Facilitating Multidisciplinary Teamwork between General Practice and  Allied Health Professionals
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Facilitating Multidisciplinary Teamwork between General Practice and Allied Health Professionals Dr Bibiana Chan, Team-link Co-ordinator Bettina Christl & Danielle Noorbergen, Data collectors. Investigators.

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Investigators

Facilitating Multidisciplinary Teamwork between General Practice and Allied Health Professionals Dr Bibiana Chan, Team-link Co-ordinator Bettina Christl & Danielle Noorbergen, Data collectors


Investigators

Investigators

Chief InvestigatorsCIAProfessor Mark HarrisCIBProfessor Nick ZwarCICProfessor Patrick CrookesCIDA/Professor David PerkinsCIEA/Professor Judy ProudfootCIFA/Professor Gawaine Powell-Davies

Associate InvestigatorsA/Professor Stephen LilliojaDr Jeff Flack

Mrs Elizabeth HarrisDr Teressa AndersonDr Andrew Boyden

Dr Upali Jayasinghe

UNSW Research Centre for Primary Health Care & Equity


Investigators

Aims

The specific objectives of the study are:

  • To design a practice-based intervention to improve multidisciplinary teamwork within general practices and between practices and other services ( by allied health professionals)

  • To evaluate the impact of this intervention on the quality of care for patients with diabetes, ischaemic heart disease and hypertension

UNSW Research Centre for Primary Health Care & Equity


The team link study

The Team-link Study

To evaluate the outcomes of multidisciplinary care in General Practice in chronic disease management

  • QUAN Data

    • The quality of care to patients with diabetes, ischaemic heart disease/hypertension (Clinical audits, SF12, Clinical Care Interviews, Practice Profile Interviews)

    • Patient satisfaction (PACIC)

    • Measures of Multidisciplinary Linkages (MoML_GP, MoML_RS)

  • QUAL Data

    • Facilitator’s Practice-visit reports

    • GPs Feedback

    • AHPs comments

UNSW Research Centre for Primary Health Care & Equity


Building effective teams requires

Building effective teams requires

Leadership

Training

Protocol

Communication

External Linkages

Defined roles

UNSW Research Centre for Primary Health Care & Equity


Structure of intervention

Structure of intervention

Education session for GPs and referral services (2 hrs)

Focus on roles and responsibilities, effective teamwork, and communication

element of shared learning - allow for building personal links

e.g. Case Conferences involving GPs, AHPs and patients

3 Structured practice visits over 6 months (1 - 1.5 hr each)

Conducting needs analysis,

helping practices formulate PDSA cycles

linkages with AHPs (visits by AHPs, small group learning sessions at DGPs, referrals and electronic record download)

Ongoing support

IT Support, troubleshooting & guidance

Provide info on evidence based care of diabetes, CVD, and hypertension.

UNSW Research Centre for Primary Health Care & Equity


Investigators

Research Participants

RR - Response Rate * Two of the Dieticians were also Ex Physiologist s Average

UNSW Research Centre for Primary Health Care & Equity


Investigators

QUAL Data: Organisational Collaboration

Local DGPs

Board Members,

Program managers,

project officers,

IT officers

AHPs

In-house AHPs ,

AHPs based at DGPs,

private practices and

public services

Practices

GPs,

Practice Nurses,

Non-Clinical staff

Support and Training

UNSW Research Centre for Primary Health Care & Equity


Investigators

Team-link Qual data : Communication

New paths

Referrals

Info from practice

Info from AHPs

Practices

AHPs

Why referred?

GPs

Professional

Advice

Patients

feedback

Staff meetings

concerns

Support

Admin stuff & Follow-ups

Reports & Visits

Prac Nurses

& staff

3-way communication via phone between GP, patient and an AHP

UNSW Research Centre for Primary Health Care & Equity


Team link qual data partnership

Team-link Qual data: Partnership

GPs

Team leaders

with decision making POWER

GPs acknowledge patient’s control of their own health

GPs - delegate jobs

PNs - case manager

Referrals & Timely reports

Patients

Patient-centred care

provide specialised care &

monitor patient progress

PNs provide education

Patients- Self-manage

Prac Nurses and other staff

AHPs

Follow-ups and other admin stuff

Team members

provide admin support &

clinical care services,

Free up GP’s time for

patient consultations

Team members

GPs acknowledge the

roles of AHPs;

Building up TRUST

within the team

UNSW Research Centre for Primary Health Care & Equity


Where does trust sharing start

Where does TRUST(sharing) start?

At the beginning GP did not entirely trust allied health professionals (dieticians) to treat the patient as he wanted them treated, so he was doing all the work himself. Now he is using Division’s dieticians and can see the value of their participation.  

(Macathur)

Most benefit was opportunity to interact with AHPs and find out what they need from us and what they can do for us and our patients to improve patient health.

(Small Group Learning Central)

The more contact with the referring Dr the more they (GPs) realise that AHPs play an integral role in the management of their patients in a positive way. The professional relationship takes time to build up, usually relies on the GPs to initiate the process. (AHP Survey). 

UNSW Research Centre for Primary Health Care & Equity


Who holds the power

Who holds the POWER?

Developing educational strategies for patients in self- management. GP is keen in supplying education on lifestyle changes for his patients  in relation to their chronic conditions (SW Syd).

 .

GP knows his patients idiosyncrasies and will pick an AH professional  that deals with the individual needs of his patients.

(Macathur)

I think it is more important to have a relationship with the doctor than the practice nurse as it is the Dr who has the decision making power regarding treatment

(AHP Survey). 

UNSW Research Centre for Primary Health Care & Equity


How to establish partnership

How to establish PARTNERSHIP?

GP suggested regular internal group meetings in the future will be helpful for them to strengthen the exchange of ideas within the internal team (SW Syd).

 .

GP stated that he is getting feedback from patients saying they are happy with the AHPthey had seen, and this is how he finds out if they have been sent to the right AH person (Macarthur).

The management of chronic disease depends on the patient moving in and out of the various layers of the health system easily (AHP Survey).

UNSW Research Centre for Primary Health Care & Equity


Investigators

Core concepts of inter-professional collaboration

(D’Amour et al 2005) Within the Team-link Intervention Process

Power

Maintain status quo

Interdependency

Understand values and

roles of Team Members

Sharing

Need to establish personal relationship and trust

UNSW Research Centre for Primary Health Care & Equity


Gps overall feedback on team link intervention

GPs’ overall feedback on Team-link Intervention


Thank you

Thank you

For more information, contact

[email protected]

or

[email protected]

www.cphce.unsw.edu.au


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