Community Health and General Practice: The Impact of Different Cultures on the Integration of Primary Care

Abstract

This study examined the existing relationship between community health centres and General Practice Divisions in the State of Victoria, including the nature of joint working arrangements and the identification of barriers to greater collaboration. Improved integration of primary health care services has been advocated to improve consumer and population health outcomes and to reduce inappropriate use of acute and extended care services. General practitioners (GPs) and community health centres are two key providers of primary health care with potential for greater integration. The current study conducted telephone interviews with 20 community health centre CEOs and 18 Executive Officers of divisions, which were matched according to catchment boundaries. Results suggest, while some joint planning is occurring, especially on committees, working parties and projects, there is an overall low level of satisfaction with the relationship between community health centres and GPs and GP divisions. Major barriers to greater integration are the financial or business interests of GPs and misunderstanding and differences in perceived roles and ideology between GPs and community health centres. Improved communication, greater contact and referral and follow-up procedures are identified as a means of improving the relationship between GPs, GP divisions and community health centres. Community health centres and general practitioners (GPs) are key providers of primary care (Australian Community Health Association, 1990).

Interprofessional teamwork innovations for primary health care practices and practitioners: evidence from a comparison of reform in three countries

“…As others have, we found that the impacts of teamwork varied, being modified by intrapractice contextual factors including practice model, colocation of services, leadership style, and space. 26 , 27 Our multijurisdictional comparison showed how the differences within the jurisdictions studied were often greater than those existing between jurisdictions. Although the extent of intrajurisdictional variation has been documented in some cross-national comparative surveys, our methods allowed us to understand the origin of this variability.…”

Intersectoral communication amongst healthcare providers regarding care plans: a scoping review

“…The importance of relationships across sectors Sources reviewed featured a variety of intersectoral communication relationships and pathways. Twelve sources examined communication from health to community sectors 25 , 31 – 33 , 36 , 37 , 39 , 41 , 43 , 49 , 51 , 52 and four investigated the opposite direction of communication; community programs communicating to the health sector. 26 , 27 , 46 , 48 Five sources included communication between health and social sectors, 26 , 28 , 30 , 38 , 47 and another four explored interactions between health sectors (primary, secondary, tertiary), 38 , 40 , 47 , 50 other pathways included primary care to pharmacy 45 , 47 and informal care providers.…”

“…This collaboration was fostered when there were supportive and trusting relationships 31 , 48 or when individuals had defined roles or ‘to-do’ lists. 37 , 46 , 51 To ensure all providers felt part of a team, Rowlands et al 48 highlighted the importance of making carers aware that there were available supports when navigating patient care. When referring to community services it was important for general practitioners (GPs) and other HCPs to understand what was provided.…”

“…The importance of community navigators in sharing the care plan and goals of care To facilitate communication between health sectors, the importance of an individual that acted as a liaison between sectors, often acting as a broker between various practices, was noted by several sources. 33 , 43 , 49 – 51 , 53 , 54 This figure took on numerous titles; namely, community matron, 33 nurse navigator, 54 a broker, 50 nurse facilitator, 43 or liaison nurse. 49 In considering the aforementioned articles depicted the importance of this role and its usefulness from both the perspective of patients and the care team.…”

Moe After Hours Medical Service: 'pillars' of success

“…Managing the relationships between the formal organisational structures of management and the culture of general practice is very challenging and should not be under-estimated (Swerissen et al 2001). Using a 'rich picture' in Figure 1 to describe MAHMS recognises the difficulty of placing this type of service into neat boxes or organisational charts.…”