GP 3+ Education Program

The Asthma 3+ Visit Plan

       CONTINUING PROFESSIONAL DEVELOPMENT

Post-session Evaluation Form
Name       (Required)
Division Name (Required)
QA Number  
Today's Date
Date of Workshop

GPs are asked to complete this survey to be eligible for 5 CPD points per hour.
GPs should complete and return this form to____________(local division)_______________________ by __(4 weeks after the event)_____.

1.    What percentage of your patients have asthma? 

0-25

26-50

51-75

76-100
 
2.    Of these, what percentage have moderate - severe asthma?

0-25

26-50

51-75

76-100
 

3.    Has your practice "signed-on" for the Practice Incentive Payment?

Yes

No

 

4.    Estimate the number of patients you have initiated an Asthma 3+ Visit Plan with over the last 3 months?

Less than 5

6-10

More than 10

 

5.    Do you feel more confident initiating an Asthma 3+ Visit Plan since the workshop?

Yes

No

 

6.    According to the MBS what are the six (6) key requirements to claim the Asthma 3+ Visit Plan SIP?

1.

2.

3.

4.

5.

6.

 

7.    In respect of your patients who suffer from asthma, do you
Never Sometimes Mostly Always
a. Complete a written Asthma Action Plan
b. Review asthma-related medication regularly
c. Provide patients with self-management educational material
d. Demonstrate how to use medication dispensing instruments
e. Conduct spirometry tests
f. Conduct or refer for skin prick testing

 

8.    What triggers you to do the above?

 

9.    Following the workshop, list three (3) changes you have made in the management of your asthma patients

i.
ii.
iii.
 

10.    Has anything been too difficult to change?  What?  Why?

 

11.    Is there any other support your Division may provide you so that the practice can systematically provide the Asthma 3+ visits?
        (eg., information, advice and materials regarding marketing visits to patients; training staff to issue recall notices; information on billing)

12.    How have your patients responded to the Asthma 3+ Visit Plan?

 

13.    What other asthma-related topics would you like to know more about?
    i.
    ii.
    iii.

 

This program has been funded by the Department of Health and Ageing.

(Thank you to the Knox Division of General Practice and GPDV for contributing to the development of this survey.)