Practice nurse-led model of facility care: addressing the challenges associated with providing high-quality and sustainable GP services to residential aged care facility residents.

The high number of GPs who struggle to provide their services to residential aged care facility (facility) residents, and the high number of residents not receiving the healthcare they need, has resulted in a new model of care being implemented. This new model is called the Practice Nurse (PN)-led model of facility care.

The implementation of this new model which includes having specialised aged-care nurses in both the facility and the emergency department (ED) has shown significant improvements in some aspects of clinical care. GP services in position at facilities resulted in a decrease in ED transfers, while access of residents to standard GP consultations increased, with after-hours consultations decreasing. 

Below are points comparing GP facility care pre- and post-implementation of the PN-led model:

Without the PN-led model

  • GP time for facilties is “squeezed” and considered additional work.
  • GPs take sole responsibility for care.
  • Consultations are approximately done monthly.
  • In case of urgent needs, facility staff need to directly contact the GP, who still has to find the time to respond.
  • The GP organises everything and does all the administrative and clinical work.

With the PN-led model

  • The GP’s time for facilities fits within their usual work, and they carry out weekly rounds twice.
  • The GPs and PNs are both responsible for care. In case of leave or absences, a colleague or reliever should be available.
  • Consultations are done every three weeks at a minimum. Additional reviews and consults are provided when needed.
  • Facility staff contact PNs first for urgent needs. The PN then collects data and attends to the need for the GP in case medical intervention is required.
  • The GP does clinical work only. The PN, on the other hand, does the administrative work including taking notes, making referrals, organising the GP’s schedule, and communicating with facility staff, families, and other service providers.

With the increasing demand for facility care, it will be beneficial to further explore different models of care and having the appropriate number of GPs will result in improved care for facility residents as more doctors can attend to their needs.

The PN-led model has been proven to help improve primary healthcare provision in facilities. It has many benefits including enabling quick responses to the needs of facility residents, support for GPs, and the continuity and improved quality of care.

Facilities will find this model useful especially with the growing demand for aged care medical services. The PN-led model will assist in streamlining operations and making the delivery of medical care more efficient.

The checklist below will help a facility determine if their residents are receiving and benefiting from these GP services. The PN-led model can aid in monitoring these areas more closely as well.

PN-led model service.PNG

Facility residents should have access to quality primary health care provided by facilities and GPs. Their needs can be addressed with the help of the new PN-led model of care. It is an effective system that addresses the challenges associated with providing high-quality and sustainable GP services to facility residents.

At Aged Care GP, our services are based upon this model published and recommended in 2016.

 

This blog article was based on the Royal Australian College of General Practitioners Silver Book and this research paper: Meade, C., Ward, B., & Cronin H. (2016). Implementation of a team model for RACF care by a general practice. 45(4). 218-222. Journal of Australian Family Practice. Retrieved from here.