Mater Presentation - Greater Metro South Brisbane Medicare Local

Report
REFUGEE HEALTH CONNECT
Building patient centred primary
health care through partnerships
and research
Donata Sackey (Senior Program Manager) Mater UQ Centre
for Primary Health Innovation
Luke Moloney (Coordinator) Primary Care Project, Greater
Metro South Brisbane Medicare Local
Background and context
• Between 2000 and 2014, Australia has
permanently resettled approximately
200,000 people from refugee and
humanitarian backgrounds from Africa,
Middle East and South Asia
Background and context
• It is well documented that people from refugee
backgrounds experience difficulties in accessing
health services due to cultural and linguistic
barriers.
• Primary health care is the best setting for the
delivery of timely and quality health care and
assessments.
Background and context
• Qld has no state-wide refugee health care model
and no refugee health policy.
• APHCRI funded study (2010-12) – identified key
components for a best practice model of refugee
health care delivery.
• MHS and GMSBML in partnership with key
stakeholders are implementing an innovative,
evidence based model of care for new arrivals in
the Brisbane South area
The Model -partnerships
• PAG (Partnerships Advisory Group) includes 22
organisations across Gold Coast, Logan, Brisbane
North and South including academic and community
representatives, HHS, MLs, clinicians and
settlement.
• CAG (Clinical Advisory Group) provides clinical
leadership and resource development. Chaired by
GMSBML clinical lead.
• Mental Health Working Group with a focus on
developing resources and capacity in primary care
and reports to PAG
• Community Advisory Group – G8 (MHS) project
The Model: Refugee Health Connect
• Refugee Health Connect:
o referral facilitation of new arrivals to Brisbane South
based at GMSBML with close collaboration with Mater
Integrated Refugee Health Service and MDA.
o Building capacity in primary care through a “Beacon”
model using Tier 1 practices to provide refugee health
assessments and care.
o In practice support (clinical leads GP/nurse) for Tier 2
practices
o Practice systems support to build sustainability
o Close collaboration with settlement services and support
to build health system knowledge.
Refugee Health– A new mode for delivering primary health care .
Tier 1 Practices
Provides:
Reduces:
Specific
Measurable
Achievable
Realistic
Time appropriate
Barriers to care
Service duplication
Gaps in service provision
Communication errors
Care
Cross-sector collaboration
Outcomes Focused
Enlists collective strengths
Ensures sustainability
Enhances communication
Facilitates ICT Integration
Provides Initial Health Assessments
Provides Care for Complex Cases
Determines Best Practice Guidelines
Enhances capacity
Facilitates Engagement
Distributes Best Practice Guidelines
Enables Advocacy
Supports teaching and education
Up-skills GPs with special interest
Linkage with General Practice:
Advisory body
Aligned Primary Care
Organisations
• Summary of Current Care
Stakeholders
with a
Shared Vision
Partnership
Advisory
Group
• Formal education of
multi-disciplinary team
Clinical
Advisory
Group
Other
Health Care
Providers
• Practice staff /Nurse/ GP/
Allied Health
• Knowledge of resources in
local community
• Informal guidance
General
Practice
Tier 2
Underpinned by
Research
Provides data for planning of interventions
Provides evidence for best practice
Evaluates needs of communities and providers
Evaluates effectiveness of interventions
General
Practice
Tier 2
General
Practice
Tier 2
Underpinned by
Community Engagement
Refugee Health Connect
Mater Refugee Health
Advisory Group
Outcomes
• RHC: facilitated 447 new referrals between JanOct 2014 (100% of all new arrivals to Brisbane
South).
• Four Tier 1 practices providing health
assessments and with agreements with MHS for
colocation of refugee health nurses/ data sharing
• Resources: online Mental Health Referral tool,
immunisation hints and tips, recommended
pathology
Outcomes
• Two peer research projects (ethics
approved) RaPH and Youth research
• Three education events per annum on
diverse topics including: mental health,
Hepatitis, TB
What next?
• Evaluation of the Brisbane Sth model –
quantitative and qualitative approach –
evaluation plan, data set and ethics
• Using a co-creation approach – a patient
centred model with a participant research
framework
• Opportunities to expand the peer led
research projects
What next?
• Collection of prevalence data
• Multi-site (Tier 1 practices and other refugee health
services – Logan – Brisbane North)
• National approach – APHCRI – development of a national
evaluation framework – partnerships with Monash, UNSW,
RHeaNA
• Qualitative
– Refugee communities (peer led interviews – focus
groups)
– Health providers (interviews)
• Empowerment of community members through health
literacy – Women as Health Leaders project
Benefits of our approach
•
•
•
•
Priorities are negotiated and agreed
Quality enhanced and not dependent on funding
Findings are translated
Dissemination
– System
– Providers
– Communities
• Enhanced capacity within the communities,
clinicians (and others)
• Less research waste
Aknwoledgements
• Dr Margaret Kay (UQ)
• Dr Ignacio Correa-Velez (QUT)
• Caroline Nicholson and Paula Peterson
(MHS)
• Andrea Vancia and Sylvia Penhaligon
(GMSBML)
• Chris Allotta and MIRHS Team (MHS)
• The communities and all key stakeholders
THANK YOU

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