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Stream Sixteen

Rapid Response Projects

 

The Australian Primary Health Care Research Institute commissioned three research projects in its Stream 16 program, which was open to researchers who actively participated in previous Streams as chief investigators. This funding was used to enable researchers to conduct a focused project that has direct relevance to primary health care policy development in Australia.

APHCRI is situated between policy advisors, the research community, primary health care providers and consumers. The projects were completed in a timely fashion to help researchers become more attuned to the time pressures faced by policy advisors.

 

A NARRATIVE SYNTHESIS OF MODELS OF INTEGRATED CARE CENTRES/POLYCLINICS
 
Powell-Davies G, McDonald J and Jeon YH
 
This team investigated to what extent integrated primary health care centres/polyclinics operate internationally, how successful they are and whether such models could be applied in Australia. Associate Professor Gawaine Powell-Davies led a Stream Four project team examining strategies used to coordinate care for people with complex care needs within primary health care and in coordination with other sectors, and Julie McDonald led a Stream Four team investigating models of comprehensive primary health care. Professor Powell-Davies and McDonald were also recipients of travelling fellowships under Stream Seven. Professor Powell-Davies travelled to the Netherlands, where he spent time at the University of Utrecht comparing Australian national policies and programs supporting coordination of care with those used in the Netherlands, with a view to understanding what Australia can learn from the Dutch experience of coordination of care and in linkage and exchange in this area. McDonald travelled to Canada to investigate primary health care reforms.

Key findings
Policy options
Full report

MANAGING CHANGE IN PRIMARY CARE: THE CONTRIBUTION OF A CLINICAL LEADERSHIP PROGRAM

Dunbar J and Reddy P

In Stream Six, Professors James Dunbar and Prasuna Reddy undertook a project called “The contribution of approaches to organisation change in optimising the primary health care workforce”. They followed through in Stream Ten with a travelling fellowship to the United States. During Stream Six, the team visited New Zealand, Canada, Netherlands and the UK. In this project, Professors Dunbar and Reddy will investigate further questions relating to clinical leadership, team development, change management and implementation that would benefit from organisational development.

They have collected a number of case histories of facilitators and barriers in Australia and overseas which are relevant to change management in primary care. The highly successful introduction of the UK’s Quality Team Development has many lessons, as does the impressive ability of health organisations in the United States to take up the latest research into clinical practice. Factors such as performance measurement and remuneration go along with leadership, culture, climate and collaboration to make for effective change management.

Key findings
Policy options
Full report

 

RETENTION STRATEGIES AND INCENTIVES FOR HEALTH WORKERS IN RURAL AND REMOTE AREAS: WHAT WORKS?

Humphreys J, Wakerman J and Pashen D

The factors that impact upon labour turnover and workforce retention, particularly in rural and remote areas, are complex and require a multi-sector response. While there exists considerable literature on workforce turnover, significantly less attention has focused on how length of stay of health workers varies according to profession, location of employment, workplace activity and nature of organisation. Nor has there been significant rigorous evaluation of the effectiveness of retention measures and incentives on improved length of stay of health workers outside of the private sector.

The need for more systematic research on workforce retention and the effectiveness of measures designed to minimise avoidable workforce turnover has only relatively recently been fully appreciated.  In Australia, the most significant contribution to health workforce retention research has been undertaken by researchers from rural and remote research units, where the need to base interventions and incentives upon a sound understanding of what triggers poor workforce retention is most fully appreciated. This research encompasses a comprehensive systematic review and critical appraisal of the literature, building on both conceptual and empirical investigations.

Professor John Humphreys, Professor John Wakerman and Dr Dennis Pashen investigated what sorts of retention strategies and incentives have been implemented to entice health workers to take-up and remain in practice in rural and remote areas. Furthermore, they looked at what workforce retention strategies have proven to be effective in attracting health workers, increasing length of stay and reducing avoidable turnover in rural and remote areas.

Key findings
Policy options
Full report