Interprofessional education & learning: Optimising the future primary health care workforce

workforce shortages and the ageing population with increasing levels of long-term chronic, complex and multiple conditions. Multidisciplinary, interprofessional and multi-professional team based approaches are promoted as solutions within primary health care service delivery. This raises the need to reflect upon the health, educational, regulatory and financial systems that currently exist, and how they promote or hinder opportunities for learning and working together in teams. This report describes the outcomes of Professor Debra Humphris�s visit as part of the APHCRI International Visiting Fellowship Program. The report includes key themes emerging from Professor Humphris�s presentations (see Appendix 1) and roundtable discussions (see Appendix 2) held during her visit from 3�7 August 2009. The report also provides implications for APHCRI�s primary health care strategic work program.The research reported in this paper is a project of the Australian Primary Health Care Research Institute which is supported by a grant from the Australian Government Department of Health and Ageing under the Primary Health Care Research Evaluation and Development Strategy

Transforming health professionals into population health change agents

Background. With the recognition that professional education has not kept pace with the challenges facing the health and human service system, there has been a move to transformative education and learning professional development designed to expand the number of enlightened and empowered change agents with the competence to implement changes at an individual, organisation and systems level. Design and Methods. Since 2010, the Department of Health and Human Services in Victoria, Australia, in collaboration with The University of Melbourne’s School of Population and Global Health, has delivered seven population health short courses aimed to catalyse participants’ transformation into population health change agents. This paper presents key learnings from a combination of evaluation data from six population health short courses using a transformative learning framework from a 2010 independent international commission for health professionals that was designed to support the goals of transformative and interdependent health professionals. Participatory realist evaluation approaches and qualitative methods were used. Results. Evaluation findings reveal that there were mixed outcomes in facilitating participants’ implementation of population health approaches, and their transformation into population health agents upon their return to their workplaces. Core enablers, barriers and requirements, at individual, organisational and system levels influence the capability of participants to implement population health approaches. The iterative and systemic evolution of the population health short courses, from a one off event to a program of inter-dependent modules, demonstrates sustained commitment by the short course developers and organisers to the promotion of transformative population health learning outcomes. Conclusions: To leverage this commitment, recognising that professional development is not an event but part of an ongoing transformative process, suggestions to further align recognition of population health professional development programs are presented

Arranging generalism in the 2020 primary care team

The National Health and Hospital Reform Commission (NHHRC) final report and the draft National Primary Health Care Strategy state a preference for multidisciplinary primary care to improve chronic disease management, promote prevention and help address workforce shortages. The patients most likely to require multidisciplinary care will be those with complex and multiple health conditions. Although team care arrangements have become a focus, less is known about what the future health care needs of patients with complex and multiple illnesses are. We also have little information about what these patients value in their primary care and how to arrange it to meet their needs. If multidisciplinary teams are to be implemented in the Australian primary care setting, how much of the holistic and fundamentally generalist values might be lost? Defining features of generalists are their knowledge of patients over time and use of patients' life stories and context balanced with technical information to provide holistic care. The study's aim was to explore patients' needs and to identify if the features of generalism have relevance for the development of multidisciplinary team care in the Australian primary care setting.The research reported in this paper is a project of the Australian Primary Health Care Research Institute, which is supported by a grant from the Australian Government Department of Health and Ageing under the Primary Health Care Research, Evaluation and Development Strategy

SIREN project: systems innovation and reviews of evidence in primary health care: narrative review of innovative models for comprehensive primary health care delivery

This review looks at innovative models for comprehensive primary health care (PHC) and lessons for Australia in terms of critical relationships, funding, quality frameworks, meso-level organisations and infrastructure.The research reported in this paper is a project of the Australian Primary Health Care Research Institute, which is supported by a grant from the Australian Government Department of Health and Ageing under the Primary Health Care Research, Evaluation and Development Strategy

What is the place of generalism in the 2020 primary care team?

Primary health care is a domain of reform and change. To maintain a cost-effective, equitable and accessible health care system, policy and strategies must address growing health system complexities. These include workforce shortages, technological advances, an ageing population, rising rates of chronic disease, increases in co-morbidity and growing multi-morbidities. A single-disease focussed approach is not sufficient. Should the generalist be developed to address these multiple issues? What is generalism and its place within the 2020 primary health care team?The research reported in this paper is a project of the Australian Primary Health Care Research Institute, which is supported by a grant from the Australian Government Department of Health and Ageing under the Primary Health Care Research, Evaluation and Development Strategy

Optimising allied health psychological treatments in primary health care: Piloting a randomised controlled trial of social worker training in focused psychological strategies (The SW-fps Study)

The SW-fps Study was part of a broader body of research which aims to improve access to evidence-based psychological treatments in primary health care. Over the last decade, major mental health reforms in Australia, such as the Better Outcomes and Better Access programs, have greatly increased community access to psychological treatments through a range of funding models designed to support provision of psychological treatments by allied health providers. More recently social workers, amongst other allied health professionals, are beginning to utilise the Medicare incentives to provide psychological treatments in primary mentalThe research reported in this paper is a project of the Australian Primary Health Care Research Institute, which is supported by a grant from the Australian Government Department of Health and Ageing under the Primary Health Care Research, Evaluation and Development Strategy

Optimising the primary mental health care workforce: how can effective psychological treatments for common mental disorders best be delivered in primary health care?

The research reported in this paper is a project of the Australian Primary Health Care Research Institute, which is supported by a grant from the Australian Government Department of Health and Ageing under the Primary Health Care Research, Evaluation and Development Strategy

Health inequalities, physician citizens and professional medical associations: an Australian case study

<p>Abstract</p> <p>Background</p> <p>As socioeconomic health inequalities persist and widen, the health effects of adversity are a constant presence in the daily work of physicians. Gruen and colleagues suggest that, in responding to important population health issues such as this, defining those areas of professional obligation in contrast to professional aspiration should be on the basis of evidence and feasibility. Drawing this line between obligation and aspiration is a part of the work of professional medical colleges and associations, and in doing so they must respond to members as well as a range of other interest groups. Our aim was to explore the usefulness of Gruen's model of physician responsibility in defining how professional medical colleges and associations should lead the profession in responding to socioeconomic health inequalities.</p> <p>Methods</p> <p>We report a case study of how the Royal Australian College of General Practitioners is responding to the issue of health inequalities through its work. We undertook a consultation (80 interviews with stakeholders internal and external to the College and two focus groups with general practitioners) and program and policy review of core programs of College interest and responsibility: general practitioner training and setting of practice standards, as well as its work in public advocacy.</p> <p>Results</p> <p>Some strategies within each of these College program areas were seen as legitimate professional obligations in responding to socioeconomic health inequality. However, other strategies, while potentially professional obligations within Gruen's model, were nevertheless contested. The key difference between these lay in different moral orientations. Actions where agreement existed were based on an ethos of care and compassion. Actions that were contested were based on an ethos of justice and human rights.</p> <p>Conclusion</p> <p>Colleges and professional medical associations have a role in explicitly leading a debate about values, engaging both external stakeholder and practicing member constituencies. This is an important and necessary step in defining an agreed role for the profession in addressing health inequalities.</p

A Health Equity Implementation Approach to Child Health Literacy Interventions

Health and behavioural inequalities exist in all populations, including children. As a social determinant of health, health literacy is a crucial driver of equitable health outcomes in children. With the increasing calls for more actions on addressing low health literacy and inequalities, health literacy interventions to improve children’s healthy behaviours have emerged as a key strategy to reduce health inequities. However, health literacy interventions face implementation challenges impacting upon potential outcomes, and disparities in the implementation of health literacy interventions also occur. Variation exists in child health literacy intervention target groups, timing, content and formats, and there is a lack of implementation specificity, resulting in a lack of clarity about which intervention strategies are the most effective in improving health literacy, related health behaviours, and associated health outcomes. While actions to facilitate child health intervention implementation exist, to minimise further perpetuation of child health inequities, this perspective calls for a health equity implementation approach to child health literacy interventions