Team-link study: AHMAC outcomes of multidisciplinary care in general practice
Project Status
Completed
Chief Investigators
Mark Harris, Nick Zwar, Gawaine Powell Davies, Judy Proudfoot, Patrick Crookes, David Perkins
Associate Investigators
Stephen Lillioja, Jeff Flack, Elizabeth Harris, Teresa Anderson, Andrew Boyden, Upali Jayasinghe
Other Team Members
Rene Pennock, Ken Cho, Barbara Ryan, Michael Moore, Chris Daniel, Maureen Frances, Sue Kirby, Danielle Noorbergen, Bettina Christl
Rationale
This study explores whether improvements in teamwork between general practitioners and referral services lead to improved patient outcomes. It has been argued that teamwork can result in organisational benefits (e.g. decreased hospitalisation costs), team benefits (e.g. improved care coordination, efficient resources use), as well as individual benefits for patients (not only improved health outcomes but also enhanced satisfaction), and individual benefits for team members (e.g. enhanced job satisfaction).
Aims
1. To examine qualitatively referral and joint care planning processes, including the development of referral relationships, the role of patients in referral relationships, factors determining referral decisions, aspects of communication, as well as referral capacity. This will inform the development of an intervention to improve the referral and shared care processes between general practice and other services.
2. To conduct a trial evaluating the impact of an intervention that aims to improve the referral and shared care process between practices and referral services which is facilitated by Divisions of General Practice in partnership with local health service providers.
Design and Method
The study has two phases:
1. A qualitative phase which involves semi-structured interviews conducted with 16 respondents – a mixture of professions (general practitioners, medical specialists, allied health) and of locality (rural, urban).
2. The trial which involves 5 Divisions of General Practice receiving either early or late intervention. A total of 32 practices are involved in the trial. The intervention focuses on facilitating effective referral relationships between general practice and referral services especially allied health services. This includes interdisciplinary education sessions that highlight the benefits of shared care, provide an opportunity for personal relationships to develop (which has been shown to strongly influence referral service choice), as well as focusing on improving the efficiency of the referral process. Divisions will facilitate the delivery of the core intervention through practice visits, with additional customisation according to the profile of the practice at baseline. It is anticipated that the intervention will impact in the following after 6 and 12 months:
(a) Quality of care
(b) Health status of patients with diabetes, ischaemic heart disease and/or hypertension
(c) Quality of referral relationships
Key Publications
Chong J., Kirby S., Frances M., Harris M. (in press) Sharing or shuffling? Accepted by Medical Journal of Australia.
Presentation
Facilitating Multidisciplinary Teamwork between General Practice and Allied Health Professionals-presented at the implementing teamwork in PHC workshop, 15th April 2009
