On Tuesday 19 March the Flinders QUEST team comprising of Richard Reed, Leigh Roeger and Toni Chappel visited Chandlers Hill Surgery for a progress meeting. The meeting was very well attended with the majority of practice staff present.
Chandlers Hill Surgery is situated in Happy Valley and has been providing care for patients in this catchment area since 1985. Chandlers is our largest QUEST practice with 9 GPs and 100 patients taking part. This means that Chandlers has approximately 20% of our Intervention participants.
Being a larger practice meant that the first key task for Chandlers’ indomitable Practice Manager (Jacky Genesin) was to get a very large group of staff working together “on the same page” for Flinders QUEST, to ensure that there was consistent delivery of the enhanced services across the team.
Jacky has flagged participants in their Best Practice software system by recording them as Health Care Homes (HCH) trial participants. She is currently experimenting with using the HCH reports programmed within the software, for our participants.
At Chandlers each QUEST participant is allocated into a ‘Pod’ which contains his or her preferred GP, a Practice Nurse and an Administration staff member. Each participant was informed (by letter) explaining how Chandlers was going to implement the trial. In the introductory letter participants were also encouraged to phone the practice to advise their ‘Pod’ of any Emergency Department presentation or hospital admission. As we all know, the discharge summary is not 100% reliable and so this will help prevent participants from falling through the cracks.
As in other practices GPs are blocking out reserved appointment slots for QUEST participants. It is thought that this will significantly improve the ability of participants to see their preferred GP (continuity of care). Longer appointments are being offered but Chandlers also reviewed the appointment frequency of participants and used this information to schedule a ‘course’ of planned longer appointments for the 12 months of the trial.
In addition (and we don’t know how they found the time to do this!) they ran a focus group for participants where they gathered lots of useful feedback not just about the trial but also the services they provide generally.
With a real ‘Pod’ team approach, Chandlers has been able to ensure that nearly all QUEST participants have a Care Plan and have been screened (where appropriate) for preventative health requirements e.g., BMD and Home Medicine Reviews.
Chandlers staff always ask very good questions and GPs had two curly ones for us. The first question was whether GP participation in Flinders QUEST could be used for CPD purposes. The answer is yes and we will post a blog next week on the specific details.
The second question (which was also raised at WOWS) was around our measure of continuity of care when GPs have a ‘buddy’ GP. We will do some investigations into this and present the data at our planned 6 month workshop for Intervention practices.
An interesting question raised by seeing all the ‘extra’ activities being undertaken by Chandlers is how does this fit into the idea of our clinical trial which is designed to test the impact of specific enhanced services. Flinders QUEST is a pragmatic trial. This means it is being conducted in the real world of practices and not a laboratory or university setting. Taking part in Flinders QUEST did not mean that practices (either Intervention/Control group) had to stand still with their quality improvement efforts. Chandlers (like all the practices in QUEST who self-selected to join our trial) were engaging in quality improvement activities long before we came along and will do so after the trial is complete. According to Jacky, Flinders QUEST enabled Chandlers to put additional focused effort into quality improvement areas that they had wanted to do for some time.
From our perspective, better quality general practice services have the potential to produce better patient outcomes. And that’s something that everyone involved in Flinders QUEST can be on the same page about.
So well done to Jacky, Meera, Casey and the whole team at Chandlers for their very proactive approach to implementing Flinders QUEST.
Next practice visit we are looking forward to is Hallett Cove.
Left to right (standing): Dr Natasha Alexandrides (GP), Dr Moira Gallagher (GP), Dr Dan Nolan (GP), Dr Laura Turnbull (GP), Dr Paul Muffet (GP/Partner), Dr Leigh Roeger (QUEST Manager), Ms Jacky Genesin (Business Manager), Dr Kerry Hancock (GP/Partner), Ms Stacey Jennings (Practice Nurse)
Left to right (seated): Prof Richard Reed (Chief Investigator), Dr Daniel Byrne (GP/Partner), Ms Casey Franchi (Practice Nurse)