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
Pharmacist minor ailments services have operated successfully in the UK (Scotland) for a number of years. The effectiveness of the kaiawhina role in improving Māori enrolments has already been proven in the Buller region 26 . 10 Risk analysis Risk Probability Impact Contingency plan Staff do not have time to engage Medium High Arrange workshops in locations and at times that suit practices. Health centres unable to implement new systems Medium High Health centre teams take lead in developing plans. Project manager visits each health centre monthly to provide support and identify early barriers. Changes made do not improve access Low High Monitor results of PDSA cycles quarterly and adapt plans as required. Insufficient training and support provided to nurses Medium High Provision of training in Health Assessment and Standing Orders (see Acute Care project). Ongoing general professional development provided (see Workforce project). At least weekly shared clinical meetings. Monitoring by clinical nurse leader. Difficult to attract Māori nurses Low High Develop a whanau ora, holistic model of care in health centres. Provide Tiriti o Waitangi workshops to other staff. Pharmacists do not have time to expand their role Medium Medium Assist pharmacists with recruitment and retention. 25 McKinlay E. Thinking beyond Care Plus: The work primary health care nurses in chronic conditions programmes NZ Fam Phys 2007;34(5):322- 7. 26 Cooke A. Evaluation: Improving Māori Access in Kawatiri. Jul 2009. Business case appendices V12 AC 25Feb2010 Page 14
11 Engagement Working group who developed this plan: Dr Greville Wood, Dr Anna Dyzel, Nigel Ogilvie RN, Dr JD Naidoo, Hecta Williams, Marie West, Dr Paul Cooper, Pauline Ansley, Helen Reriti, Karyn Kelly, Julie Kilkelly, and Kerri Miedema. Other clinicians involved: Workshops were initially held in Greymouth and Westport, with all nurses, GPs and practice managers invited. Follow-up meetings were held in each health centre to refine the content of this proposal. 12 Organisational accountabilities The change management process will be managed by the PHO in consultation with health centre owners of all health centres; private and DHB. 13 Budget considerations Costs from this plan include: practice, district and regional change management support and facilitation modeling and analysis of changes in model of care on practice viability development/ adaptation and annual administration of community survey kaiawhina employment (SIA). Year one Year Two Year Three Change management facilitation and $74,000 $50,000 $40,000 support Analysis of effects of changes on $10,000 $10,000 $10,000 practice viability Community survey $10,000 $10,000 $10,000 Kaiawhina ($60,000 from SIA Budget) Total $94,000 $70,000 $60,000 These costs are included in the Investing in Change budget, Section 11.1 in the business case. Estimated savings to health centres from changing the model of care are included in Section 9.2 of the business case. Business case appendices V12 AC 25Feb2010 Page 15
- 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 and 42: Nick Goodwin, Kings Fund 14 , in hi
- Page 43 and 44: Quality domains Each new initiative
- 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: C. Extended role for pharmacists:
- 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
- Page 93 and 94: Year three Community education camp
- Page 95 and 96: 13 Costs Budget considerations:
- Page 97 and 98: established. This group now oversee
- Page 99 and 100: Output measures Tobacco control / s
- Page 101 and 102: Improving immunisation coverage - h
- Page 103 and 104: Year three Continued joint plan
- Page 105 and 106: extending health promotion activiti
- Page 107 and 108: Immunisation Coverage Funder Provid
- Page 109 and 110: The Community Health System Deliver
- Page 111 and 112: Clinical care Practice self managem
- Page 113 and 114: and increases in the numbers of pat
- Page 115 and 116: Ambulatory Sensitive Hospitalisatio
- Page 117 and 118: % CVD on lipid lowering drugs, beta
- Page 119 and 120: Health navigators/ kaiawhina: chan
- Page 121 and 122: Committee‟s objectives 41 of prov
- Page 123 and 124: - lack of consistency of care betwe
- Page 125 and 126: qualifications and skills. Where ca
- Page 127 and 128: 6 Deliverables / activities Impleme
- Page 129 and 130: “With an aging population and an
- Page 131 and 132: Differences between revenue generat
- Page 133 and 134: Appendix Seven: Integration - Healt
Pharmacist minor ailments services have operated successfully in the UK (Scotland) for a<br />
number of years.<br />
The effectiveness of the kaiawhina role in improving Māori enrolments has already been proven<br />
in the Buller region 26 .<br />
10 Risk analysis<br />
Risk Probability Impact Contingency plan<br />
Staff do not have<br />
time to engage<br />
Medium High Arrange workshops in locations and at<br />
times that suit practices.<br />
Health centres<br />
unable to implement<br />
new systems<br />
Medium High Health centre teams take lead in<br />
developing plans.<br />
Project manager visits each health<br />
centre monthly to provide support and<br />
identify early barriers.<br />
Changes made do not<br />
improve access<br />
Low High Monitor results of PDSA cycles<br />
quarterly and adapt plans as required.<br />
Insufficient training<br />
and support provided<br />
to nurses<br />
Medium High Provision of training in Health<br />
Assessment and Standing Orders (see<br />
Acute <strong>Care</strong> project).<br />
Ongoing general professional<br />
development provided (see Workforce<br />
project).<br />
At least weekly shared clinical<br />
meetings.<br />
Monitoring by clinical nurse leader.<br />
Difficult to attract<br />
Māori nurses<br />
Low High Develop a whanau ora, holistic model of<br />
care in health centres.<br />
Provide Tiriti o Waitangi workshops to<br />
other staff.<br />
Pharmacists do not<br />
have time to expand<br />
their role<br />
Medium Medium Assist pharmacists with recruitment<br />
and retention.<br />
25 McKinlay E. Thinking beyond <strong>Care</strong> Plus: The work primary health care nurses in chronic conditions programmes NZ Fam<br />
Phys 2007;34(5):322- 7.<br />
26 Cooke A. Evaluation: Improving Māori Access in Kawatiri. Jul 2009.<br />
Business case appendices V12 AC 25Feb2010 Page 14
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