March 2019 Practice visits: Hackham Medical Centre

On Wednesday 13 March the Flinders QUEST team of Leigh Roeger and Heilie Kwok visited Hackham Medical Centre for our first on-site progress meeting.

Hackham Medical Centre is in Huntfield Heights and is one of the largest practices in the trial. Hackham has 83 participants (child/young people: 7; adults aged 18-64: 32; adults aged over 65: 44). It is primarily a bulk billing practice serving a patient population in a disadvantaged area.

At the progress meeting representing Hackham were the Practice Managers (Mr Zeeshan Khan and Ms Sue Daglish), Practice Nurse (Ms Belinda Blackstock) and Drs Navtej Pal Singh Sandhu, Edwin Lapidario, Muhammad Durani, Mahbubul Alam and Blaceline Costelo-Sayo.

QUEST participants have been relatively healthy since the beginning of the trial but Hackham doctors are gearing for a difficult flu season during the winter months.

Hackham are implementing the enhanced services for Flinders QUEST participants with a direct approach. All QUEST participants have been flagged in the practice system and are routinely offered double appointments with their preferred GPs.

Anecdotally we heard that patients are very positive about the trial and are feeling that they are receiving “better” services. Participants are not using their QUEST ID card as much as when the trial started but do remind practice staff verbally that they are QUEST participants.

Since the start of the trial, it is estimated around 20 participants have experienced hospitalisations. In these cases, discharge summaries were forwarded to each participant’s preferred GP who conducted the follow-up phone call.

It was great for us to catch up with the team at Hackham Medical Centre and to see the interventions getting implemented. The next practice visit will be at Wirreanda on Wheatsheaf Surgery on Thursday 14 March.

Hackham

March 2019 Practice visits: Torrens Clinic

On Wednesday 6 March the Flinders QUEST team of Richard Reed, Leigh Roeger and Heilie Kwok visited one of our Intervention group practices – Torrens Clinic – for our first full team on-site progress meeting.

Torrens Clinic is located in Flinders Park and is one of the most northern practices in Flinders QUEST. Torrens has 45 participants (child/young people: 6; adults aged 18-64: 9; adults aged over 65: 30).

At the progress meeting representing Torrens were the Practice Manager (Ms Melissa Williams) and Drs Alan Forbes, John Tsavdaridis and Sheeper Ahmed. We heard that it was a particularly busy time for Torrens as they prepare for accreditation and coordinate renovations that are underway in their sister practice.

We mentioned to Melissa that we were happy to forward her a copy of the Flinders QUEST Ethics Approval for accreditation purposes (see indicator C3.6; 5th edition). If any other Practice Managers would like a copy of the Ethics Approval for Flinders QUEST please let us know by email to quest@flinders.edu.au.

Torrens Clinic are implementing the enhanced services for Flinders QUEST participants with a straightforward approach. Doctors are reserving a spare appointment each day for QUEST participants and staff are very confident participants will be able to see their preferred GP on the same/next day. According to Torrens staff patients need very little convincing of the benefits of seeing their preferred GP to promote continuity of care. This is very much patients’ strong preference.

Longer appointments are routinely offered for participants. Several participants with chronic conditions have pre-booked routine appointments (30 minutes) several months in advance so that their health conditions can be proactively managed.

Four participants have experienced hospitalisations since the start of Flinders QUEST. Melissa did the follow-up with them and none needed further GP follow-up. Torrens staff felt that generally QUEST patients had been remarkably healthy over summer, but they expect higher rates of health problems during the winter months.

GPs commented that the “QUEST ID card” has proved to be very popular with several participants reminding GPs of their new “special” status.

It was great for us to catch up with Torrens Clinic and very pleasing to see how the Flinders QUEST enhanced services have been able to be readily integrated into their systems of care. The next “cab off the rank” for a practice visit will be Hackham Medical Centre on Wednesday 13 March.

TorrensLeft to right: Dr Leigh Roeger (QUEST Manager), Dr John Tsavdaridis (GP), Prof Richard Reed (Chief Investigator), Dr Sheeper Ahmed (GP), Dr Heilie Kwok (QUEST Coordinator), Ms Melissa Williams (Practice Manager), Dr Alan Forbes (GP)

Flinders QUEST in 2019

Welcome to 2019!

During 2019 we will provide blog entries here to keep everyone up to date with progress on the trial and as a forum to address any of your questions or issues.

To briefly recap – Flinders QUEST has 20 participating practices, 92 GPs and 1044 patients. Practices were randomised to Control / Intervention groups and the Intervention practices are currently delivering the enhanced general practice services to their trial participants.

Last week Richard, Heilie and Leigh travelled to Melbourne to meet with members from the RACGP sister trial being conducted in NSW, Victoria and Tasmania (called ‘EQuIP-GP’), and officials from the RACGP and the Department of Health.

Flinders QUEST is leading the pack in terms of practice and participant recruitment and meeting timelines. This is a great result for everyone’s hard work in 2018 and we have proved that SA can implement a nationally significant general practice trial to very high standards.

As many of you would be aware, the Federal Government has extended the Health Care Home trial through to June 2021 and the implications of this for the two RACGP trials was discussed. More work on this needs to occur and we will keep you posted on any updates.

During March members of the QUEST team (Richard, Leigh, Heilie, and Toni) will visit as many of the Intervention practices as we can. We need to hear from the practices as to how we can best help each practice to deliver the enhanced services to trial participants. And everyone is always interested in what everyone else is doing in the trial and so it is a good opportunity for us to share information.

The 6 monthly data collection from all participants in both the Control and Intervention practices will take place in April which is a big logistical job here.

We are expecting Medicare (MBS / PBS) item level data (for participants in the 12 months prior to joining Flinders QUEST) to arrive from Canberra any day now. This will provide baseline insights into two key components in our trial – a measure of continuity of care (what proportion of GP visits people make to their preferred GP) and the distribution of appointment time lengths.

Thank you for your ongoing support of Flinders QUEST. Please get in touch if you have any items you would like us to post about on this blog.