North East Valley DGP eNews

No 1306: March 13, 2013
eNews is a weekly electronic newsletter sent to all GP practices (with email addresses) within the NEV catchment. The aim is to provide up to date information relevant to GPs and to disseminate the latest activities and resources from the division. All feedback and enquiries welcome and should be addressed to Patty Marshall. You can also visit our website at: http://www.nevdgp.org.au/.
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In this issue:

Editorial                                                Finally - some general practices admitted to NMML membership, Passing of Dr Stephen Larkins   

Australian Doctor Articles                  The Collaboratives

Chronic Disease Management            Annual health professional symposium 2013: Diabetes Down Under        

Professional Development                 CPD events   

Immunisation                                       Eligibility criteria for free secondary school-based vaccines         

Information Management                  Medical Director Tips

Items of interest                                  Changes in Referral Path to Northern Health’s Ambulatory and Sub-Acute Services as of 12th March, CLOSING - Mercy Hospital for Women’s IVANHOE Clinic, NEMICS Newsletter,

Women’s Health                                  ThinkGP women’s health series, Mercy Hospital for Women 2013 GP Seminar program                            

Positions vacant/wanted                            

Fun stuff                                                        

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A Word from the Editor

Finally - some general practices admitted to NMML membership

After nearly 6 months of waiting, we have been advised by the following practices - Andrew Place Clinic, Hurstbridge Medical Centre, Livingstone Street Medical Clinic, Wingrove Medical Clinic, Eltham Clinic and Croxton Medical Centre - that their application for membership of the NMML has been accepted. In addition we have been contacted by other practices who had applied but have heard nothing. If you have applied but haven't heard we would encourage you to contact the NMML on 9353 8555 to find out what’s happening with your application.

To the best of our knowledge, the criteria for membership selection or exclusion has not been announced, which is puzzling in itself for a publically funded organization whose decision making processes you would expect to be transparent and public.

If you have received a letter of either acceptance or rejection following your application please let us know.

In the meantime we would encourage all NEVDGP practices to apply for membership to ensure that the voice of General Practice is able to be heard. 

 

Passing of Dr Stephen Larkins

It is with regret that we pass on the news that Dr Stephen Larkins died last week after a long battle with illness. Stephen was a solo practitioner in the Greensborough area for more years than we care to remember. Our sympathies go to Dr Larkin’s family but also to Leigh Kelly, the Practice Manager for 20+ years of Dr Larkins practice. Rest in Peace.

 

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Australian Doctor Articles

The Collaboratives

In July 2009 I wrote about the Australian Primary Care Collaboratives and its quality improvement program using PDSA cycles (Plan, Do, Study, Act) to improve patient care and outcomes. Surprisingly I also mentioned that clean clinical data was a necessity in order to accurately measure the quality improvements. Those who experienced the excitement, the rapid change process and the ideas-sharing of the Collaboratives journey had the problem of once returning to the workplace, how to enthuse the non-attendees back at the practice?

One very enthusiastic practice manager used the PEN Clinical Audit Tool to create a table every month that displayed the statistical analysis for every GP in the practice. Each month a personal copy of the table was placed in an envelope and given to each GP - all the other GPs were de-identified. A completely de-identified copy of the table was also pinned on the staffroom noticeboard. This proved to be non-threatening and brought the “under-performing” GPs into line with better recording of patient clinical information and encouraged a team approach. In short, a measurable improvement in the quality of the practice data was achieved in a short period of time whilst also encouraging the GPs to be enthusiastic about their better clinical recording.

This same approach is used in the clinical audits that Noel and Wendy are running for practices of the NEVDGP. If you want to join the 25+ practices that have experienced these audits over the past 12 months simply contact Noel or Wendy at the division on 9496 4333.

It should also be noted that the APCC program is still being run through the Improvement Foundation with a number of Medicare Locals who are recruiting practices.

For the full article click here. For the current APCC program click here.

 

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Chronic Disease Management

Annual health professional symposium 2013: Diabetes Down Under

Friday 10 May at Melbourne Exhibition Centre. Diabetes Australia – Vic is hosting this educational event for diabetes nurse educators, dietitians and diabetes health professionals in partnership with Baker IDI Heart & Diabetes Institute. Download the symposium flyer for further information. Registrations are open and can be made by contacting Baker IDI Heart & Diabetes Institute. Early bird bookings close 8 April 2013.

 

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Continuing Professional Development

Influenza & Immunisation Update

Tuesday March 19th 7pm-9.15 pm (Dinner from 6.30pm) Presented by Dr Peter Eizenberg at John Scott Meeting House, La Trobe University, Bundoora. Flyer

 

GP Skin Cancer Workshop

Saturday 23 & Sunday 24 March at Monash University. This two-day GP workshop includes differentiating between benign and suspicious skin lesion, managing skin cancers and Dermoscopy teaching and practical hands-on interactive sessions using pigskin. For further information and flyer see here.

 

ThinkGP MTBI activities

With the football season now underway there is a higher chance we will be managing patients with Mild Traumatic Brain Injury (MTBI). MTBI is often associated with motor vehicle accidents, but is also common in contact sports. Update your knowledge on MTBI with the activities listed below and be prepared.

Primary Care for Mild Traumatic Brain Injury - managing the complex patient
This activity discusses the role of the GP in the assessment and management of patients who sustain a mild traumatic brain injury and who have sequelae persisting beyond three months after injury. The indications for specialist referral and the role of brain injury rehabilitation units are outlined.
Primary Care for Mild Traumatic Brain Injury - the GP’s role
This activity discusses the role of the GP in the assessment and management of patients who sustain a mild traumatic brain injury. The various assessment tools are discussed and their role in assessment explained. This activity will focus on the patient in the first three months post injury.
MTBI from the perspective of the GP - Video
Welcome to this discussion on the diagnosis and management of mild traumatic brain injury from the GP’s perspectives.

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Immunisation

Eligibility criteria for free secondary school-based vaccines

Human Papillomavirus (HPV) vaccine (Gardasil®)
This vaccine is offered to all Year 7 students (the program has been extended to boys from 2013). Students are given three injections with two months between the first and second dose and four months between the second and third dose. A catch-up program will also be available for boys in Year 9 in 2013 and 2014. All doses of HPV vaccine administered should be reported to the National HPV Vaccination Program Register.
Call the Register on 1800 478 734 or visit here. Find out more here.
Chickenpox (Varicella) vaccine (Varilrix®)
This vaccine is offered to all Year 7 students if they have never had the chickenpox disease or you are unsure if they have had the disease in the past. If an adolescent previously had a dose of the chickenpox vaccine, they should still receive another dose in Year 7 as a single injection. Find out more here.
Hepatitis B vaccine (H-BVax II Adult®)
From 2013, this vaccine will no longer be administered as part of the school-based program in Year 7 of secondary school as most Year 7 students will have had the vaccine when they were an infant.  Year 7 students who have not completed a course of the hepatitis B vaccine can get the vaccine from their doctor or local council immunisation service for free in 2013 only. Find out more here.
Diphtheria, tetanus, pertussis (whooping cough) vaccine (Boostrix®)
This vaccine is offered to all Year 10 students and protects against the three diseases in a single injection. Find out more here.

 

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Information Management

Medical Director Tip - SOAP protocol of Progress Notes

The Progress Notes of Medical Director are structured according to the SOAP protocol:

·         Subjective – this includes information you have learned from the patient. Shortcut = S: (i.e. S followed by a colon)

·         Objective - this section includes observations and measurements that you have made during the physical examination. This includes:

o   the vital signs.

o   a general description of the patient. Shortcut = O:

·         Assessment – this is effectively the diagnosis. Shortcut = A:

·         Plan – which diagnostic testing and how you will treat each problem, such as with medications, therapy, lifestyle change. Shortcut = P:

 

This week’s IM problem - SOAP protocol in Progress Notes

Question: Is there a way to make alcohol and smoking assessments come up in a different place in progress notes? Currently it is always first.

Answer: I don't believe you can change where MD places things in the progress notes. It follows the order of the SOAP protocol so I assume that it treats the smoking and alcohol assessments as “general” or taking a history (Subjective) and not as a diagnosis (Assessment) or a Plan. Hence "subjective" or “general” items always come first, except if you initially free typed information directly into the progress notes.

 

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Items of Interest

Changes in Referral Path to Northern Health’s Ambulatory and Sub-Acute Services as of 12th March

Northern Health Launches the Ambulatory Care Entry and Triage Service (ACETS) and the Access to Sub-Acute Services (ATSAS).  The implementation of two new services at Northern Health will streamline the referral process and improve access to ambulatory and sub–acute services.  For more information click here.

 

CLOSING - Mercy Hospital for Women’s IVANHOE Clinic

Please be advised that the Mercy Ivanhoe Clinic, 113 Waterdale Rd, Ivanhoe, will close at the end of Friday 5 April 2013. All services previously accessed at the Ivanhoe Clinic will be provided at the Mercy Hospital for Women at 163 Studley Rd, Heidelberg from 8 April 2013. Patients who have appointments beyond 5 April 2013 will be contacted and informed of the change of location. For further information, please contact Deb Pidd, Nurse Unit manager, Outpatient Department T: 8458 4203.

Thank you for your support of the Mercy Ivanhoe Clinic and for your ongoing support of the Mercy Hospital for Women.

 

North Eastern Melbourne Integrated Cancer Service Newsletter

March edition of the NEMICS Newsletter.  Highlights for this edition are: Victorian Integrated Cancer Services Inaugural Conference 2013; Moving Forward with Confidence project update; Supportive Care updates; New Cancer Resources; Northern Health and Mercy Hospital for Women staff update.

 

GP Network News

This week’s edition includes: GP Leaders Demand No Budget Cuts To GP Care; 'Too Many GPs' Report Defies Reality; AMA To Work With Medical Board On Health Services for Doctors; New Report on Primary Health Care; Influenza Vaccination Information for 2013; TGA alert: Fluarix influenza vaccine;

 

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Women’s Health

ThinkGP women’s health series

As the second part of our new women’s health series, ThinkGP, in collaboration with the NSW STI Programs Unit (STIPU), presents this month’s topic of 'STI testing in general practice’.

 

Mercy Hospital for Women 2013 GP Seminar program

For full Mercy Hospital for Women 2013 GP Seminar program details and registration click here or for further information: Merran Mackie mmackie@mercy.com.au or 8458 4831.

 

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Positions vacant/wanted

Please note: only new ads or resubmitted ads will be posted here. All other ads can be found on the website

 

Positions vacant

Doctors

Watsonia - Rosanna Medical Centre is seeking a PT/VR GP. A computerised, accredited, mixed billing, long established practice. Friendly supportive team. Please call (03) 9435 1191.

 

Practice Staff

Diamond Creek Medical Centre - Practice nurse Div 1, part time. Computer literatacy – knowledge of Medical Director an advantage, Typing skills, Wound management experience, Preferably vaccination experience. Monday and Friday 9.30-2pm and available to fill in for present nursing staff holiday and sick leave.

Please contact Lina Rogers on 9438 1911 or email linarog@hotmail.com

 

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Humour

Stay

I pulled into the crowded parking lot at the local shopping centre and rolled down the car windows to make sure my Labrador Retriever Pup had fresh air.

She was stretched full-out on the back seat and I wanted to impress upon her that she must remain there. I walked to the curb backward, pointing my finger at her and saying emphatically:

"Now you stay. Do you hear me?" "Stay! Stay!"

The driver of a nearby car, a blonde young lady, gave me a strange look and said:

"Why don't you just put the handbrake on?"

 

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And remember

 

            Nothing sucks more than that moment during an argument when you realise you're wrong.