‘A powerful tool’: Practices urged to take part in patient study

A new survey is ‘a fantastic opportunity’ for Australian general practices to understand how to improve patient outcomes and experiences, according to the Chair of the RACGP Expert Committee – Standards for General Practices.
 
Dr Louise Acland has urged general practices to take part in the recently opened Patient-Reported Indicator Surveys (PaRIS), which is an Organisation for Economic Co-operation and Development (OECD) initiative.
 
Overseen in this country by the Australian Commission for Quality and Safety in Healthcare (ACSQHC), the survey will look at how patients with chronic conditions feel about their health.
 
It aims to show how involved patients feel in the decision-making about their care, their perception on their overall quality of life, and how outcomes may vary according to different backgrounds.
 
While the OECD-wide initiative is gathering information for those aged 45 and older, in Australia practices will have the option to include all patients aged 18 and over with a chronic condition.
 
Dr Acland, who is part of the PaRIS governance committee, said the survey is likely to produce ‘meaningful’ results.
 
‘It will give practices a really good data set for adult patients who have chronic conditions, and let practices know what their patients need in terms of their experience and their health outcome measures,’ she told newsGP.
 
‘It’s a fantastic opportunity for practices to contribute to gaining this information for the first time in Australia.
 
‘We strongly encourage our GP member practices to take part because the more data we obtain, the more meaningful the outcomes are going to be.’
 
According to the ACSQHC, the survey will allow practices to study de-identified data about their patients’ experiences and compare them to other clinics in Australia and overseas.
 
‘This type of information has proven to be a powerful tool to improve the quality of care,’ the ACSQHC states.
 
It also says the initial provider survey, which can be completed by a GP, practice nurse or practice manager, takes about 20 minutes.
 
Patients who have visited the practice in the last six months are eligible to take part, with a separate organisation called ORIMA Research sending survey invitations. General practices also have the option to distribute the survey directly.
 
There is no payment for taking part, but Dr Acland notes that practices can use their involvement to contribute to their CPD requirements.
 
The information gathered should also contribute to policymakers understanding which health systems help patients with chronic conditions, the ACSQHC says – an area the OECD says is poorly understood.
 
‘Although health systems across the OECD spend around 9% of their GDP on health, it is shocking how little we know about whether health systems are truly delivering what people need,’ an introduction to the survey on the OECD website states.
 
Professor Mark Morgan, Chair of the RACGP Expert Committee – Quality Care, also welcomes the prospect of data that allows greater understanding of general practice.
 
‘As a researcher, it is exciting to think we will have within country and international comparisons about patient perspectives of chronic disease management by GP clinics,’ he told newsGP.
 
‘These are important, but often unmeasured aspects of what we do as GPs. There has long been a focus on measuring what is easy to measure rather than what is important to measure.
 
‘Diabetes care, for example, often resolves down to HbA1c levels because these are easy numbers to collect and analyse.
 
‘This completely misses quality of life, levels of distress, levels of disability and burden of treatment.’
 
However, Professor Morgan warns of the likely challenges in putting the data to the best use.
 
‘My concern is that the collective effort and cost of data collection will not be backed by adequate infrastructure and supports to implement and measure meaningful change,’ he said.
 
‘GP clinics will need to decide whether to participate and the decision will be determined to some extent by how prepared they are to engage in all the steps required for the activity to improve patient experience and outcomes.’
 
He suggests that interested clinics can consider getting everyone on board, including GPs, students, nurses, allied health, receptionists, practice managers and patient representatives.
 
‘Ideally there will be a shared vision around using PaRIS for quality improvement,’ he said.
 
‘The clinic might identify champions who will lead this work.
 
‘They will need to make a plan about how the clinic will use the dashboard of graphs when they are finally available. How will capacity and time be made available to consider the results?
 
‘In addressing the findings from PaRIS surveys, clinics will need to make a plan for one or two priority improvements and decide how to evaluate the outcome of these improvements.’
 
Professor Morgan is also concerned data could be ‘misinterpreted and sensationalised’ by the media.
 
‘There is a risk that headlines will focus on a subset of negative findings and that the media will describe the “what” without exploring the “why”’, he said.
 
‘It is just as important to understand what is working well so we can hang onto it as it is to identify opportunities for improvement.’
 
According to ACSQHC, the data will allow general practices to compare their results across the whole country, or with more localised results for practices in the local area, or those with a similar size.
 
‘We’re very interested in healthcare with the patient as a central focus of the service that we provide,’ Dr Acland said.  
 
‘What are the factors that influence the outcomes reported by the patient? Will it be their location? Will it be their socio-demographic status? Will it be their age?
 
‘There’ll be variables there that we as GPs can’t necessarily control, but at a national level, that might be very interesting data that could enable targeted health initiatives to be introduced.
 
‘If we know what their experiences and outcomes are, then we can engage with them to try and address those issues.’
 
Full details about the survey and how practices can participate are on the ACSQHC website.
 
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