Here is how you pump up the volume - The trifecta of improving primary healthcare

15 May 2018

A collaborative healthcare approach with nurses at the helm of managing patient care is not a new concept.  Yet this alternate model of care is neither well understood nor fully embraced by the primary health sector.

The benefits of nurse clinics in such settings have been widely documented in both international and Australian studies. For example, in delivering a chronic disease management approach to care within a general practice setting, nurses work more autonomously to provide a holistic approach to patient care. The results show increased patient satisfaction; improved quality of life; improved clinical outcomes; increased patient understanding of their condition; and improved access to other health professionals.

In the primary health sector, nurse clinics today empower nurses to take on roles such as the screening and detection of symptoms of early disease; to act as care coordinator, to monitor a patient’s health condition; and to provide health education and support.

And by making better use of the experience and skills of the nurses, primary healthcare providers will be more able to deliver patient-centred, high quality and financially sustainable healthcare.  

Stemming the tide of ballooning health care costs

Greater use of the primary health care nursing workforce is vital if Australia is to effectively and efficiently reduce the excessive burden of chronic disease.

Nurse clinics in primary care are a key solution for shifting health care to the more cost-effective community sector; by allowing nurses to work to their fullest potential in facilitating better outcomes for patients.

Already, APNA’s Enhanced Nurse Clinic (ENC) project has recorded some stunning results. The project began in 2016 with funding from the Australian Government Department of Health to demonstrate replicable models of best practice ENCs in primary care. Here are two case studies.

Wound Clinic in General Practice

At Junction Place Medical Centre in Melbourne’s eastern suburbs, a wound clinic improved healing time by allowing patients to access quality wound treatment without travelling further to wound specialists or vascular surgeons.

Junction Place Medical Centre GP, Dr Simon Wong, said having a dedicated practice nurse for wound management was good for GPs’ time management and quality of patient care.

Nurse clinics should be expanded in the context of a large clinic – they should have a complementary role to medical practitioners and contribute to clinic decision-making. Areas of practice that would lend themselves to nurse clinics would include dermatology, women’s health and diabetes –all chronic health problems.

Teen Clinic in General Practice

In rural NSW, Bega Valley Medical Practice established a Teen Drop-in Clinic to increase young people’s access to a wide range of health services. Teens could come in by themselves and consult with a nurse. The overwhelming community acceptance and demand has since resulted in several new teen clinics opening in other General Practices in the surrounding region. 

Practice Principal Duncan MacKinnon explains: “It always astounds me what patients will divulge to a nurse but leave the GP guessing! The nurse-led model for this purpose, is so fundamentally effective in allowing an easy entry to health care that it is a no brainer!”

Nurse Clinics in primary care – A holistic approach to patient management

Nurse Clinics offer a win-win-win solution. Patients receive continuity of care with reduced waiting time; GPs get more consulting time and reduced caseload pressure; nurses gain more autonomy in their practice and build deeper patient relationships.  

While there is no set formula, we have documented several successful models that can be either replicated or used to guide your own model. We have also developed a series of resources, including eight nurse clinic building blocks which provide a modular approach to setting up a nurse clinic. And if health care providers focus on what patients want, how they want it and when they want it – the results will follow.

So, should you start a Nurse Clinic?

How will it benefit your medical practice and patients?

Ten questions to ask yourself

  • Is there a specific community health need that is not being fulfilled?
  • Do you want to reduce patient barriers to accessing health care?
  • Do you want to reduce waiting time for patients?
  • Do you want to provide patients with more time for in-depth consultations?
  • Do you want to build deeper patient relationships to provide better support?
  • Do you want to empower patients with more knowledge and strategies to self-manage?
  • Does your practice want to increase the capacity of your team to meet increased patient demand?
  • Does your practice want to cut time inefficiencies?
  • Do you want to create a collaborative multi-disciplinary all-of-practice team environment?
  • Does your practice want to empower nurses to work to their full potential by developing their knowledge and practice in a specialist area?

If the answer is YES, I would love to hear from you.

Karen Booth, APNA President

Recent Comments

  • June 07, 2019 - Karen Osborne (1)

    HI, i'm not sure if this comments box is till working? But will give it a go! I am an experienced Primary Health Care Nurse who has run several nurse led clinics. I have worked at the same practice for 10 years. I have been fortunate to have been given a lot of respect to work autonomously by a practice with high integrity. Unfortunately as our practice is closing I am forced to be seeking work elsewhere. I have been disappointed to find so many practices won't allow for autonomous practice, Drs and Practice managers seem think a GP needs to stick there head in the nurses door to validate them and their charging an unnecessary billing item , obviously they think the PNIP is to fund their overseas holiday and not to compensate the practice to enable the practice nurse to practice autonomously , even if they have an Immunisation registration. Of course they are ceasing the opportunity to double dip into the public purse. I have fought this mentality with practices in the western suburbs when I ran a project program GASP, to establish Nurse Led Asthma Clinics. Where management felt they needed to control and bill for every minute of the Practice Nurses day, long forgetting the $75, 000 medicare provision they have already received via a PNIP. I personally do not see the current funding and structuring of the PNIP to be working effectively for Practice Nurses. Practice nurses on the whole continue to be underpaid and undervalued. I believe there needs to be a review of the current Medicare renumeration for Practice Nurses that currently advantages Doctors and Managers and does little to empower Practice Nurses. I look forward to discussing this further with APNA Kind Regards, Karen Osborne Report

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