healthy Core general practice care Long Term Conditions Core general practice care Referred services Business plan Business case EoI V38 AC 25Feb10 Page 42
Quality domains Each new initiative will be assessed to ensure that the following domains of quality have been addressed 16 : evidence based patient centered organisational and staff competency and capacity outcomes and Continuous Quality Improvement approach financial viability. Safety The following safety initiatives are part of this plan: Significant event auditing (a required aspect of Cornerstone Accreditation). Safe clinical care: all primary and community providers caring for the same patients use the same electronic clinical notes. Safe prescribing: hospital discharge medications copied to pharmacies and adopting electronic prescribing when available. Safe feedback: The development of active feedback loops so that any concerns about the quality of patient care will be fed back to the health providers concerned in a constructive, educational environment. Monitoring and evaluation The PHO has a strong track record in evaluating programmes regularly (either internally or externally) particularly any new or resource intensive initiative. The work plans in the appendices all have associated output and outcome measures (with baselines and targets) that can be used for both quality improvement and evaluation purposes. Regular monitoring and reporting against these measures will become part of the regular PHO quarterly report. In addition every six months a half day 'review of progress' workshop will identify any early risks to the successful implementation of the plan, and address any issues that have arisen. We have supported the application to the Health Research Council by Dr Jeff Foote and colleagues at the Institute of Environmental Science and Research (ESR) Ltd to carry out a systems analysis on the effectiveness of this business case. 16 Adapted from the RACGP Quality framework http://www.racgp.org.au/qualityframework Business case EoI V38 AC 25Feb10 Page 43
- Page 1 and 2: Business Case Better, Sooner, More
- Page 3 and 4: 1 Caveats/status This business case
- Page 5 and 6: Current situation By three years Wa
- Page 7 and 8: staffed on a capacity model - in wh
- Page 9 and 10: support from DHBs, specialist clini
- Page 11 and 12: 10.4 Key milestones................
- Page 13 and 14: Annual government health funding pe
- Page 15 and 16: Ambulatory Sensitive Hospitalisatio
- Page 17 and 18: The base populations of the three d
- Page 19 and 20: Māori/Pacific Not Māori/Pacific D
- Page 21 and 22: 4.7 West Coast region service deliv
- Page 23 and 24: 5 Future model of care 5.1 The desi
- Page 25 and 26: support them. Help with understandi
- Page 27 and 28: LEVERS VISION Better, sooner, more
- Page 29 and 30: providing the majority of care). Th
- Page 31 and 32: The Community Health System Deliver
- Page 33 and 34: To better integrate the support pro
- Page 35 and 36: 5.5 Enablers A key aspect of this b
- Page 37 and 38: Two rounds of meetings with front l
- Page 39 and 40: While doctor-nurse substitution has
- Page 41: Nick Goodwin, Kings Fund 14 , in hi
- Page 45 and 46: Preventative Acute LTC management R
- Page 47 and 48: Preventative Acute LTC management R
- Page 49 and 50: The core services are provided or p
- Page 51 and 52: Total required FTEs for the Grey IF
- Page 53 and 54: 7 Governance, Ownership & Managemen
- Page 55 and 56: Option D: PHO/DHB jointly owned Pri
- Page 57 and 58: The IFHS will need the ability to b
- Page 59 and 60: Of note, a large proportion of the
- Page 61 and 62: The DHB delegates decision making o
- Page 63 and 64: Limited integration of community se
- Page 65 and 66: 10.4 Key milestones The table below
- Page 67 and 68: Expanded pharmacy roles Improving a
- Page 69 and 70: Devolved community based services w
- Page 71 and 72: Appendices Appendix One: Health Equ
- Page 73 and 74: ongoing GP shortage creating an env
- Page 75 and 76: 10. What are the unintended consequ
- Page 77 and 78: It is common for people with an acu
- Page 79 and 80: Outcome measures Indicator Baseline
- Page 81 and 82: determine ratio of nurses and GPs t
- Page 83 and 84: C. Extended role for pharmacists:
- Page 85 and 86: 11 Engagement Working group who dev
- Page 87 and 88: Appendix B: Acutely unwell adult pa
- Page 89 and 90: 4 Objectives to implement nur
- Page 91 and 92: Review Buller after hours arrangeme
Structure Process Outcomes<br />
Facility environment Clinical care<br />
Health status<br />
Facility systems<br />
Relationships<br />
Equity<br />
Patient experience<br />
Cost<br />
The following table demonstrates expands on this by identifying which aspects of the quality<br />
framework are addressed by the various work plans:<br />
Domain Quality activity Work plan<br />
Structure – facility environment Cornerstone accreditation of each IFHC Workforce<br />
Structure – facility systems QI teams and clinical governance systems<br />
in each IFHC<br />
<strong>Better</strong> after hours arrangements<br />
Process - clinical care HealthPathways care guidelines<br />
Electronic decision support for LTCs<br />
<br />
<br />
<br />
MDT Professional development activities<br />
Active feedback loops<br />
Patient pathways<br />
Process - relationships Core general practice teams<br />
Facilitated planning sessions<br />
MDT teams<br />
<br />
<br />
Shared mental health assessments<br />
Integrated health promotion activities<br />
Outcomes- health status PHO Performance Programme indicators<br />
Long term condition programme<br />
indicators<br />
Public health indicators<br />
Outcomes - equity All access and clinical indicators reported<br />
for Māori and rest of population<br />
Outcomes – patient experience Measure access delays<br />
Develop a community satisfaction<br />
questionnaire<br />
Outcomes - cost Align clinical and financial incentives<br />
Monitor effects of changes to model of<br />
care on finances<br />
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<br />
<br />
Workforce<br />
Acute care<br />
HealthPathways<br />
Long Term<br />
Conditions<br />
Workforce<br />
Workforce<br />
Integration:<br />
community based<br />
services<br />
Mental Health<br />
Frail elderly<br />
Direct access to<br />
diagnostics<br />
Core general<br />
practice care<br />
Integration:<br />
community based<br />
services<br />
Mental health<br />
Frail elderly<br />
Mental Health<br />
Keeping People<br />
Healthy<br />
Workforce<br />
Long Term<br />
Conditions<br />
Keeping People<br />
Healthy<br />
Core general<br />
practice care<br />
Long Term<br />
Conditions<br />
Core general<br />
practice care<br />
Referred services<br />
Business plan<br />
Business case EoI V38 AC 25Feb10 Page 42
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