Fremantle Family Doctors commenced in Sept, 05'

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(No Transcript)
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Introduction

• Fremantle Family Doctors commenced in Sept, 05.
• 5 GPs (4 of whom own the practice)
• 1.6 FTE Practice Nurses
• 1.8 FTE Reception Staff
• Practice / Business Manager
• 500 patients per week

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Collaboratives

• We commenced the Third Wave in July, 06,
  appointing one GP and a PN to be our delegates
  (drivers).
• Everyone in the practice is involved in the
  Collaboratives we have an update report at each
  practice meeting and then progress with PDSAs
  from items raised at the meeting.

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• The Business of Enhanced Primary Care

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The Items

• Annual Health Assessments 700s
• GP Management Plans Reviews 721 725
• Team Care Arrangements Reviews 723 727
• Home Medicine Reviews 900
• Diabetes SIP Items 2517 2525
• Asthma SIP Items 2546 2552
• 45 49 Health Check 717

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What are the benefits?

• Better health management and outcomes for
  patients.
• More efficient use of appointments as visits are
  scheduled rather than emergency visits.
• More appropriate financial compensation for work
  done.

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Should we use them?

• Decide as a practice whether you have the
  following before going ahead with any EPC item
• Capacity do you have the appointment spaces
  required?
• Resources GPs, nurses and other staff who have
  time to complete or assist with EPC items
• Patients who will comply and get benefit from
  these items
• Are they good business?

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Case Study of a Diabetic patient
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What do we do?

• Decide as a practice what the business model will
  be, who will be involved e.g. 15 minute appt with
  nurse then 15 minutes with GP and let everyone in
  the practice know how this will work. It is
  extremely important that you have the process
  worked out before you commence.
• Pull lists of patients for each criteria e.g. 45
  49 year old health checks
• Have a member of staff go through each list to
  weed out those who are inappropriate.
• Mail merge a letter to patients inviting them to
  have the health check

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Plan, Do, Study, Act

• PDSA each step work through it with everyone at
  the practice - you will be amazed at the outcomes!

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Review, Revise, Amend

• At regular intervals make the time to review each
  step, work out what is working efficiently and
  what is not, e.g. nurses need more time with
  patient before they see the GP.
• Amend the process as you find better or more
  efficient ways to administer the program.

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How do we keep track?

• Appoint one or two people in the practice to
  track the patients through the system and ensure
  they are being seen, accurately billed
  recalled, and that the practice is complying with
  the Medicare criteria (process).

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An example..
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Key
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Where to now

• Find out what your numbers are, e.g. patients
  over 75, 45 49, diabetics, etc. concentrate
  on one group at a time.
• Then work out how many eligible patients have EPC
  items and if the appropriate recalls are in
  place. What percentage coverage rate would make
  you happy?
• Share the load some of the administrative work
  can be done by non clinical staff.

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Persist

• Continue through each EPC group until you are
  happy your database is accurate.
• Update on a weekly basis run a report to find
  out which patients had EPC item numbers billed
  and then make sure they are on your spreadsheets
  and recall list.
• It will get easier and the bottom line will get
  better!

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Better Access

• How it works for us
• We colour code our appointment book yellow for
  pre-booking slots and orange for Book on Day only
  slots.
• We have 50 Book on Day slots for Mondays and
  Fridays and 25 for the other days.
• We still have flexibility for appointment times
  the reception staff can take a Book on Day slot
  if they replace it with another somewhere within
  the session.

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The Advantages

• Patient access is excellent they know they can
  get an appointment on the day if they need it,
  and therefore respect the system by not using a
  Book on Day if it is something that can be
  scheduled.
• Reception time is reduced as it is quicker to
  say, Yes I have an appointment available at
  10.00 a.m., than to explain they dont have
  anything and then search for another appointment
  time.

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Advantages, ctd

• Capacity to manage your appointments if there are
  unforseen circumstances e.g. a doctor cannot
  attend their session.
• Happier staff.
• Happier patients.
• Happier doctors.

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Thank you