General Practice Quality Improvement
Our commitment to Quality Improvement (QI)
The Royal Australian College of General Practitioners (RACGP) defines continuous quality improvement (CQI) as an ongoing activity undertaken within a general practice with the primary purpose to monitor, evaluate or improve the quality of healthcare delivered to practice patients.
Brisbane South PHN is committed to working with the primary care sector to deliver best practice, person centred care through CQI activities. Our Primary Care team can provide practical advice and resources that will help you plan, implement, and review quality improvement (QI) activities in your practice. Outcomes of QI are best summarised by The Quadruple Aim.
Why is everyone talking about QI and CQI?
A business or organisation will never realise their full potential until improvement becomes part of every worker’s day job, rather than a temporary phenomenon¹
¹ Batalden P, Davidoff F. What is “quality improvement” and how can it transform healthcare?
Qual Saf Health Care 2007;16:2–3
Quality Improvement (QI) in General Practice
Quality Improvement (QI) is foundational to high performing primary care. It includes team-based approaches, peer reviews, reflective practice, best practice, and data analysis. It can improve uptake of evidence-based practices for better patient outcomes, better professional development, and better system performance. Quality Improvement is also a change concept of the Patient Centred Medical Home (PCMH).
Case Study- Quality Improvement Strategy and Person Centred Care in general practice
QI generally follows these steps:
- Utilise data extraction tool to conduct clinical audit
- Record outcomes of clinical audit
- Document proposed actions following clinical audit, including delegated responsibilities
- Keep evidence of implementation
- Document follow up plans
Brisbane South PHN can provide a number of tools to help practices to analyse and improve their data. The PEN CS suite including CAT4 and Topbar are provided at no cost to the practice. The benefits of using these tools are summarised here. To find out more about CAT4 tools, click here or contact Brisbane South PHN’s digital health team on: eHealth@bsphn.org.au
The following tabs provide further information on how practices can be involved in QI activities at the practice.
Practice Incentive Program (PIP) Quality Improvement (QI)
PIP QI Is an incentive payment given to general practices once a quarter for demonstrating that they are providing continuous quality care by participating in continuous QI activities in partnership with their PHN. Practices are required to:
- Participate in Continuous Quality Improvement (CQI): Practices may undertake QI activities that focus on the specified Ten Improvement Measures or alternatively, choose to focus activities in other areas but must be informed by their clinical information system data and meet the needs of their practice population.
- Provide the PIP Eligible Data Set to your local PHN: The PIP Eligible Data set is de-identified data* that is encrypted and sent securely to Brisbane South PHN as specified in the data sharing agreement between the practice and Brisbane South PHN.
- Practice Incentive Program (PIP QI) Fact Sheet (Updated 28/11/2019)
- Department of Human Services Resources relating to the PIP QI can be found here.
PIP QI Improvement Measures
The collection of de-identified data* includes the PIP QI Eligible Data set required to calculate the PIP QI ten Improvement Measures. The Improvement Measures are not designed to assess individual general practice or general practitioner performance. They do support a regional and national understanding of chronic disease management in areas of high need, and future iterations will respond to emerging evidence on areas of high need.
The Ten Improvement Measures are:
- Proportion of patients with diabetes with a current HbA1c result
- Proportion of patients with a smoking status
- Proportion of patients with a weight classification
- Proportion of patients aged 65 and over who were immunised against influenza
- Proportion of patients with diabetes who were immunised against influenza
- Proportion of patients with COPD who were immunised against influenza
- Proportion of patients with an alcohol consumption status
- Proportion of patients with the necessary risk factors assessed to enable CVD assessment
- Proportion of female patients with an up-to-date cervical screening
- Proportion of patients with diabetes with a blood pressure result.
Further information is provided by the Department of Health here.
Practice Readiness for PIP QI
Register for PIP QI via your Provider Digital Access (PRODA). Instructions on DHS’ website.Start planning and actioning quality improvement activities using our QI Toolkits & Resources
Practice readiness checklist:
|▢ Practice accreditation||▢ Arrange to share data with with Brisbane South PHN, and train your practice team in using PEN CS’ CAT 4 and Topbar tools|
|▢ Register for PIP QI via your Provider Digital Access (PRODA). Instructions on DHS’ website.||▢ Start planning and actioning quality improvement activities using our QI Toolkits & Resources|
|▢ Complete this form to provide your PIP ID to Brisbane South PHN and a nominated email to receive monthly benchmark reports and updates about PIP data submissions.||▢ Maintain a record/register of quality improvement activities and progress (e.g. virtual folders or physical folder)|
QI Toolkits & Resources
Quality Improvement Activities using The Model for Improvement and PDSA
Brisbane South have a developed a Quality Improvement toolkit for general practice. Throughout modules of the toolkit your practice team will be guided to explore your data to understand more about your patient population and the pathways of care being provided in your practice. Reflections from the module activities and the related data will inform improvement ideas for you to action using the Model for Improvement.
The Model for Improvement uses the Plan-Do-Study-Act (PDSA) cycle, a tried and tested approach to achieving successful change. It offers the following benefits:
- It is a method to plan, develop and implement change that anyone can apply.
- It reduces risk by testing small changes before wider implementation.
- By starting small, there is less resistance to change.
- You can achieve team unity on common goals.
- It encourages individual creativity and ideas from team members.
After completing any of the workbook activities, you may identify areas for improvement in the management of patients. Follow these steps to conduct a Quality Improvement Activity using The Model for Improvement and PDSA.
- Quality Improvement Toolkit: Overview
- Quality Improvement Toolkit: PIP QI Ten measures
- Model for improvement/PDSA template
- PDSA Examples
- Quality Improvement Toolkit: Chronic Obstructive Pulmonary Disease (COPD)
- Quality Improvement Toolkit: Patient Populations
- Quality Improvement Toolkit: Cancer Prevention
- Quality Improvement Toolkit: Flu Vaccines
- Quality Improvement Toolkit: Prevention Pneumococcal
- Quality Improvement Toolkit: Shingles
- Quality Improvement Toolkit: Osteoporosis
- Quality Improvement Toolkit: Chronic Kidney Disease (CKD)
- Quality Improvement Toolkit: Cardiovascular Disease (CVD)
- Quality Improvement Toolkit: Older People
- Quality Improvement Toolkit: Palliative Care
Tools to support QI and data analysis and extraction
Train IT resources
- Brisbane South PHN have a library of webinars and resources from Train IT that guide your practice through QI activities. Please contact the Digital Health team by email email@example.com or phone 1300 467 265 to gain access to these resources.
- QI resources
- PDSA Samples
- CAT 4 recipes for 10 measures (Step-by-step guides)
- Removing patients from upload to PHNs
- PEN CS PIP QI FAQs
- Improving health record quality in general practice: This guide outlines what constitutes a high-quality health record and how practices can put systems in place to ensure they produce health records that are fit for purpose.
Providing De-identified Data to Brisbane South PHN*
Brisbane South PHN provides practices with free access to the PEN CS CAT 4 software suite to enable secure encryption, de-identification, and transmission of data from the practice to Brisbane South PHN. Please see Brisbane South PHN’s Data Sharing Agreement Fact Sheet for further information.
Brisbane South PHN will produce a benchmark report for your practice each month using your practice data. This will help you identify key priority areas and quality improvement opportunities particular to your practice.
Information about Privacy
- PEN CS’ Privacy Poster for General Practice
- PEN CS’ Data extraction process
- PEN CS’ De-identification process
- Brisbane South PHN’s Agreement to receive CAT 4 software free of charge: Please contact your Area Account Manager
If you require assistance or would like further information, please contact your Area Account Manager or the Digital Health team: email firstname.lastname@example.org or phone 1300 467 265.