Implementation of a team model for RACF care by a general practice.

ABSTRACT

OBJECTIVE: Many general practitioners (GPs) struggle to meet the demand for their services at residential aged care facilities (RACFs). The aim of this study was to describe and examine the effect on service provision and GPs of a new model of RACF care in a rural general practice. METHODS: A mixed-method case study was used to examine the practice nurse-led team model of RACF care. In-depth, semi-structured interviews with GPs and other staff were analysed using a thematic approach. Medicare Benefits Schedule (MBS) item analysis examined service provision in the two years pre- and post-implementation of the new model. RESULTS: Key themes that emerged were access to care, GP satisfaction, the role of the practice nurse, the model's financial viability and lessons for other practices. Under the new model of care, residents' access to standard general practice consultations increased from 6.69 to 14.09/resident/year. At the same time, after-hours consultations were reduced from 0.16 to 0.10/resident/year. There were also significant increases in provision of Medicare quality improvement services. GPs reported that their workload and stress decreased, while their levels of professional satisfaction increased. DISCUSSION: This service model has much to offer GPs who are willing to engage in team care. It is an efficient model of high-quality care that overcomes key barriers associated with providing sustainable general practice services to RACF residents.