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We’ve talked about the Zen concept of ‘Falling Forwards’.
In Japan, they talk about ‘Kaizen’ – continuous improvement.
Locally, the concept might be expressed as ‘Fix the Flaming Thing’ – FTFT for short.
Some improvements require wholescale system changes. (The American Healthcare System, for example).
But some very simple policy and procedural changes by the ‘powers that be’ in Austrlia could make it much easier for us to care for our patients.
So FTFT.
‘Lean Thinking’ challenges us to look for waste in our work processes so that we can better allocate resources to where they produce the most value.
What simple regulatory or legislative changes could be made that would make things better for you and your patients?
Let’s collate a list and then nail it to the church door.
To start, here are some of my suggestions.
- The constant barrage of requests for repeat scripts for my nursing home patients takes me about an hour each week to complete. The patients already have medication charts that have to be regularly rewritten. This double handling detracts from patient safety – is the chart or the prescription the ‘record of truth’? In our private hospital, the medication chart also acts as a PBS prescription.
So why can’t the PBS accept medication charts in Aged Care Facilities as prescriptions?
- I have now attended 5 presentations from Medicare Australia about EPC items (lucky me).
The need for collaboration before the Team Care Arrangement can be claimed is the major source of consternation at these presentations. It is a Catch 22, and a ridiculous administrative burden that adds nothing to patient care.The requirements for Item 723 should be changed so that the item can be claimed at the time the Team Care Arrangement is prepared. If they insist, they could instead make the TCA review (Item 727) dependent on having received feedback from at least two of the providers in the plan.
- We are told by the Health Minister that we need to increase our use of practice teams. No argument from any of us.
So the next step then should be to increase the number of eligible Allied Health Visits under the EPC scheme from 5 to 20, as previously flagged.This would significantly increase our ability to source appropriate care for our patients.
Please post your suggestions in the comments below.
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6 Comments
Hear Hear !! Couldn’t agree more!!.
So, who are these backroom boys (or girls) in DOH who insist on making life nearly impossible for GPs ? Have any of them ever been out to the coal face to see how their policy works in the real world ?
Glad to hear they are actually seeking the opinion of the profession (I presume that’s why you were invited !)
From an administrative aspect, one of the most annoying
things is not being able to check on “lost medicare cheques”
I can understand and certainly appreciate patient
confidentiality, but the cheque is made in favour of the GP.
The 90 day scheme is “great” to a point but when things dont
go as they should, its almost impossible to track these
lost cheques. Patients tend to get a bit peeved having call medicare, and then they are told its going to take 6 or 7
to get a search done. Then of course they need to bring the search document into the surgery. Solution – would be much easier for practice staff to chase these cheques as happened in the past. Less aggression from patients and far less stress for the staff. Bronwyn – Hills Medical Service.
Tony , I particularly agree with your beef about the EPC items. I was starting a petition at our first collaboratives weekend this year , but lost momentum . I am sure that a concerted push of signatuures from our group might make a difference to powers that be . If others agree , perhaps we can use this blog as a defacto petition and forward it to Nicola Roxson.
I am very pleased to be part of such an important public health move and find your work realy inspirational.
Sophie
Here’s a suggestion – what about allowing self certification of illness as is done in the UK?
The number of visits we get that go ” I know I’ve only got a cold but I have to see you to get a sick note” could be removed at one fell swoop!
This is from the RCGP in 2002:
Providing reports and sick certificates for employees
Present Situation: GPs are responsible for providing sick notes for short-term sickness absence.
Action: The Managing Absence Campaign5, run by the Doctor Patient Partnership, has spread the message that
private and public sector employees should take greater responsibility for managing short-term sickness. Additionally,
GPs no longer have to sign a certificate of sickness for an absence of less than seven days. This project is now
complete.
Benefits: It is estimated that this campaign could save 2.4 million GP appointments plus an additional 37,000 hours
of GP time each year.
The constant barrage of requests for repeat scripts for my nursing home patients takes me about an hour each week to complete. The patients already have medication charts that have to be regularly rewritten. This double handling detracts from patient safety – is the chart or the prescription the ‘record of truth’? In our private hospital, the medication chart also acts as a PBS prescription.
So why can’t the PBS accept medication charts in Aged Care Facilities as prescriptions?
As someone who also does a lot of Nursing Home work, this suggestion makes great sense. So how do we push this agenda? Maybe the Collaborators can come up with a plan. Ideas anyone? Surely it does not have to be a petition! If every Division of GP asked DOHA the question would it work? Who will organise this?. I’m happy to start the ball rolling, if interested please respond to this mail to patrick.kinsella1@bigpond.com
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