Better Sooner More Convenient Primary Care - New Zealand Doctor

ecomes business-as-usual). Input is also provided by expert speakers and reports of
successful initiatives in other places.
Implementation plan: to June 30
A. IHI PDSA cycles methodology to improve health centre delivery systems:
identify team(s) in each health centre to work on this project with at least one nurse,
one GP and the practice manager in each team
facilitate one workshop for health centre teams in both Greymouth and Westport
facilitate two team workshops with each health centre
identify the current patient pathway for common types of presentation to general
practice as per the Stratified Levels of Care model in the Primary Health Care Advisory
Council report 20 (see Appendix A)
reach consensus on the desired patient pathways (see Appendix B for potential change in
patient pathway for acutely unwell adult)
implementation of at least two PDSA cycles in each health centre that may include the
following initiatives to improve the patient pathway:
- increased role for nurses as first contact;
- triage systems for deciding who patient needs to see and length of appointment;
- GPs providing back up for a nurse team (patients make appointments with nurses,
GP provides input and advice at the end of nurse consultations);
- implementation of standing orders (see Acute Care plan);
- longer booked consultations with GPs for complex patients;
- GP and nurses divided into smaller teams within the health centre, each with its
own designated population;
- development of the nurse practitioner role within practice teams;
- regular clinical meetings of GP and nurse teams;
- shared review of clinical notes for high needs patients;
- e-mail and phone consultations;
- extended hours clinics during the week;
- drop in nurse clinics;
- development of a health assistant role;
- using Dr Info for recall letters;
- provide focused education for frequent flyers
development of data definitions and collection mechanisms for measuring continuity of
care and community satisfaction with services
identification of training needs of nurses and arrange for Nursing Post Graduate
Certificate Health Assessment paper to be delivered on the Coast in 2010 (see Acute
Care paper)
20 Primary Health Care Advisory Council. Progress Report of the Council‟s work to provide advice to the
Ministry of Health and District Health Boards on Primary Health Care Service Models. Nov 2009
Business case appendices V12 AC 25Feb2010 Page 10