PCD Strategy Evaluation 2007.pdf - NT Health Digital Library ...
PCD Strategy Evaluation 2007.pdf - NT Health Digital Library ... PCD Strategy Evaluation 2007.pdf - NT Health Digital Library ...
General Practice programsGeneral practices are present in urban, rural and remote Northern Territory. There are a widerange of general practice organisations in the NT and Australia-wide who represent differentpreferred interests. Many of these organisations have developed chronic disease programs andguidelines.In most states, there is a state based organisation for Divisions of General Practices, and a RuralWorkforce Agency. In the NT, these two organisations – the NT Remote Health WorkforceAgency and General Practice Divisions NT – merged in 2004 to form the General Practice andPrimary Health Care NT (GPPHCNT). It is the new peak body representing and providingprofessional support for general practitioners working in private practice and non-governmentorganisations.In 2005, the GPPHCNT began coordinating the National Primary Care Collaboratives program inthe NT, of which two major themes are diabetes and heart disease. Over the three years of thisprogram, lead personnel in participating practices and non-government services have been linkedup with other participating practitioners across Australia, and they have been working onimproving an aspect of their practice within these specific theme areas. The aim is to implementsystems to improve care within practices using the “Plan, Do, Study, Act” cycle (64) . The NPCC‟shave been instrumental in bringing about a change in general practice to implement evidencebasedguidelines, care planning and recall systems supported by enhanced use of EPC Medicareitems. In the Northern Territory overall 220 people have participated in the NPCC program with22 GP‟s involved in the program, which is estimated to be approximately 10 per cent of GP‟s inthe NT.TEDGP conducts a number of programs concerned with chronic disease management, which theysee as a core role in supporting general practices/GPs to provide optimal care and to contributeto the achievement of the best possible health outcomes for patients with diabetes (65) . Amongother roles the TEDGP: Identifies and engages organisations, service providers and consumer/carer groups tofacilitate patient access to optimal diabetes care in the Top End Secures consumer opinion and direction through co-ordination with consumer referencegroup to support chronic disease management strategiesChapter 3: Progress Against PCDS Objectives – Evaluation of the NT Preventable Chronic Disease Strategy 2007 54
Identifies priority practices to increase usage of recall systems via clinical informationsystems and endorses „systematic‟ approach to signify the use of electronic not paperbased systems Conducts generic training in IM /IT systems on a needs basis to support Division‟s CDmanagement strategy Organises diabetes CPD sessions for GPs and practice nurses (and other CD) Collects and disseminate, Australian Best Practice Guidelines for diabetes care (65) .The Central Australian Division of PHC provide similar support particularly with linking in to alliedhealth services through the more allied health program.General Practice IncentivesThere are incentives in place for General Practice to deliver a high level of care through thePractice Incentive Program (PIP). PIP payments were originally introduced by the Federalgovernment in 1995 (the scheme was known as the Better Practice Program until July 1998).Practices accredited by Australian General Practice Accreditation Limited (AGPAL) are able toclaim payments for evidence of high level of practice in a number of defined areas includingelectronic prescribing and information transfer, teaching medical students, and diabetesscreening and outcomes.A PIP diabetes incentive payment was introduced in November 2001 to practices that use apatient register and recall reminder system to assist in managing patients with diabetes.Payments are made to practices that reach overall screening targets. In addition, a ServiceIncentive Payment (SIP) was developed for providers who complete an annual cycle of care forpatients with established diabetes mellitus (annual funding $8.7 million Australia-wide from2002). Australia-wide, 82 per cent of PIP practices were participating in this scheme by May2002. An outcomes component for participating PIP practices that reach target levels for thediabetes annual cycle of care for patients was introduced in 2003.In 2004 the Australian Institute of Health and Welfare published a report on the uptake of PIPitems for that year. Data from this report suggested that the proportion of general practiceservices provided by accredited practices participating in the PIP exceeds 70 per cent of the totalnumber of GP services in every state except the Northern Territory where fewer practices wereaccredited (66) . (Figure 3.3)Chapter 3: Progress Against PCDS Objectives – Evaluation of the NT Preventable Chronic Disease Strategy 2007 55
- Page 21 and 22: Choosing the 5 chronic conditionsTh
- Page 23 and 24: Table 1.1Key Result Areas + Best Bu
- Page 25 and 26: prior to the launch of NTPCDS, such
- Page 27 and 28: Year * Action Outcome1999 S NT Prev
- Page 29 and 30: Year * Action Outcome2005 P Aborigi
- Page 31 and 32: CHAPTER 2.EVALUATION METHODOLOGYThe
- Page 33 and 34: 2.2 Evaluation StagesThe NTPCDS eva
- Page 35 and 36: chronic disease activities funded t
- Page 37 and 38: internal project team. It was very
- Page 39 and 40: Situation at Baseline1. The Guideli
- Page 41 and 42: 3.1.2 Patient information and recal
- Page 43 and 44: Ferret Miwatj, Numbulwar, Marngarr,
- Page 45 and 46: Medicare information is not for pub
- Page 47 and 48: was in place in Central Australia i
- Page 49 and 50: What orientation and ongoing traini
- Page 51 and 52: programs focus on chronic disease p
- Page 53 and 54: The information collected as part o
- Page 55 and 56: Assessment against objectiveMost se
- Page 57 and 58: career development, and retention i
- Page 59 and 60: are. Indigenous employment is NTDH&
- Page 61 and 62: NTDH&CS Programs that encourage Hea
- Page 63 and 64: 2002 Aboriginal and Torres Strait I
- Page 65 and 66: delivering any prevention and healt
- Page 67 and 68: The Community Services Division - A
- Page 69 and 70: 1 x AHW Central Australia 2001 S100
- Page 71: One clinic stated it had no care pl
- Page 75 and 76: There has been a significant growth
- Page 77 and 78: about 25 per cent of the hospital b
- Page 79 and 80: The level of funding provided by th
- Page 81 and 82: Central Australia and two zones cur
- Page 83 and 84: The diabetes education teams at HLN
- Page 85 and 86: maintenance group for people with l
- Page 87 and 88: Rebates for participating or arrang
- Page 89 and 90: Use of Medicine Programmes. Althoug
- Page 91 and 92: CHAPTER 4. CLINICAL OUTCOMES OF THE
- Page 93 and 94: improvements have been made to serv
- Page 95 and 96: A recent ten-year follow-up of a co
- Page 97 and 98: The NTDH&CS also collect birthweigh
- Page 99 and 100: Figure 5.3 Vaccination coverage for
- Page 101 and 102: It is also important to note that k
- Page 103 and 104: eported that 50 per cent of the Ind
- Page 105 and 106: The current action plan identifies
- Page 107 and 108: The availability and cost of health
- Page 109 and 110: Hoy et al in 1995-2000 (100) , and
- Page 111 and 112: 5.6 Best practice management5.6.1 P
- Page 113 and 114: disease care in urban areas regardi
- Page 115 and 116: PCIS was developed by NTDH&CS as th
- Page 117 and 118: emote staff can access training and
- Page 119 and 120: In the Top End there appeared to be
- Page 121 and 122: APPENDIX 1EVALUATION OF THE NT PREV
General Practice programsGeneral practices are present in urban, rural and remote Northern Territory. There are a widerange of general practice organisations in the <strong>NT</strong> and Australia-wide who represent differentpreferred interests. Many of these organisations have developed chronic disease programs andguidelines.In most states, there is a state based organisation for Divisions of General Practices, and a RuralWorkforce Agency. In the <strong>NT</strong>, these two organisations – the <strong>NT</strong> Remote <strong>Health</strong> WorkforceAgency and General Practice Divisions <strong>NT</strong> – merged in 2004 to form the General Practice andPrimary <strong>Health</strong> Care <strong>NT</strong> (GPPHC<strong>NT</strong>). It is the new peak body representing and providingprofessional support for general practitioners working in private practice and non-governmentorganisations.In 2005, the GPPHC<strong>NT</strong> began coordinating the National Primary Care Collaboratives program inthe <strong>NT</strong>, of which two major themes are diabetes and heart disease. Over the three years of thisprogram, lead personnel in participating practices and non-government services have been linkedup with other participating practitioners across Australia, and they have been working onimproving an aspect of their practice within these specific theme areas. The aim is to implementsystems to improve care within practices using the “Plan, Do, Study, Act” cycle (64) . The NPCC‟shave been instrumental in bringing about a change in general practice to implement evidencebasedguidelines, care planning and recall systems supported by enhanced use of EPC Medicareitems. In the Northern Territory overall 220 people have participated in the NPCC program with22 GP‟s involved in the program, which is estimated to be approximately 10 per cent of GP‟s inthe <strong>NT</strong>.TEDGP conducts a number of programs concerned with chronic disease management, which theysee as a core role in supporting general practices/GPs to provide optimal care and to contributeto the achievement of the best possible health outcomes for patients with diabetes (65) . Amongother roles the TEDGP: Identifies and engages organisations, service providers and consumer/carer groups tofacilitate patient access to optimal diabetes care in the Top End Secures consumer opinion and direction through co-ordination with consumer referencegroup to support chronic disease management strategiesChapter 3: Progress Against <strong>PCD</strong>S Objectives – <strong>Evaluation</strong> of the <strong>NT</strong> Preventable Chronic Disease <strong>Strategy</strong> 2007 54
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