Great news – but with a health warning!  Dr Hayley Scott, GP Owner, Health Te Aroha, shares personal reflections of implementing the Health Care Home within the practice.

Dr Hayley Scott

We started our HCH journey five years ago. From a GP owner perspective here is a personal reflection of my top 6 learning points

Lesson 1. Mind your own Business

Don’t wait for someone else to come and change your business.We wasted some time waiting for the HCH team to come and tell us what to do.  GPs need to show leadership.

Lesson 2. Smart thinking

You CAN have better control of your working day without losing income. This journey has been about working smarter, not harder.  Contrary to popular belief out there, seeing more patients a day does not necessarily equal more income.

Lesson 3. Smarter leadership

It’s difficult to lead staff through change if you are seeing patients every 15 mins or so, GP headspace away from direct patient care is essential and I have one session a week protected to do this without which we would not have progressed as far. If you are concerned about loss of income during this time, go back and read number two!

Lesson 4. Rallying the troops

Gaining all practice staff buy-in is crucial and unfortunately not easy. We tried many ways. The HCH Leadership Programme was invaluable to us with me the GP lead, our nurse lead and practice manager training and learning together. We have used the principles from this in developing our Vision, Mission, Values and Goals and communicating them well.  Staff are now coming up with and implementing their own change in their specific areas which has been a pleasure to see.

Lesson 5. It’s all in the huddle

As part of our continuous improvement activity we discovered we used the equivalent of a full time person a week in meetings! We applied the lean methodology and cut that down to 15 minutes a day. We use our morning practice huddle to get through the same content. As a practice team we now spend 5-7 minutes on the day ahead and 8-10 minutes on management issues.  As a result of being disciplined and focused in that time we have improved the quality of care, reviewed complaints, organised roster issues, reviewed practice protocols, trained the practice in health and safety legislation changes and much more.

Lesson 6.  Last but not least, the patient comes first.

The patient is the centre of the HCH model.  “Patient centred” services however is not the same thing as “on demand” service.  We found a community meeting with the patients was very helpful to discuss with them the changes we were undergoing and why.  We continue to find ways to make the experience more patient centred, balanced with the demand on the practice.  If we don’t manage the demand, we can’t give the quality experience to our patients, nor have happy staff.  Do we have it perfect? Of course not, but we are much closer than we were 5 years ago and we plan to be even closer in the next 5years

Oh, and here’s the health warning: This is a hard journey!

A few years ago I listened to GPs from Northcare, who were the first to adopt the Health Care Home model, talking about how hard this journey was. And they were right! We have made the journey, with still lots to do, but it has been harder than we expected due to the sheer effort involved to gain the buy in to change and then do it –  whilst still running a busy practice. However, I make no apologies for sharing some of the good stuff we have now achieved for us as a team and for our patients. We are extremely proud of all our hard work, we love to brag and we love to hear others brag about their achievements too

The changes that are happening in our practice are a direct result of implementing the HCH and it is great to be part of something that hopefully will sustain GP services in NZ over the coming years