Australian Primary Care Collaboratives Program (APCCP)
The aims of the Australian Primary Care Collaboratives Program are to improve clinical health outcomes, reduce lifestyle risk factors, maintain health for chronic and complex conditions and improve access to Australian general practice.
The Collaboratives Program comprises a number of key elements:
Program topics: these topics were identified on the basis of their potential for early and concrete results, evidence of best practice, of gaps between current and best practice and examples of how to close the gaps. For each topic, an Expert Reference Panel identified aims, principles and ideas for change, and measures of improvement. The topics for the current Collaboratives Program are diabetes, coronary heart disease and access to general practice services.
Learning workshops: participating general practices attend an orientation day and participate in a series of three learning workshops. The workshops provide participants with the opportunity to consider how to improve care and practice systems, and access to ideas and experiences from fellow practices. Three series of state based learning workshops (waves) are being held in 2008-09.
Activity periods with local support: during these periods between and after the learning workshops, practices test and implement improvements through cycles of small incremental changes. Practices are provided local level support for these activities through participating Divisions of General Practice.
Data reporting and feedback: participating practices submit monthly data to an online data reporting system, and are provided analysis and feedback on the impact of their improvements over time. Practices are expected to provide data for at least the 18 month period of their participation in the program and are able to continue to submit data after their participation.
Spread and sustainability: participating Divisions are encouraged to spread knowledge of the Collaboratives methodology to general practices not otherwise participating in the Program, and to apply their knowledge of the methodology to other topic areas, such as other chronic diseases.
Phase One of the Collaboratives Program was implemented from July 2004 to December 2007 and was managed by Flinders University. The Program funded about 500 practices in 42 Divisions of General Practice to participate in the Program.
General practices made measurable improvements in patient care and health outcomes in the first phase:
- 105% increase in patients with diabetes who have appropriate cholesterol levels;
- 45% increase in patients receiving recommended medications after a heart attack;
- 70% increase in patients with acceptable blood pressure levels;
- 43% increase in patients with Coronary Heart Disease (CHD) whose last recorded blood pressure was of an acceptable level;
- 32% increase in the number of patients with CHD who were recorded as being on an appropriate medication; and
- 76% increase in patients with acceptable HbA1c levels.
Data on patient outcomes for Phase Two are being collected at present and aggregated trend data will be available around September 2009 on completion of the first wave of the Collaboratives Learning Workshops.
The 2008-09 Budget committed $22.5m over four years to the Collaboratives Program.
More information on the Australian Primary Care Collaborative Program can be found at: http://www.apcc.org.au