ID-5184 Wonca Abstracts supplement A-K 13-10-23 - Flipbook - Page 88
WONCA 2023 Supplement 1: WONCA 2023 abstracts (A–K)
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Lessons learnt from understanding the consumer
experience of the journey to dialysis across the primary/
tertiary care interface
Dr Christopher Bollen1, Shilpanjali Jesudason2,3, Samantha Welke2, Andrew Kellie4
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BMP Healthcare Consulting, 2Central Northern Adelaide Renal and Transplantation Service (CNARTS),
Royal Adelaide Hospital, 3Adelaide Medical School, Faculty of Health and Medical Sciences, The
University of Adelaide, 4East Adelaide Medical Centre
The healthcare journey to chronic dialysis can be a medical and psychological challenge. Patients may
disengage from primary healthcare as dialysis approaches, but continuity of primary healthcare is vital
for holistic, preventative care. The project aimed to understand the perspectives and experiences of
consumers and key stakeholders about kidney care to prevent patients from falling through service
gaps. The project conducted a qualitative interview study of 76 stakeholders and a survey of 58
consumers to gain insight into the challenges and barriers to primary care engagement. In the study,
79% of all patients had a regular GP. The findings showed multifactorial challenges in maintaining
primary care relationships, driven by inconsistent and inefficient communication and collaboration
pathways. In all, 22% of patients reported a decrease in the frequency of GP consultations, while 44%
of patients were interested in their GP being more involved in the management of their kidney care.
The findings were translated into targeted initiatives, co-designed with key stakeholders, to develop
collaborative partnerships for integrated person-centred care. An audit of renal discharge summaries
found 30% of patient discharges did not have a summary completed and 89% of GPs stated the
summaries lacked clear GP actions and continuity of care plans.
The findings were then translated into targeted initiatives to develop collaborative partnerships,
including improved communication and GP involvement, patient education and support, and
integrated care plans. An evaluation of the project confirmed the impact and sustainability of these
changes.
We learnt a dedicated project officer is required to implement projects. Clinicians do not have the time/
capacity to implement large projects. Consumers also expressed appreciation for the opportunity to
provide honest advice and feedback to an impartial project officer.
Innovation and determination are required to implement successful and sustainable quality
improvement strategies when delivering healthcare within large systems and across the primary/
tertiary care interfaces.
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