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Australian Journal of Primary Health Australian Journal of Primary Health Society
The issues influencing community health services and primary health care
RESEARCH ARTICLE

Connecting Care in the Community: what works and what doesn’t

Elizabeth Lucas A C , Elizabeth Halcomb B and Sandra McCarthy A
+ Author Affiliations
- Author Affiliations

A Grand Pacific Health, PO Box 1198, Wollongong, NSW 2500, Australia.

B School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Northfields Avenue, Wollongong, NSW 2522, Australia.

C Corresponding author. Email: llucas@gph.org.au

Australian Journal of Primary Health 22(6) 539-544 https://doi.org/10.1071/PY15141
Submitted: 29 September 2015  Accepted: 14 December 2015   Published: 16 May 2016

Abstract

As the burden of chronic and complex disease grows, there is an emphasis on programs that enhance the quality of care within primary care. The Connecting Care in the Community (CCC) program is an example of the implementation of care integration. This qualitative study sought to explore the experiences general practice staff face in managing clients with chronic and complex care issues, and their perceptions of the contribution of the CCC program to this care. Seventeen general practice staff from 11 practices throughout the Illawarra/Shoalhaven region participated in semistructured interviews. Five main themes emerged: (1) awareness of the CCC program; (2) varying program exposure and value placed on the program; (3) practice ‘busyness’ and role confusion; (4) communication and information sharing; and (5) the need for staff education and knowledge of local resources. If policymakers and healthcare organisations can gain a better understanding of the experiences of general practice staff, they will be able to design and implement programs that best meet the needs of the providers that they are attempting to integrate.

Additional keywords: care coordination, general practice, perception.


References

Australian Government (2010) A national health and hospitals network for Australia’s future: delivering the reforms. Available at http://www.yourhealth.gov.au/internet/yourHealth/publishing.nsf/Content/DeliveringTheReforms/$FILE/DeliveringTheReforms.pdf [Verified 10 November 2015]

Australian Institute of Health and Welfare (2008) Framework for performance improvement in health. Available at http://www.ipart.nsw.gov.au/Home/Industries/Other/Reviews_All/Health/Framework_for_performance_improvement_in_Health [Verified 7 January 2015]

Australian Institute of Health and Welfare (AIHW) (2011) Health expenditure Australia 2009–10. Cat. no. HWE 55. AIHW, Canberra.

Braun V, Clarke V (2006) Using thematic analysis in psychology. Qualitative Research in Psychology 3, 77–101.
Using thematic analysis in psychology.Crossref | GoogleScholarGoogle Scholar |

Britt H, Miller G, Henderson J, Bayram C, Harrison C, Valenti L, Wong C, Gordon J (2014) ‘General practice activity in Australia 2013–14. General practice series no. 36.’ (Sydney University Press: Sydney)

Bywood P, Jackson-Bowers E, Muecke S (2011) Initiatives to integrate primary and acute health care, including ambulatory care services. Available at: http://www.phcris.org.au/phplib/filedownload.php?file=/elib/lib/downloaded_files/publications/pdfs/phcris_pub_8357.pdf [Verified 7 January 2016]

Commonwealth of Australia (2010) Building a 21st century primary health care system. Australian Government, Canberra.

Garling P (2008) Final report of the Special Commission of Inquiry: acute care services in NSW public hospitals. Available at http://www.dpc.nsw.gov.au/__data/assets/pdf_file/0003/34194/Overview_-_Special_Commission_Of_Inquiry_Into_Acute_Care_Services_In_New_South_Wales_Public_Hospitals.pdf [Verified 7 January 2015]

GP NSW (2013) NSW Health chronic disease management – Connecting Care in the Community Program (CDMP). Available at http://www.gpnsw.com.au [Verified 1 October 2013]

Greb S, Baan C, Calnan M, Dedeu T, Goenewegan P, Howsan H, Maroy L, Nolte E, Redaelli M, Saarelma O, Schmackee N, Schumacher K, van Lente E, Vrighoef B (2009) Coordination and management of chronic conditions in Europe: the role of primary care – position paper of the European Forum of Primary Care Quality in Primary Care 17, 75–86.

Health NSW (2014) State-wide evaluation NSW Health Chronic Disease Management Program – final report, October 2014. Health NSW, Sydney.

May C, Murray E, Finch T, Mair F, Treweek S, Ballini L, Macfarlane A, Rapley T (2010) Normalization Process Theory on-line users’ manual and toolkit. Available at http://www.normalizationprocess.org [Verified 11 February 2015]

McDonald K, Sundaram V, Bravata D, Lewis R, Lin N, Kraft S, McKinnon M, Paguntalan H, Owens D (2007) Closing the quality gap: a critical analysis of quality improvement strategies. Available at http//www.ahrq.gov/downloads/pub/evidence/pdf/caregap/caregap.pdf [Verified 7 January 2016]

McInnes S, Peters K, Bonney A, Halcomb E (2015) An integrative review of facilitators and barriers influencing collaboration and teamwork between general practitioners and nurses working in general practice. Journal of Advanced Nursing 71, 1973–1985.
An integrative review of facilitators and barriers influencing collaboration and teamwork between general practitioners and nurses working in general practice.Crossref | GoogleScholarGoogle Scholar | 25731727PubMed |

Moaveni A, Gallinaro A, Conn LG, Callahan S, Hammond M, Oandasan I (2010) A Delphi approach to developing a core competency framework for family practice registered nurses in Ontario. Nursing Leadership (Toronto, Ont.) 23, 45–60.
A Delphi approach to developing a core competency framework for family practice registered nurses in Ontario.Crossref | GoogleScholarGoogle Scholar | 21301256PubMed |

National Health and Hospitals Reform Commission (2009) A healthier future for all Australians: final report. Available at http://www.health.gov.au/internet/nhhrc/publishing.nsf/Content/nhhrc-report [Verified 7 January 2015]

National Health Priority Action Council (2006) National chronic disease strategy. Australian Government Department of Health and Ageing, Canberra.

NSW Agency for Clinical Innovation 2013, NSW Chronic Disease Management Program – Connecting Care in the Community. Available at http://www.aci.health.nsw.gov.au/resources/chronic-care/cdmp/nsw-cdmp [Verified 7 January 2015]

Oandasan IF, Hammond M, Conn LG, Callahan S, Gallinaro A, Moaveni A (2010) Family practice registered nurses: the time has come. Canadian Family Physician 56, e375–e382.

Powell-Davies G, Williams A, Larsen K, Perkins D, Roland M, Harris M (2008) Coordinating primary healthcare: an analysis of the outcomes of a systematic review. The Medical Journal of Australia 188, S65–S68.

Saunders C (2011) ‘Chronic disease management in primary care.’ (GP NSW: Sydney)

Smith AC (2011) Role ambiguity and role conflict in nurse case managers: an integrative review. Professional Case Management 16, 182–196.
Role ambiguity and role conflict in nurse case managers: an integrative review.Crossref | GoogleScholarGoogle Scholar | 21646893PubMed |

Tieman J, Mitchell G, Shelby-James T (2007) Integration, coordination and multidisciplinary care: what can these approaches offer to Australian primary healthcare? Australian Journal of Primary Health 13, 56–65.
Integration, coordination and multidisciplinary care: what can these approaches offer to Australian primary healthcare?Crossref | GoogleScholarGoogle Scholar |

Victorian Government (2005) Improving chronic disease care: learnings from the integrated disease management projects. Available from http://www.health.vic.gov.au/pcps/publications/index.htm [Verified 8 January 2015]

Wagner EH, Austin BT, Davis C, Hindmarsh M, Schaefer J, Bonomi A (2001) Improving chronic illness care: translating evidence into action. Health Affairs (Project Hope) 20, 64–78.
Improving chronic illness care: translating evidence into action.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD38%2FovVagug%3D%3D&md5=580ec216283d9f264b3e1635035c159cCAS |

Young K 2013, The NSW Health Chronic Disease Management – Connecting Care in the Community Program (CDMP): program overview and discussion paper (last updated 21 March 2013). GP NSW, Sydney.