The New Zealand Experience. p Ruth Vause. Practice Manager, - - PDF document

The New Zealand Experience. p

Ruth Vause. Practice Manager, Redwoodtown

Doctors, Blenheim

Executive member of New Zealand Practice

Managers and Administrators Association of New Zealand New Zealand.

PHO Practice Manager Facilitator RNZCGP Cornerstone Practice Assessor RNZCGP Cornerstone Practice Assessor.

Small Businesses.

• Ownership. Mostly GP owned. Limited

emergence of community trust or tribal

• wnership
• wnership.
• Size. Solo to 20 plus GPs. Average is 3.5 .

Size 1 GP 1500 urban 1 GP 1200 Rural

• Size. 1 GP 1500 urban, 1 GP 1200 Rural.

Practice team. GPs, Practice Nurses,

Reception,Administration and Practice Reception,Administration and Practice Manager.

Ministry of Health. Funders and policy. Primary Health Care Strategy. Population

health and personal health. O i i f i MOH DHB

Organisation of primary care. MOH- DHB-

PHO.

Funding Mixed revenue Capitation and Fee

• Funding. Mixed revenue. Capitation and Fee

for service. Patient copayments.

Health and Disability- Code of patient rights. Health and Disability

Code of patient rights.

ACC No fault accident legislation. Over 30 Acts to comply with.

p y

3.5 GPs, 5 all working part time or multiple

roles.

Nursing staff. 3 with a practice assistant. 4 Reception and administration team. Practice Manager. Teaching practice. New graduate nurses

d 5th di l t d t and 5th year medical students.

Accredited. Fully computerised electronic medical Fully computerised electronic medical

• records. PMS with secure national intranet.

Practice management is emerging mostly as

specialised operational management.

GP shortage. Increasing complexity.

I i li HR l l l

Increasing compliance. HR, contractual, legal. Change in funding fee for service to

capitation 100% practices have migrated

• capitation. 100%

practices have migrated.

Contracting to PHO. Practice accreditation Practice accreditation.

Overview of Overview of Practice Managers Role Practice Managers Role

Financial ncial Human Human Resource Resources Planni Planning ng Clin Clinical O ical Operatio ions Professional Professional b l b l IT IT Risk Risk Manage Manageme ment nt Responsi Responsibility ity Leadership Leadership

Mission Mission

To provi To provide e quality quality patie patient t

Practice Organisation Practice Organisation

IT IT

centered ered c care

Outpu Outputs

Com Complaint laint Mana Management S ement Significant nificant P i P i i f i p resolution resolution g g g g Even Events A i A i A High staff morale/ low turnover High staff morale/ low turnover Accreditation - Accreditation - meeting standards eeting standards I d I d C i Pat atient sat ent satisfact action

• n

Appropr ppropriate ate Access ccess Improved Clinical Improved Clinical Outcome Outcome Improve mproved Capac apacity ty

100%

practices have PMS. 90% EMR

Effi i St ff ti d

• Efficiency. Staff time and space.

Reception – triage. Alerts. Timetabling Timetabling. Program management i.e. breast screening screening. Patient register and PHO reporting. Financials Financials. Access from a distance. Task Management Task Management.

Commonality of role.

I l t d i ti

Isolated in our practices Need to network for sharing and learning.. Need to organise ourselves to meet Need to organise ourselves to meet

professional needs.

Constituted a membership organisation. Constituted a membership organisation.

Employers and key stakeholders- to

understand the scope of management role.

Risk management, business and patient

safety safety.

Role in the delivery of quality. RNZCGP.

Professional/ patient/ practice Professional/ patient/ practice.

Team leadership. Overveiw of organisation. Change management. Change management.

Membership organisation. 350 members .

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National Executive with local branches. National Executive engages in strategic

l planning to support our mission.

Developed relationships with key stakeholders.

Qualification step to professional status

Qualification- step to professional status. Salary survey and scopes of practice

management. management.

Annual conference. Local branch meetings and national newsletter.

g

100%

• Accreditation. Business aligned with

hil h f F il M di i philosophy of Family Medicine.

Changing contractual obligation. Move to

performance focus. PMP and funding. performance focus. PMP and funding.

Chronic conditions management. Shift secondary services to primary settings.

(S fi ld b l i b d (Starfield – better population based

• utcomes. )

Training practices: Nurse and Doc tor Training practices: Nurse and Doc tor Practice Manager role: qualifications and

development of professional status.

Opportunity to engage in quality

t management.

• Framework. RNZCGP recognises the

“practice” practice

Assisted in developing indicators for NZ tool.

Cornerstone. E l M i f i l

• Examples. Managing professional

development to meet practice needs. Strategic and business planning. Significant Strategic and business planning. Significant event management. HR. Patient Safety- triage, test results, prescribing.

Recognition of practice managers. Both in

selection of indicators, assessors and practice role.

Improved practice performance and Improved practice performance and

capability and capacity. Move from day to day administration to quality management. (QA administration to quality management. (QA and CQI)

Practice management resource development.

RNZCGP, NZMA, IPA, private.

Professional recognition by fellow professional

bodies bodies.

Step up - Qualification- code of ethics and PD. Role recognition by employers.

g y p y

Role recognition by MoH and funding

• rganisations.

Resource development Resource development. Quality management. Standard setting and CQI. Change management. Peer support. Education.