Your best Health Insurance is Your GP v2.0

Yesterday we talked about risk. Risk is mitigated by knowledge and experience. I don’t know who said this, but I’m going to take a wild and crazy guess and say it wasn’t from Terry Pratchett’s wonderful Discworld series. This gives us another way to mitigate risk. Insurance.

Risks come at us everyday in our personal and professional lives. We accept that life involves risk. Risk happens.

‘Life is a risky business, no-one gets out alive’

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Health concerns us all, especially now, and we try to improve our health or at least to manage it. Some risks are foreseeable but some are not. These drive our uptake of health insurance. Health insurance is therefore a bit of a ‘grudge purchase’ – we don’t really want to buy it but we don’t want to do without it. Is it worth the money we pay for it? Some high profile voices say no. A past president of the AMA agrees:

A past president of the RACGP concurred:

if you increase the number of GPs by 1 per 10,000 people the death rate goes down 9%

Dr Bastian Seidel; Past President, RACGP

Your health is your wealth, as the saying goes, and you build wealth by spending wisely.

Some tests, treatments and procedures provide little benefit. And in some cases, they may even cause harm.
Use the 5 questions to make sure you end up with the right amount of care — not too much and not too little.

Do I really need this test, treatment or procedure?

Tests may help you and your doctor or other health care provider determine the problem. Treatments, such as medicines, and procedures may help to treat it.

What are the risks?

Will there be side effects to the test or treatment? What are the chances of getting results that aren’t accurate? Could that lead to more testing, additional treatments or another procedure?

Are there simpler, safer options?

Are there alternative options to treatment that could work. Lifestyle changes, such as eating healthier foods or exercising more, can be safe and effective options.

What happens if I don’t do anything?

Ask if your condition might get worse — or better — if you don’t have the test, treatment or procedure right away.

What are the costs?

Costs can be financial, emotional or a cost of your time. Where there is a cost to the community, is the cost reasonable or is there a cheaper alternative?

Your GP can be a great ally in navigating through the health system, a great support for you in times of need, and a great investment in your health. 

“Patients whose care is well managed and coordinated by their usual GP are less likely to cost the health system more in the long run because their GP-coordinated care will keep them out of hospital.

“Supporting general practice to continue managing these patients – who are growing in number each year – is an investment in health care that can help make the health system more sustainable.”

Past AMA President, A/Prof Brian Owler

PartridgeGP works with you to help you make your best health decisions. We pride ourselves on great communication and we’re ready to share our professional skills and knowledge with you. This is only MORE important now, in the time of a global pandemic with a new vaccine on the horizon. The way forward is clear: make your appointment with us conveniently online right here – or call our friendly reception team on 82953200.

Better, for you.

Want more?

Photo by Miguel u00c1. Padriu00f1u00e1n on Pexels.com

For everyone, we believe that having a usual GP or General Practice is central to each person’s care and recommend that people with any health issues that come to the attention of other health professionals should be advised to attend their usual GP or General Practice rather than a specialised service (ie a place not providing the holistic care a specialist GP would).   If  they say that they don’t have a usual GP or general practice, they should be helped to find one and to actually attend it. Call PartridgeGP on 82953200 or make an appointment online here.

(Hat tip: Dr Oliver Frank)

(TL;DR – Get a regular GP or General Practice and use them!)

Photo by Miguel u00c1. Padriu00f1u00e1n on Pexels.com

If you’re employed, get a side hustle and get into business. If you’ve already got a business, get a network. Want to get started? Find your tribe here!

Photo by Miguel u00c1. Padriu00f1u00e1n on Pexels.com

If you are a great GP or a great Allied Health Professional, and you want to serve your clients or patients to the best of your ability, without worrying about all the non clinical things that get in your way, lets talk. Call Mrs Hayley Roberts on 8295 3200 and have a coffee and chat with us as to how PartridgeGP can help you to help others.

Risk

In 1990 I watched Graham Gooch of England make 333 and 123 in a Test Match against India at Lord’s. It was a different time and a different country. Gooch looked decidedly unathletic (although apparently a fitness fanatic) and I certainly don’t remember the Indian pace attack as anything like the current potent crew. As Gooch approached his three hundredth run, the BBC cut to a horse race showing the usual tin ear of public broadcasters. It was compelling but hadn’t quite reached exciting. For those of you not baptised into the religion of Test Cricket, simply put, one fellow throws a small hard leather ball in a special way (bowling) at some wooden poles (the wickets) from a distance of 22 yards (the pitch) while another fellow (the batsman) uses a wooden club (bat) to prevent this. Other fellows stand around to catch or intercept the ball, and also provide commentary on the batsman’s skill, character, and parentage.

I moved to Australia and one of the instant upgrades was supporting the Australian cricket team. Staying up in 1995 to listen to Steve Waugh wearing bouncer after bouncer after bouncer as Australia finally rolled the West Indies in their own backyard was incredibly exciting. Part of that excitement was risk. The players had arm/chest guards, gloves, pads, boxes, helmets, and increasingly large bats but the spectacle and danger of confronting 140-150 kilometre missiles was enthralling.

It had a lot of value for the players involved and for the audiences in the West Indies, Australia, and around the world. The West Indies are a collection of independent island countries who only come together as the West Indies for cricket. Much the same could be said about Australia and it’s Federation of States (especially in light of recent border shenanigans). Australia had been planning this assault for years. The West Indies were coming off a long period of world domination and were raging against the dying of the light as their great players aged.

Fast forwarding again, I went back to England in 2013 to watch the Australian team play England at Lord’s. One of the Australian players to watch was a star of the future – Phillip Hughes. He didn’t have the most auspicious day at Lord’s but certainly looked a player of the future. It was to be his final Test Match. Hughes was a short man, like many of the great batsmen, and so had become accustomed to bowlers aiming at his chest and head. He was an accomplished player of this style of (short pitched) bowling. Sadly, in 2014, Hughes was batting in a State game and despite all of his protective apparel, was hit in the neck by a short pitched ball. He was incredibly unlucky to be hit in the neck in precisely the wrong spot. Wikipedia recounts:

causing a vertebral artery dissection that led to a subarachnoid haemorrhage. The Australian team doctor, Peter Brukner, noted that only 100 such cases had ever been reported, with “only one case reported as a result of a cricket ball”

The risk that made the matches in the West Indies so enthralling and the risk that added value to that spectacle was the same risk that ended with Phil Hughes’ death. Certainly players, spectators, and officials thought long and hard about this risk afterwards. As a result of this we now have something called a stem guard which is a little bit of plastic that protects that very vulnerable area of the neck. Hopefully this particular type of injury will never happen again with these consequences. The amount of short pitched bowling decreased, for a while, but then returned to previous levels (perhaps regressed to the mean). Then, something else happened. 

Today we can see players like Neil Wagner eulogised for bowling into the batsman’s armpit, shoulder, and head. This line of attack into the batsman’s blind spot can hit them, hurt them, or just put them off their game. Wagner recently won a Test Match for his country like this (with two broken toes).

“Neil Wagner was outstanding,” Stead said. “I’m not sure there are too many individuals that could do what he did in that Test match.

Further statistics during the current Australia vs India test series show a clear advantage gained by short pitched bowling. Furthermore, almost uniquely in top level sport, this involves the some of one team doing what they do best against some of the other team doing what they do worst (bowlers bowling at bowlers batting).  Is this too much risk and who makes this decision and on what basis?

This conundrum – the risk of injury and death versus the benefits of economic value resulting from the spectacle – mirrors some situations we face in medicine and life:

Lockdowns vs Targeted Protection

New Vaccines vs New Viruses

Medication vs Lifestyle

I don’t have a universal answer for this, in cricket, life, or in medicine. I firmly believe that we should have these conversations and come to answers that are transparent and workable. From the macro level in Australia and the world to the micro level in the consult room, I think this is the way we should manage risk. We should be mindful of risk in all of our consultations and all of our dealings with patients. If you would like to be part of a team that can afford and prioritise the time taken to consider risk in each and every consultation and dealing then the way forward is clear: make your appointment with us conveniently online right here – or call our friendly reception team on 82953200 or…

here are the steps!

Photo by Miguel u00c1. Padriu00f1u00e1n on Pexels.com

For everyone, we believe that having a usual GP or General Practice is central to each person’s care and recommend that people with any health issues that come to the attention of other health professionals should be advised to attend their usual GP or General Practice rather than a specialised service (ie a place not providing the holistic care a specialist GP would).   If  they say that they don’t have a usual GP or general practice, they should be helped to find one and to actually attend it. Call PartridgeGP on 82953200 or make an appointment online here.

(Hat tip: Dr Oliver Frank)

(TL;DR – Get a regular GP or General Practice and use them!)

Photo by Miguel u00c1. Padriu00f1u00e1n on Pexels.com

If you’re employed, get a side hustle and get into business. If you’ve already got a business, get a network. Want to get started? Find your tribe here!

Photo by Miguel u00c1. Padriu00f1u00e1n on Pexels.com

If you are a great GP or a great Allied Health Professional, and you want to serve your clients or patients to the best of your ability, without worrying about all the non clinical things that get in your way, lets talk. Call Mrs Hayley Roberts on 8295 3200 and have a coffee and chat with us as to how PartridgeGP can help you to help others.

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

 

img_20200127_145549_wm7637784655035031070.png

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!

Resourcing, not medication restrictions, needed in aged care

Thanks to Dr Michael Clements and NewsGP from the RACGP for highlighting the needs for aged care 👍🏼

Dr Michael Clements


9/12/2019 3:14:11 PM

The Government’s recent funding injection has to be specifically targeted to address the problems GPs, staff and patients face within residential aged care facilities, Dr Michael Clements writes.

Aged care
Dr Michael Clements believes that while aged care requires a significant funding boost, it will only be helpful if it is specifically targeted to the sector’s needs.

‘Mrs X was found wandering at night in the carpark, can you please prescribe medication?’
 
This was how one recent residential aged care facility (RACF) interaction began for me.
 
After meeting with the staff and ruling out delirium or biochemical causes, and noting a worsening in the behavioural aspects of dementia, I suggested the patient move to the restricted ward or have extra supervision.
 
But my request was declined due to lack of beds and I was specifically asked, once again, to commence a medication to prevent the patient from wandering.
 
The situation was clear: under-staffing in this facility led to pressure to prescribe sedative medications that would keep the patient compliant and allow staff to attend to other residents.
 
Provision of care within RACFs has become more complex and time-consuming as the population ages and rates of dementia rise. Unfortunately, funding models have not kept pace, even as clinical governance requirements in RACFs have increased and nurse autonomy reduced.
 
This has led to a situation for many GPs who work within RACFs in which countless night-time phone calls, form-signing, box-ticking and compliance measures now form the largest part of their care. It has also led to an overreliance on anti-psychotic medications for the behavioural aspects of dementia, as understaffed facilities come under pressure to medicate their problems away.
 
GPs have been looking forward to the Royal Commission into Aged Care, Quality and Safety because they, along with RACF staff, have seen cost-cutting measures applied in facilities, with reductions in numbers of trained staff, greater reliance on lower-skilled assistants, and decreased activities and programs.
 
Staff across the aged care sector want to see better diversionary activities and care services, nursing numbers, and funding to allow GPs to spend more time with patients and their families. This is felt most acutely in rural and regional areas, which are already experiencing aged care staff and GP workforce shortages.
 
The Federal Government has suggested high prescriptions of anti-psychotic medications in RACFs is a source of the problem, rather than an indicator of a system that is under-resourced to deal with the complex issues of dementia care.
 
However, the latest promise of extra funding from the Federal Government does nothing to address the reasons behind the increased use of anti-psychotic medications for the behavioural aspects of dementia; it is simply ‘shooting the canary’ and will have no impact on the gas leak in the coalmine the canary has been screaming about for the last five years.
 
What RACFs need instead is funding targeted towards sufficient numbers of appropriately trained nursing staff, for GPs to provide comprehensive team-based care, and for tertiary services to get out of hospital grounds and into RACFs to work with GPs.
 
Novel solutions are required to the problems faced in residential aged care, and each facility will need to find one that reflects their community workforce and need.
 
But some general steps that will be helpful across the board include:

  • additional money injected into the system from federal and state health budgets
  • patients getting used to private fees for GP services
  • nurses and nurse practitioners being allowed to practice at their full scope
  • GP-led rather than GP-delivered care being utilised where possible.

The message should be clear: fund RACFs and GPs in order to enable them to provide the care that is so desperately needed.

Do not shoot the canary.

© 2018 The Royal Australian College of General Practitioners (RACGP) ABN 34 000 223 807

PartridgeGP and Dr Nick Tellis are doing our best for better aged care in many of our local aged care facilities. We will do more in 2020! Watch this space 👍🏼

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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Alternative…Patients – #kickback edition

Thanks George Forgan-Smith 😉

 

 

It’s the week after the RACGP AKT and KFP exams for some and before a busy week for others. You may be a little flat and the world may seem a bit chaotic at the moment so I thought I’d take a minute to remind us all of how good we have it in Australian General Practice.

 

What are some of the little things your patients have done for you? (#kickbacks 8-)) These are three that come to mind for me:

 

 

 

Sugar free, too 👍👍👍

 

 

 

When the person I squeezed in for an appointment because they were ‘really ill’ stopped the consult to give me a (sugar free 👍) lolly when I was coughing at the end of a long day with lots of sniffling kiddies.

 

 

 

A Series of Unfortunate Events

 

 

 

A lovely painting I got for ‘mates rates’ after helping someone through a ‘series of unfortunate events’ (see the main picture!)

 

 

 

Needs banana for scale 🍌

 

 

 

3. A fantastic steak dinner cooked for me when I was spotted sneaking out of the practice clutching a bag of chips on a big on call night.

 

 

 

 

 

What little things have your patients done for you? 

 

 

Sunset at Glenelg

 

 

Take a moment to have a think and feel grateful – we really do have the best job in the world!  👍

 

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 would like to be:

part of a great team where everything is set up to help you help others

helping great patients

near the beach

working fewer hours and earning more with private billing

 

 

join the team