Coronavirus Help Desk – Partridge GP (update with Repat drive through clinic info)

We find ourselves at the start of a seeming pandemic.

 

Coronavirus – latest government info – CLICK HERE

 

If unwell with cough/cold symptoms, stay home and use the phone

 

CALL coronavirus hotline 1800 020 080

free advice, home testing after doctor advice

CALL healthdirect 1800 022 222

free advice

 

If further advice needed

 

CALL PartridgeGP 0882953200

phone consult, private fee, no Medicare rebate

CALL/ATTEND

nRAH

Flinders Medical Centre

Lyell McEwin Hospital

coronavirus clinics

free, can see and/or swab

 

updated re the Repat drive through clinic

 

Accessing the Repat Collection Centre:

Patients must be booked into this service to ensure a controlled flow

Bookings are to be made by the practice by ringing 8222 3000

The practice is to advise patient of date and time of booking

Fax the request form to SA Pathology on 7117 5085

The service is available between 8.00 am and 4.30 pm Monday to Friday

Access is via Gate 4, 216 Daws Road, then follow the signs

Please ask patients to remain in their car and the SA Pathology staff will come to them

Instruct the patient to remain in isolation until the results have been communicated to them by you (their GP)

 

The Royal Adelaide Hospital

7 days a week 0900-2000 – walk in, just follow the signs!

Royal Adelaide Clinic Location HERE

NEW Southern Suburbs Coronavirus Priority Care Clinic

 453 Morphett Rd, Oaklands Park 7 days a week, walk in 1000-2000

 

How Do I Self-Isolate- click HERE!

AND HERE

OR HERE!

 

 

 

coronaadvice

 

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Drive through COVID in Victoria!

Oh…you thought I meant testing!

I meant THIS

 

1552719486937

 

In other news

We find ourselves at the start of a seeming pandemic.

Coronavirus.

In addition to the medical risks to themselves, their friends and families, and their patients, GPs have to consider the risks to their livelihood and practices.

We can’t help our patients if we are ill.

We can’t help our patients if our practices are closed.

We can’t help our patients if we are isolated at home.

There may be solutions. One, from Dr Todd Cameron and Dr Sachin B Patel, is outlined in the following videos.

 

1. GPs to instigate protocols in the way they see patients

2. GPs to alter the things they need to see patients face to face for

3. GP Practices to support the GPs who pay them to do so

4. Use telehealth and have MBS item numbers 23/36 cover this in this time of need

The videos are here

 

And here

 

So what can you do as a GP to make these things happen?

Stephen Covey talks about a circle of influence and a circle of concern. Your circle of influence should be larger than your circle of concern or you just worry about things you can’t change. Let’s go further and consider a circle of impact.

Where can you apply your time and skills to make a change?

Here it is.

Join the AMA.

They have about 6000 GP members (my guesstimate). You can join for a monthly fee of somewhere between $15-130 a month as a GP or registrar. You don’t have to join the AMA – it is entirely voluntary. You can leave at any time, and take your money with you.

So join.

On your application, quite clearly state why you are joining and that this is THE thing you would like the AMA to make an impact on. The AMA have access to the politicians. From your membership to their ears.

Watch the videos.

Make your decision.

Join.

Take action.

Make a difference.

Good luck!

 

 

Coronavirus Help Desk – Partridge GP

We find ourselves at the start of a seeming pandemic.

Coronavirus – latest government info – CLICK HERE

 

If unwell with cough/cold symptoms, stay home and use the phone

 

CALL coronavirus hotline 1800 020 080

free advice, home testing after doctor advice

CALL healthdirect 1800 022 222

free advice

 

If further advice needed

 

CALL PartridgeGP 0882953200

phone consult, private fee, no Medicare rebate

CALL/ATTEND

nRAH

Flinders Medical Centre

Lyell McEwin Hospital

coronavirus clinics

free, can see and/or swab

The Royal Adelaide Hospital

7 days a week 0900-2000 – walk in, just follow the signs!

Royal Adelaide Clinic Location HERE

NEW Southern Suburbs Coronavirus Priority Care Clinic

 453 Morphett Rd, Oaklands Park 7 days a week, walk in 1000-2000

 

How Do I Self-Isolate- click HERE!

AND HERE

OR HERE!

 

 

coronaadvice

 

img_20200127_145549_wm7637784655035031070.png

GPs. Protect yourself. Join the AMA. Good reading for politicians!

We find ourselves at the start of a pandemic.

Coronavirus.

In addition to the medical risks to themselves, their friends and families, and their patients, GPs have to consider the risks to their livelihood and practices.

We can’t help our patients if we are ill.

We can’t help our patients if our practices are closed.

We can’t help our patients if we are isolated at home.

There may be solutions. One, from Dr Todd Cameron and Dr Sachin B Patel, is outlined in the following videos.

1. GPs to instigate protocols in the way they see patients – pivot to PHONE

2. GPs to alter the things they need to see patients face to face for – PHONE!

3. GP Practices to support the GPs who pay them to do so – BE SAFE!

4. Use telehealth and have MBS item numbers 23/36 cover this in this time of need

The videos are here

And here

So what can you do as a GP to make these things happen?

Stephen Covey talks about a circle of influence and a circle of concern. Your circle of influence should be larger than your circle of concern or you just worry about things you can’t change. Let’s go further and consider a circle of impact.

Where can you apply your time and skills to make a change?

Here it is.

Join the AMA.

They have about 6000 GP members (my guesstimate). You can join for a monthly fee of somewhere between $15-130 a month as a GP or registrar. You don’t have to join the AMA – it is entirely voluntary. You can leave at any time, and take your money with you.

So join.

On your application, quite clearly state why you are joining and that this is THE thing you would like the AMA to make an impact on. The AMA have access to the politicians. From your membership to their ears.

Watch the videos.

Make your decision.

Join.

Take action.

Make a difference.

Good luck!

Secrets Healthy Men know with PartridgeGP and Coles

Tim Ferriss asked a question in his book Tribe of Mentors.

 

 

‘If you could put a message on a billboard, to be seen by millions (or billions) of people, what would you say?’

 

 

I was lucky enough to have an opportunity to answer this in real life when a journalist from Coles contacted me. They wanted to know a GPs views on Men’s Health. The article we produced is here (and reproduced below). This is in the Coles Health and Beauty magazine – they have printed 500,000 copies of this! What was that one message I wanted to get across?

 

 

dr nick tellis coles health and beauty the money quote
The Message!

 

 

 

 

Our practice, PartridgeGP, our GPs, and the rest of our team are here for you. No billboards needed – just book in for an appointment 😎

 

 

 

 

 

 

 

 

 

 

IMG_20190404_191100

 

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The Road to being a GP with PartridgeGP

Just check out this picture of what someone goes through to become a GP. Wow!

(thanks to Dr Jared Dart for finding this)

 

 

How do doctors get to be doctors.jpg

 

 

 

 

 

 

PartridgeGP is an accredited General Practice and is further accredited by our Regional General Practice Training Provider GPEx.

 

 

 

This means that the GPs at PartridgeGP are teaching the Doctors and Medical Students who will be the future of medicine in Australia. It’s a big responsibility and a privilege we take very seriously.

 

 

 

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Teaching Practice of the Year

 

 

All of our doctors here at PartridgeGP are fully qualified ‘Fellows’ (or are studying towards this) holding a specialist qualification with either the Royal Australian College of General Practitioners (FRACGP) or the Australian College of Rural and Remote Medicine (FACRRM) or both (3-4 years of full time study and 3 exams on top of an undergraduate university medical degree and supervised trainee ‘intern’ year in a hospital). This is our minimum specialist standard and we may have other qualifications and skills.

 

 

 

Our Fellows provide supervision and advice to our Registrars and you may find that they are called in to consult with the Registrar on your case. ‘Registrars’ are qualified doctors who have completed their hospital training and are now embarking on their General Practice training. Some may already have other qualifications in medical or other fields.

 

We also supervise and teach Medical Students from Flinders University. They are still studying to become doctors. All of us – Fellows, Registrars, and Medical Students – make up the Clinical Team here at PartridgeGP with our excellent Practice Nurses. We all uphold the highest standards of privacy, confidentiality, professionalism, and clinical practice.

 

 

 

Some of our recent GP registrars

Dr Katherine Astill

Dr Clare Mackillop

 

 

 

 

IMG_20190404_191100

 

 

 

 

Dr Gareth Boucher

 

Dr Nici Williams

 

Dr David Hooper

 

Dr Penny Massy-Westropp

 

Dr Monika Moy

 

Dr Clare Mackillop

 

Dr Katherine Astill

 

Dr Jen Becker

 

Dr Nick Mouktaroudis

 

Dr Nick Tellis

 

Welcoming Dr Katherine Astill back to PartridgeGP

Dr Katherine Astill Partridge Street General Practice new female registrar

 

 

Dr Katherine Astill commenced her specialist General Practice training with PartridgeGP in August 2017 and has returned to work with us at our new site in August 2019! She graduated with a Bachelor of Physiotherapy from the University of South Australia in 2009 and furthered her education with a Bachelor of Medicine and Surgery from Deakin University in 2013. After holding positions with the Muscular Dystrophy Association and the Women’s and Children’s Hospital, she decided to specialise in General Practice, with a special interest in Women’s and Children’s Health completing her Diploma of Child Health in 2016.

Dr Katherine has a passion for holistic care and preventative health.

 

 

 

She loves the local Glenelg area and is keen to hit the ground running with the rest of our Great Team here at PartridgeGP!

 

 

 

 

 

 

 

 

PartridgeGP is an accredited General Practice and is further accredited by our Regional General Practice Training Provider GPEx.

 

 

 

This means that the GPs at PartridgeGP are teaching the Doctors and Medical Students who will be the future of medicine in Australia. It’s a big responsibility and a privilege we take very seriously.

 

 

 

img_1954
Teaching Practice of the Year

 

 

All of our doctors here at PartridgeGP are fully qualified ‘Fellows’ (or are studying towards this) holding a specialist qualification with either the Royal Australian College of General Practitioners (FRACGP) or the Australian College of Rural and Remote Medicine (FACRRM) or both (3-4 years of full time study and 3 exams on top of an undergraduate university medical degree and supervised trainee ‘intern’ year in a hospital). This is our minimum specialist standard and we may have other qualifications and skills.

 

 

 

Our Fellows provide supervision and advice to our Registrars and you may find that they are called in to consult with the Registrar on your case. ‘Registrars’ are qualified doctors who have completed their hospital training and are now embarking on their General Practice training. Some may already have other qualifications in medical or other fields.

We also supervise and teach Medical Students from Flinders University. They are still studying to become doctors. All of us – Fellows, Registrars, and Medical Students – make up the Clinical Team here at PartridgeGP with our excellent Practice Nurses. We all uphold the highest standards of privacy, confidentiality, professionalism, and clinical practice.

 

 

 

Dr Katherine Astill is a valuable member of our growing Clinical Team!

 

 

 

 

IMG_20190404_191100

 

 

 

 

Dr Gareth Boucher

 

Dr Nici Williams

 

Dr David Hooper

 

Dr Penny Massy-Westropp

 

Dr Monika Moy

 

Dr Clare Mackillop

 

Dr Katherine Astill

 

Dr Jen Becker

 

Dr Nick Mouktaroudis

 

Dr Nick Tellis

 

Welcoming Dr Nici Williams to PartridgeGP

PartridgeGP is proud to welcome Dr Nici Williams to our team!

 

IMG_20190601_223800

 

Born in South Africa, Dr Nici graduated from the University of New South Wales in 2010. She has worked in Indigenous Communities in Cairns, and spent two years on Thursday Island in the Torres Straits where she obtained her Fellowship of the RACGP as well as Fellowship in Advanced Rural General Practice. Following a further year practicing medicine in rural NSW, she and her family relocated permanently to Adelaide in 2018.

Dr Nici also works at the Refugee Health Service, and other interests include dermatology, contraception (including Implanon) and optimising health. She is accredited for Obstetric Shared Care in SA.

 

 

We welcome Dr Nici to Our Team here at PartridgeGP to be Your GP!

 

 

She is available to help you with all of your General Practice needs from mid April 2019 and you can book your appointment with her conveniently online right here – or call our friendly reception team on 0882953200.

 

 

Dr Nici Williams - your gp

 

All of our doctors here at PartridgeGP are fully qualified ‘Fellows’ (or are studying towards this) holding a specialist qualification with either the Royal Australian College of General Practitioners (FRACGP) or the Australian College of Rural and Remote Medicine (FACRRM) or both (3-4 years of full time study and 3 exams on top of an undergraduate university medical degree and supervised trainee ‘intern’ year in a hospital). This is our minimum specialist standard and we may have other qualifications and skills.

 

 

Our Fellows provide supervision and advice to our Registrars and you may find that they are called in to consult with the Registrar on your case. ‘Registrars’ are qualified doctors who have completed their hospital training and are now embarking on their General Practice training. Some may already have other qualifications in medical or other fields.

 

 

We also supervise and teach Medical Students from Flinders University. They are still studying to become doctors. All of us – Fellows, Registrars, and Medical Students – make up the Clinical Team here at PartridgeGP with our excellent Practice Nurses. We all uphold the highest standards of privacy, confidentiality, professionalism, and clinical practice.

 

 

IMG_20190321_202633

 

DR PENNY MASSY-WESTROPP

dr penny massy westropp - your gp

DR MONIKA MOY

dr monika moy- your gp

DR JEN BECKER

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DR DAVID HOOPER

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Welcoming Dr Jen Becker to PartridgeGP

PartridgeGP is proud to welcome Dr Jen Becker to our team!

tellis becker mouktaroudis

Dr Jen completed her medical degree at Flinders University in 2012 and since then has worked in hospitals across Adelaide and beyond. She most recently completed a 6 month term in public health in Darwin.

Her medical interests include sexual health, women’s health, and adolescent health. Outside medicine, her energies go into cooking, travel, and spending time with family.

We welcome Dr Jen to Our Team here at PartridgeGP to be Your GP!

She is available to help you with all of your General Practice needs from mid April 2019 and you can book your appointment with her conveniently online right here – or call our friendly reception team on 0882953200.

All of our doctors here at PartridgeGP are fully qualified ‘Fellows’ (or are studying towards this) holding a specialist qualification with either the Royal Australian College of General Practitioners (FRACGP) or the Australian College of Rural and Remote Medicine (FACRRM) or both (3-4 years of full time study and 3 exams on top of an undergraduate university medical degree and supervised trainee ‘intern’ year in a hospital). This is our minimum specialist standard and we may have other qualifications and skills.

Our Fellows provide supervision and advice to our Registrars and you may find that they are called in to consult with the Registrar on your case. ‘Registrars’ are qualified doctors who have completed their hospital training and are now embarking on their General Practice training. Some may already have other qualifications in medical or other fields.

We also supervise and teach Medical Students from Flinders University. They are still studying to become doctors. All of us – Fellows, Registrars, and Medical Students – make up the Clinical Team here at PartridgeGP with our excellent Practice Nurses. We all uphold the highest standards of privacy, confidentiality, professionalism, and clinical practice.

IMG_20190321_202633

DR NICK TELLIS

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Your Specialist In Life

DR NICK MOUKTAROUDIS

20190217_030137_0000

DR GARETH BOUCHER

20190217_030535_0000

DR PENNY MASSY-WESTROPP

dr penny massy westropp - your gp

DR MONIKA MOY

dr monika moy- your gp

DR ABBY MUDFORD

20190217_125508_0000

DR JEN BECKER

20190311_183441_00004079926566896563315.png

DR DAVID HOOPER

20190217_125824_0000

Discharge summary versus clinical handover: language matters

PartridgeGP is all about professional, comprehensive, and empowering General Practice care by our GPs. When we refer our valued patients for treatment elsewhere we promote the same high standards, values, and communication  that we provide. A letter, referral, or phone call is just part of the standard PartridgeGP service – it’s good clinical handover. Dr Nick Tellis recently collaborated with some excellent GPs in writing an article for the Medical Journal of Australia’s online Insight Blog on ways to improve communication during these times and stressing the importance of better clinical handover. It’s another one of the ways PartridgeGP provides Better Healthcare for our valued patients. Read on.

 

This article is part of a monthly series from members of the GPs Down Under (GPDU) Facebook group, a not-for-profit GP community-led group with over 6000 members, that is based on GP-led learning, peer support and GP advocacy, and was originally published at the Medical Journal of Australia (MJA) Insight Blog here

 

IN our earlier article we described the concept of “passing the baton” when talking about transfers of patient care. All patients come from their communities and to their communities they shall return. In this transition from tertiary hospital to primary care, they benefit from timely, safe, effective clinical handover as defined in the National Safety and Quality Health Service Standards.

 

In primary care, communication matters, perhaps more so than in tertiary care. Words matter. The language we use matters. It informs thought at conscious and subconscious levels and influences behaviour.

 

The words “discharge summary” evoke feelings of an administrative process at best, and various unsavoury processes at worst. The accidental discharge, the dishonourable discharge, and the smelly discharge all come to mind. The words “clinical handover” instantly sound more professional. They reflect the sort of interaction between clinicians of which we want to be part. Clinical handover is a term familiar to both clinicians and administrators. It is taught in medical schools around the country and practised between junior and senior doctors within our hospitals.

 

Transition of care is well known to be a time of maximum risk: “Adverse events are seen to increase particularly during a transition of care, when a patient is transferred between units, physicians and teams.

 

Clinical handover is a recognised, evidence-based, structured and essential safety mechanism for minimising this risk. Remember, all patients come from their communities and to their communities they shall return. Their community doctor, their primary care physician, is their GP. Patients deserve the best clinical handover we can provide, whether transitioning into or out of our hospitals.

 

Junior doctors in hospitals presently perform the clear majority of clinical handovers to primary care, labelled as “discharge summaries”. According to the Discharge Summary – Literature Review, published by Queensland Health in May 2017 (not available online):

 

 

“Junior doctors perform the clear majority of discharge summaries:

  • Many interns have a flippant attitude to the completion of discharge summaries and have a low perception on the importance of a safe handover of care;

  • Most medical education programs provide minimal education on the completion of discharge summaries;

  • Most interns learn from each other with little input or guidance from registrars and consultants;

  • Interns tend to ‘lump’ discharge summaries together, often completing the summaries on patients they have never met.”

 

 

This frequently happens after the transition has occurred. To borrow from our legal friends, you cannot sell what you do not own. How then can you transfer the care of a patient you have never cared for?

 

 

Junior doctors report that they have limited supervision and lack templates or guides to help them produce a comprehensive and useful handover for community-based care whereas they receive a considerable amount of training for internal clinical handover.

 

 

Medical practitioners frequently use ISBAR (introduction, situation, background, assessment, recommendation) to guide clinical handover. A recent GPDU discussion highlighted that the Gold Coast University Hospital was moving to an ISBAR format for clinical handover to primary care. This was seen by many in GPDU to be a significant step in the right direction. ISBAR for the clinical handover to primary care aligns with hospital handovers and can only improve the transfer of care. Brewster and Waxman recently proposed amending ISBAR slightly to K-ISBAR by adding some kindness into the equation. Taking the opportunity to actively incorporate empathy and understanding into the primary care handover would be a great place to enhance collegiality across community and hospital teams.

 

 

When deciding who is tasked with a clinical handover within the hospital, it is unlikely that this would be handed to the most junior member of the team, and exceedingly unlikely that it would be delegated to someone who had never treated or met the patient. Within hospitals, it is expected that a clinical handover occurs at or before the time a patient’s care transitions to another team or provider. Why should this be any different for the clinical handover back to the GP?

 

 

In our first InSight+ article, we used the analogy of passing the baton. But what happens when the baton is dropped?

 

 

Dr Mandie Villis recently wrote a heartfelt plea for hospital doctors to inform GPs when patients passed away on their watch. Discussions around primary care clinical handover are now occurring around the country and pockets of significant improvement are being made. Momentum is building in regard to formally recognising and changing the language used from “discharge summary” to “clinical handover”. Several hospital and health services have, or are in, the process of implementing “same day” or “24-hour” clinical handover policies, and ultimately the best practice standard will be that this clinical handover occurs at the time of transition of care.

 

 

My Health Record (MHR) has been touted as a partial solution to the problems that have traditionally plagued clinical handover. It is important, however, to remember what MHR is and what it was created for. It is a repository of information for patients – a “shoebox” of documents akin to the jumble of receipts we burden accountants with at tax time. It is not, nor was it designed to be, a communication tool for clinicians. The baton transfer cannot occur within the MHR shoebox. It was not designed to replace current clinical record systems or current communication channels between clinicians. These limitations and precautions are outlined in the RACGP My Health Record guide for GPs:

 

 

“My Health Record is not designed as a substitute for direct communication between healthcare providers about a patient’s care, and should not be used in this manner. Healthcare providers must continue to communicate directly with other healthcare providers involved in the care of a patient through the usual channels, preferably through secure electronic communication.”

 

 

The  Australian Digital Health Agency states:

 

 

“The My Health Record system supports the collection of Discharge Summary documents. When a healthcare provider creates a Discharge Summary document, it will be sent directly to the nominated primary healthcare provider, as per current practices. A copy may also be sent to the individual’s digital health record.”

 

 

Mission creep of MHR is real, with multiple reports on GPDU of GPs stumbling across clinically relevant information in MHR rather than receiving a timely clinical handover. Important clinical information is “pushed” into MHR and the receiving clinician is not “pulled” to it by any sort of notification. There is no handover without closing the communication loop. Health professionals and organisations must ensure that clinical handover occurs with the intended recipient at the time of care transition. A copy uploaded to MHR for the patient to access, as an archive, may serve as a safety net if all else fails, but should not be relied on as the only source of communication.

 

 

Hospital systems must support and value the safety delivered by effective clinical handover to primary care. This will reduce the readmission rates to hospital care and improve the care patients receive. Patient care and practitioner wellbeing should not continue to be compromised due to the hospital culture of a discharge summary being an administrative task undertaken by the most junior team member. The challenges of high administrative burdens, inadequate staffing and unpaid overtime all need addressing. Junior doctors should not be left alone grappling with piles of outstanding discharge summaries to complete on patients they have never met.

 

 

The patient journey can be tracked, important milestones bookmarked, and plans documented as they are formed so that when it’s time for a transition, the “baton” is ready. The need for handover cannot come as a surprise when the patient’s trajectory was plotted from the day they were admitted. Adequate clinical staffing levels with protected time for clinicians to prepare clinical handovers should be a key performance indicator in hospital care. Proactive strategies must be put in place to identify and document who will be receiving the clinical handover. The culture that prevails within many of our hospitals needs to change.

 

 

Safety and quality bodies, such as the Australian Commission on Safety and Quality in Health Care through its National Safety and Quality Health Service Standards, and the Australian Council on Healthcare Standards through its accreditation regime, can provide effective oversight. All clinicians must lead in continuous improvement in “best practice” for quality and safety in transition of care both into and out of our hospitals.

 

 

Let us recognise and applaud our hospitals and health services leading the way in acknowledging discharge summaries as the clinical handovers that they are. May 2019 bring us all closer to high quality, timely, safe and patient-centred clinical handovers.

 

 

GPDU dragon head-3

 

clinical handover

 

Dr Katrina McLean is a Gold Coast-based GP, Assistant Professor in the School of Medicine and Health Sciences at Bond University, and a GPDU administrator.

 

Dr Michael Rice is past president of the Rural Doctors Association of Queensland, an educator of students and registrars, a long term resident and rural GP in Beaudesert. He’s a keen user of social media.

 

Dr Nick Tellis is passionate about great general practice. He’s a proud GP, beachside Adelaide practice owner, and a happy new father. He blogs at www.partridgegp.com when not administrating on GPDU.

 

Contact Dr Nick Tellis at drnt@partridgegp.com.au or 0882953200 if You are a Great GP and want a Better Place to practice great medicine!

 

 

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