Ipswich, Lockyer Valley and Parts of the Our Region Scenic Rim, Somerset and Brisbane Local Government Areas

THE IMPROVEMENT CHALLENGE How local health performance information creates opportunities to improve rural and remote health outcomes Real Results: Meeting the challenge in Primary Health Care Sharon Sweeney and Sue Scheinpflug West Moreton-Oxley Medicare Local Using data to prioritise efforts and resources to improve health outcomes in the West Moreton-Oxley region West Moreton-Oxley Medicare Local’s Comprehensive Needs Assessment methodology – data and other evidence prioritising needs identifying strategies planning and implementation – whole of organisational approach About WMOML The West Moreton–Oxley Medicare Local region is located in the western corridor of South East Queensland includes the local government areas of Ipswich, Lockyer Valley and parts of the Our region Scenic Rim, Somerset and Brisbane local government areas. Brisbane Using data to prioritise efforts and resources to improve health outcomes in the West Moreton-Oxley region CNA project stages Assess Establish Plan Confirm need priorities priorities Demography and Groups of Special Need Issues and Options Who’s in the region? - Impact of need - Options for addressing Health Status Set Priorities How well are we? - In context of resources & likely effect – rank order response to need Health Services How many and where? CNA project stages Assess need Assess inequalities, demographic trends, special needs groups Current health status/outcomes and health service utilisation Service and capacity mapping Stakeholder views on health concerns and capacity issues Demography and Groups of Health Services Health Status Special Need How many and where? How well are we? Who’s in the region? Concepts and data from a variety of sources allows us to zoom in on specific locations and specific sub-groups PHIDU Benchmarking our region the West Moreton Oxley region was evaluated by comparison to either • all Medicare Locals (61 in total) • other similar Medicare Locals (seven that are referred to as Metro 3 Medicare Local peer group) • Queensland and Australian averages, and • (where available) trend data about the region. PLUS: information from extensive consultations with stakeholders including community members, consumers and private, public and non-government service providers undertaken in February and March 2014. Benchmarking our region less desirable How do we compare on eighteen indicators against similar Medicare Local cohort (Metro 3)? lower use less desirable lower use less desirable lower use less desirable lower use less desirable lower use Higher potentially avoidable deaths Lower life expectancy Higher barriers to seeing specialists less Adults overweight desirable Obese adults Adults who smoke daily Higher rate of avoidable hospitalisations Lower rates of GP attendances Higher rate of adult admissions to hospital lower use Lower rates of specialist attendances Higher rate of adults visiting hospital Higher rates of allied health attendances A quick snapshot - Rapid population growth • The current estimated resident population is 379,765 (30 June 2013) • It is projected to grow by more than 90% to 721,107 residents by 2031 – an annual rate of growth well above the projected Queensland rate. • Much of this growth will be in Ripley, Rosewood and the Ipswich eastern corridor (Bellbird Park- Brookwater, Springfield Lakes and Redbank Plains). Areas of socio-economic disadvantage • a Indexkey of Relative determinant Socio-economic Disadvantage of health 51.7% of the WMOML region is categorised in the two lowest quintiles for socio-economic disadvantage. (Qld average is 40%) Developmentally vulnerable children The AEDC results for children in the region are poorer compared to Queensland and Metro 3 Medicare LocalHigher peer group on the average negative percentages. indicators Most notably when looking at the proportion of children developmentally on track compared to the other 61 Medicare Locals nationally, children in the region rank very low in: • Physical health and wellbeing – 53rd • Social competence – 57th • Emotional maturity – 59th Lower on the positive • Language and cognitive skills – 61st. indicators WMOML chronic disease profile There are specific locations with above average chronic disease indicators • Ipswich-Central • Ipswich East • Laidley • Darra-Sumner/Wacol Emergency Department presentations Identifying areas of greatest need Regionally specific understanding Qualitative data collection Quantitative data collection Population health data, service Interviews and focus groups utilisation data, capacity mapping Qualitative data analysis Quantitative data analysis • Thematic analysis • Data analysis to identify hotspots, • Summary of consultation disease patterns and service gaps themes • Summary of data Integrate information and compare results • Synthesis of information • Cross-checking and comparing data • Population profile Confirm needs assessment findings and results • Key themes, needs and service or capacity issues identified and confirmed • Shortlist of needs Shortlist of needs/issues Health condition/issue Vulnerable populations • Mental health • Aboriginal and Torres Strait Islander peoples • Child development • Areas of chronic disadvantage • Obesity (nutrition and physical inactivity) • Refugees and humanitarian entrants Smoking • • People with a disability • Premature death: heart • Health services for older people disease • Health of children and young • Premature death: chronic people obstructive pulmonary disease Health system • Premature death: lung cancer • Service coordination and integration Type 2 diabetes • • Substantial population growth CNA project stages Establish priorities Issues and options analysis Priority Setting and validation CNA project stages Issues and options analysis Impact Severity and size of the problem Potential strategies Drawn from a review of published literature and and interventions programs and initiatives currently being delivered by West Moreton-Oxley Medicare Local and other Medicare Locals Analysis Critical analysis of the strategies and interventions – included consideration of evidence of effectiveness, health gains, appropriateness and acceptability, equity, cost effectiveness, and feasibility, sustainability, consistency with health policy, alignment with Medicare Local key results areas and impact on service coordination and integration CNA project stages Priority Setting and validation Criteria Description Effectiveness Identified evidence suggests the intervention will result in improved health of target group and/or improvement in health services for consumers Cost effectiveness The intervention is affordable and can deliver results at a reasonable cost Feasibility The intervention can be managed or delivered by WMOML or by WMOML in association with other organisations Confirm priorities Our nine priority areas • disease or health condition issues • health inequities or service gaps • health system improvements Our 19 strategies health inequities or service gaps health system improvements disease or health condition issues Our 19 strategies WMOML structural logic WMOML Board Planning and Performance Vision Management Board Meetings and Annual Board Retreat CEO and Purpose Strategic Leadership Plan Annual Staff Team Planning Goals Day Operational Plan Quarterly Reviews Strategies Our people Budget Team Annual Meetings Work/ Work Project Plans Plans Staff Performance Activities Strategies/interventions Chronic diseases Obesity (nutrition and physical - Life expectancy in WMOML is low inactivity) compared to peer Medicare Locals and - The obesity rate (38%) for WMOML is the Medicare Locals nationally (46th of 61) highest in its Medicare Local peer group - Diseases which cause greatest numbers - Rates of adequate fruit and vegetable of premature deaths in the region are heart intake and physical inactivity in the region disease, lung cancer and COPD are worse than Qld rates Support general Promote practices in targeted Short term lifestyle opportunities for communities to and self- Deliver community participation in implement best management based healthy living healthy eating practice in support programs and lifestyle physical activity and prevention, for people with programs healthy lifestyle screening, early Strategies diabetes programs in the intervention and region management Strategies/interventions - implementation • Intensive program of • In partnership with education and practice Diabetes Queensland: Regional support to six General Educational • Workshops conducted Practices for a period of six Events for people living with months Diabetes – Diabetes – • Initial full day workshop What Now? – • Monthly education sessions delivered by diabetes Intensive educator and dietitian via webinar (Improvement Practice Foundation, PenCS) Support • Workshops for health • Two practice visits per professionals – e.g. month from WMOML and Insulin Administration Credentialled Diabetes (Practice Nurses); Educators from Diabetes webinars – Diabetes Queensland Management Strategies/interventions - implementation • Data collected on the each month using PenCAT/PatCAT • Used to analyse and discuss practice improvements • Longer term plan - begin getting an aggregated understanding of our region as further practices participate. • % pts over 40 • % of patients • % of all diabetic • % of all diabetic screened for with any of the patients with a patients have a diabetes in the following risk recorded recorded Blood last 3 years factors have HbA1c HbA1c test in Pressure within using a had a fasting

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