Staff perceptions of primary healthcare service change: influences on staff satisfactionRachel Tham A B , Penny Buykx A C , Leigh Kinsman A C , Bernadette Ward A C E , John S. Humphreys C , Adel Asaid D , Kathy Tuohey D and Rohan Jenner D
B Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Vic. 3010, Australia.
C Centre of Research Excellence in Rural and Remote Primary Health Care, Monash University, Bendigo, Vic. 3552, Australia.
E Corresponding author. Email: firstname.lastname@example.org
Australian Health Review 38(5) 580-583 https://doi.org/10.1071/AH14015
Submitted: 29 July 2013 Accepted: 20 August 2014 Published: 6 October 2014
Strong primary healthcare (PHC) services are efficient, cost-effective and associated with better population health outcomes. However, little is known about the role and perspectives of PHC staff in creating a sustainable service. Staff from a single-point-of-entry primary health care service in Elmore, a small rural community in north-west Victoria, were surveyed. Qualitative methods were used to collect data to show how the key factors associated with the evolution of a once-struggling medical service into a successful and sustainable PHC service have influenced staff satisfaction. The success of the service was linked to visionary leadership, teamwork and community involvement while service sustainability was described in terms of inter-professional linkages and the role of the service in contributing to the broader community. These factors were reported to have a positive impact on staff satisfaction. The contribution of service delivery change and ongoing service sustainability to staff satisfaction in this rural setting has implications for planning service change in other primary health care settings.
What is known about this topic? Integrated PHC services have an important role to play in achieving equitable population health outcomes. Many rural communities struggle to maintain viable PHC services. Innovative PHC models are needed to ensure equitable access to care and reduce the health differential between rural and metropolitan people.
What does this paper add? Multidisciplinary teams, visionary leadership, strong community engagement combined with service partnerships are important factors in the building of a rural PHC service that substantially contributes to enhanced staff satisfaction and service sustainability.
What are the implications for practitioners? Understanding and engaging local community members is a key driver in the success of service delivery changes in rural PHC services.
References Department of Health and Ageing. Building a 21st Century Primary Health Care System Australia’s First National Primary Health Care Strategy. Canberra: Australian Government; 2010.
 National Health and Hospitals Reform Commission. A Healthier Future For All Australians: Final Report of the National Health and Hospitals Reform Commission. Canberra: Commonwealth of Australia; 2009.
 Standing Council on Health. National Primary Health Care Strategic Framework. Canberra: Commonwealth of Australia; 2013.
 Buykx P, Humphreys J, Tham R, Kinsman L, Wakerman J, Asaid A, Tuohey K. How do small rural primary health care services sustain themselves in a constantly changing health system environment? BMC Health Serv Res 2012; 12 81
| How do small rural primary health care services sustain themselves in a constantly changing health system environment?CrossRef | 22448876PubMed |
 Australian Bureau of Statistics (ABS). Census Quick Stats 2012. Canberra: ABS; 2012. Available from: http://www.censusdata.abs.gov.au/census_services/getproduct/census/2011/quickstat/SSC20455?opendocument&navpos=220 [verified dd mmm yyyy].
 Asaid A, Riley K. From solo practice to partnering: the evolution of the Elmore model of primary health. Aust Fam Physician 2007; 36 167–9.
| 17339982PubMed |
 Tham R, Humphreys J, Kinsman L, Buykx P, Asaid A, Tuohey K. Study protocol: Evaluating the impact of a rural Australian primary health care service on rural health. BMC Health Serv Res 2011; 11 52
| Study protocol: Evaluating the impact of a rural Australian primary health care service on rural health.CrossRef | 21356123PubMed |
 Tham R, Humphreys J, Kinsman L, Buykx P, Asaid A, Tuohey K, Riley K. Evaluating the impact of sustainable comprehensive primary health care on rural health. Aust J Rural Health 2010; 18 166–72.
| Evaluating the impact of sustainable comprehensive primary health care on rural health.CrossRef | 20690913PubMed |
 Stake R. Qualitative case studies. In Denzin N, Lincoln Y, editors. The handbook of qualitative methods. 3rd edn. Thousand Oaks, CA: Sage; 2005.
 Guba E, Lincoln Y. Competing paradigms in qualitative research. In Denzin N, Lincoln Y, editors. Handbook of Qualitative Research. Thousand Oaks, CA: Sage; 1994.
 Miles M, Huberman A. Qualitative data analysis: an expanded sourcebook. Thousand Oaks: Sage Publications; 1994.
 Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care 2007; 19 349–57.
| Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups.CrossRef | 17872937PubMed |
 Hendy J, Barlow J. The role of the organizational champion in achieving health system change. Soc Sci Med 2012; 74 348–55.
| The role of the organizational champion in achieving health system change.CrossRef | 21444137PubMed |