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Aiming for Excellence RNZCGP Standard for NZ General Practice 2011 Dr Chris Fawcett Maureen Gillon Waveney Grennell PowerPoint Presentation
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Aiming for Excellence RNZCGP Standard for NZ General Practice 2011 Dr Chris Fawcett Maureen Gillon Waveney Grennell. Aiming for Excellence – what is it & who uses it?. RNZCGP Standard for NZ General Practice Reinforces the unique character & contribution of general practice

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Aiming for ExcellenceRNZCGP Standard for NZ General Practice 2011 Dr Chris FawcettMaureen Gillon Waveney Grennell
aiming for excellence what is it who uses it
Aiming for Excellence– what is it & who uses it?
  • RNZCGP Standard for NZ General Practice
  • Reinforces the unique character & contribution of general practice
  • Makes the values of general practice explicit
  • Provides a guide to building a platform to manage increasing diversity and complexity to facilitate a patients journey
  • Is the standard used by 800 practices in the CORNERSTONE programme
  • Increasingly used by other sector organisations as a benchmark
review of aiming for excellence
Review of Aiming for Excellence

RNZCGP Governance

  • RNZCGP Council
  • RNZCGP Board
  • RNZCGP Professional Practice Expert Advisory Group
  • Aiming for Excellence Expert Advisory Group

Sector interest

  • General practices
  • RNZCGP Programmes; CORNERSTONE, Education, MOPS
  • CORNERSTONE Assessors
  • NZ College of Practice Nurses NZNO
  • PMAANZ – practice managers
  • Wellington School of Medicine – clinical effectiveness work
  • General Practice Networks
  • Consumer/communities
  • Health & Disability Commissioner
  • PHOs
  • DHBs
  • NGO/Community sector, Te Wana
  • MOH
  • Health Quality & Safety Commission
  • Health IT Board
  • ACC
the development team aiming for excellence expert advisory group
The Development Team:Aiming for Excellence Expert Advisory Group
  • Dr Chris Fawcett (Chair, CORNERSTONE Chief Censor)
  • Dr Jane Burrell (Chair, Professional Practice Expert Advisory Group)
  • Dr Tane Taylor (GP, Te Akoranga a Maui, CORNERSTONE Assessor)
  • Dr Jim Vause (GP Te Akoranga a Maui, GP Assessor)
  • Dr Jocelyn Tracey (GP, PHO Performance Programme)
  • Dr Malcolm Dyer (GP, PHO Performance Programme)
  • Dr Jane O’Hallahan (RNZCGP Group Manager Professional Practice)
  • Dr Keri Ratima (GP, RNZCGP Tumauaki Maori Principal Advisor)
  • Helen Bichan (Service User)
  • Jane Ayling (CORNERSTONE Assessor, Practice Nurse, NZNO)
  • Rosemary Gordon (CORNERSTONE Assessor, ProCare Quality Manager)
  • Hayley Lord (Quality Manager, Midlands Health Network)
  • Luis Villa (Advisor, Midlands Health Network)
  • Kevin Rowlatt (Practice Manager)
  • Waveney Grennell (RNZCGP CORNERSTONE Manager)
  • Jeanette McKeogh (RNZCGP Senior Policy Advisor, legal)
  • Madhukar Mel Pande (Advisor, Research)
  • Helen Glasgow (RNZCGP CORNERSTONE QI Coordinator)
  • Dr Roshan Perera (Academic Advisor)
  • Dr John Wellingham (Peer reviewer)
  • Stella McFarlane (Peer reviewer)
  • Maureen Gillon (Project Lead)
method
Method
  • First consultation phase – 6mths
  • Review of quality landscape & literature
  • Feedback from CORNERSTONE practices & assessors on 2009 version
  • Legal, safety and risk criteria updated
  • Other criteria reviewed
  • A4E working group – rebuild
  • Testing for SMART – specific, measurable, achievable, relevant, timely:
    • Notified general practices, networks and sector organisations
    • Consumer workshops
    • Practice visits
    • Sector workshops
    • Targeted organisations
  • Second consultation phase
  • Refinement by A4E Working Group
  • Peer review
  • A4E Expert Advisory Group Handover & recommendation
  • Signoff by College Board & Council
result of feedback on previous version
Result of feedback on previous version

Improved relevance and acceptability:

  • Legal safety & risk measurements were revised and updated
  • Duplication stripped out
  • Reduced number of indicators and criteria
  • Clarity was improved
  • More emphasis on the patient journey – integration, continuity, transfer of care
  • Emphasis on results
  • Greater emphasis on clinical effectiveness
  • Standards ratified by College
a new structure was developed to reflect current thinking by the college
A new structure was developed to reflect current thinking by the College

4 areas:

  • Patient experience
  • Practice Environment & Safety
  • Clinical Effectiveness Processes
  • Professional Development

Purpose:

  • Focus on improving outcomes for patients

Improving outcomes for patients

improved understanding about the intent of criteria
Improved understanding about the intent of criteria
  • Needed to improve specificity of each criterion
  • Removal of the guide to interpretation to improve understanding and enable the CORNERSTONE programme to provide better advice to practices
  • Introduction of a rationale

Indicator 16

The practice ensures effective infection control to protect the safety of patients and team members

Criteria Rationale

a focus on supporting the patient journey
A focus on supporting the patient journey

Supported by the findings from the Voyage to Quality work – R. Perera, more emphasis on:

  • Clinical effectiveness
  • Systems to manage patient care
  • Robust information
  • Transfer of care
  • Continuity
  • Integration
next steps enabling clinical effectiveness
Next steps: Enabling clinical effectiveness
  • A General practice Quality System
  • RNZCGP Quality Framework
  • New three year structure incorporating clinical effectiveness requirements for CORNERSTONE
  • Clinical Effectiveness Modules
  • A CORNERSTONE resource library – practice access to modules
  • Clinical outcome indicators
  • The Healthcare Quality Measures NZ – library of indicators (Patients First) – practice access to clinical measures
  • Clinical management tools – PHOs
  • Patient self management
  • Feedback loops – results
  • Publish the Profile of CORNERSTONE General Practices 2009-2011
cornerstone
CORNERSTONE
  • Practices in the CORNERSTONE programme use Aiming for Excellence standards to develop their practice systems
  • Total number of general practices in NZ – 1086
  • Registered with programme – 757 (70%)
  • Accredited Cycle 1 – 640 (59%)
  • Accredited Cycle 2 – 81 (62%)
  • PHO – 69 (prior to amalgamations)
  • DHB – 21
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Next
  • Continue to accept feedback on Aiming for Excellence
  • Establish closer links with general practices to identify clinical effectiveness opportunities
  • Work with other general practice and primary care organisations to support patient improvement opportunities