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September 2000 | |
CONTENTS
Vic representatives on ADGP
Nurse Practitioners
National Divisions’ Youth Health Alliance
New MBS Items
Results of the Second Effective Discharge Patient Record Audit
IT Funding
HealthExchange
Progress on the General Practitioner Registry
Vic representatives on ADGP
Vic representatives on ADGP
At the ADGP board meeting on 27 August Julie Thompson (Victorian
rural representative) was elected as Chair and Jill Grogan,
recently re-elected as Victorian metropolitan representative, was
elected as Vice Chair.
Nurse
Practitioners
The Minister is proceeding with the introduction into Victoria of
Nurse Practitioners, and has allocated $3 million over 3 years to
fund demonstration projects. Evaluation reports on the 11
projects funded in the first round were due at DHS at the end of
August and scrutiny of these reports is expected to be completed
during September.
Following the assessment of the evaluation reports on the
existing projects, DHS will seek Expressions of Interest for the
development of new models for testing and will give priority to
community-based and rural proposals that differ from the first
round projects, which were all hospital-based.
GPDV will work closely with the divisions - six so far - that
indicate their interest in the development of the Nurse
Practitioner models, and with DHS staff working on the project.
If you are interested and wish to be involved, please contact
your division.
National Divisions’ Youth
Health Alliance
At ADGP’s National Divisions Conference in Brisbane, Michael
Wooldridge announced funding for a National Divisions’ Youth
Health Alliance. The Commonwealth will provide $300,000 per year
for three years.
New
MBS Items
The Standards & Guidelines prepared by the RACGP for the
Enhanced Primary Care MBS items were launched by Minister
Wooldridge on 23 August. The kits containing the guidelines are
now being distributed by DH&AC and every GP can expect to
receive one by early September.
Results of the Second Effective
Discharge Patient Record Audit
The Department of Human Services engaged KPMG to conduct the
second effective discharge patient record audit in acute and
sub-acute facilities in Victoria. This audit was conducted on a
sample of 9,887 patient records relating to separations during
the period July to December 1999.
KPMG found that overall the discharge documentation of hospitals
has improved since the initial audit with 45% of hospitals
demonstrating significant improvement. However there is still
further scope for improvement as only 20% of hospitals had high
compliance with the revised discharge standard. A further 32%
were assessed as achieving medium compliance, and the remaining
48% were assessed as low compliance.
| Category | Total # of sites | High compliance | Medium compliance | Low compliance |
| Acute | 93 | 16 (17%) | 24 (26%) | 53 (57%) |
| Aged Care | 10 | 6 (60%) | 3 (30%) | 1 (10%) |
| Extended Care | 11 | 1 (9%) | 9 (82%) | 1 (9%) |
| MPS | 5 | 1 (20%) | 2(40%) | 2 (40%) |
| TOTAL | 119 | 24(20%) | 38(32%) | 57 (48%) |
The results indicate that there is inferior compliance in acute
hospitals. However of all acute facilities, rehabilitation and
small rural hospitals had generally higher compliance. There was
superior compliance in aged care, and to a lesser extent,
extended care and Multi-purpose services.
The areas where hospitals scored least well were involvement of
community service providers (including GPs) in decision making
around discharge. The score for this aspect was particularly low
for metropolitan hospitals. However, where community service
providers were involved in decision making, it was most likely to
be the GP who was involved. Involvement of patients and carers in
decision making around discharge also received a low score.
On the positive side the auditors found that in 72% of cases
compliance had been achieved in the organisation of
post-discharge hospital medical services.
The patient’s GP was notified as part of the post discharge
arrangements in 44% of cases where post discharge arrangements
had been made. Extended care, aged care, medium sized hospitals,
and large rural hospitals were much more likely to notify the GP
than other facilities audited. However notification was generally
unnecessary for smaller rural facilities and rehabilitation
centres where the patient’s GP was often the VMO.
Where a patient’s GP had been notified the audit found 52%
of records contained evidence that the patient’s GP was
notified before or on the day of discharge.
The auditors conclude that there have been positive changes in
response to the Effective Discharge Strategy. In particular
hospitals are focussing greater attention on patients with more
intensive needs, and discharge planning is significantly higher
for planned admissions. Nevertheless there is considerable scope
for improvement.
For a copy of the full report contact Kathleen McLaughlin at DHS
on (03) 9616 7124.
IT
Funding
The Minister announced on 25 August that Commonwealth funding for
the IT program which provides divisions and SBOs with dedicated
IT staff has been extended for six months. This will keep the
program going until the end of the financial year while
transitional arrangements are developed.
It is expected that the future direction of the Commonwealth in
this area will be to encourage GPs to be involved in data
collection and information management.
HealthExchange
HealthExchange has announced that it will cease operation and
discontinue the provision of services from 7 September 2000.
HealthExchange (formerly GP Network) provided internet services,
email lists, and web hosting services for divisions and GPs for
several years. After all efforts to find an appropriate merger
partner failed, the company’s board decided to wind up the
company.
Statistics were gathered during a recent divisional ITNetwork
meeting held at GPDV to gauge the impact the demise of Health
Exchange will have on divisions and GPs.
Services Utilised Divisions GP Members
Helpdesk services 10 minimal
ISP 3 160
Email accounts 6 160
We site hosting 9 minimal
PKI 5 45
Mailing lists* All high
*emailing lists include Victorian divisions, Australian
divisions, GPnet and more.
ADGP is currently negotiating with HealthExchange to take over
some of the services currently provided. GPDV will keep divisions
informed about developments.
Progress on the General
Practitioner Registry
The General Practitioner Registry (GPR) is a Statewide database
of GP contact information. It will be used by Victorian hospitals
to facilitate transfer of information from hospitals to general
practitioners about the current episode of care for their
patients.
The GPR currently stores contact details of over 4300 GPs from
divisions’ existing databases. All the information must be
validated before the database can be used. We have validated over
84% of the records and expect to complete validation by mid
September.
The contract between the subscriber (hospital) and GPDV will be
in the form of a licence agreement which hospitals will sign in
order to be given access to the Registry.
Expected date to “go live” - Monday 2 October.
* Indicates division has not yet provided data
Note: GP member contact details from Melbourne Division’s
database have been received and are now being imported into the
GPR.