Coordination of AHS-GP Care GP Green Card: Overview 18 June 2008

2 Timely visit to GP post-hospital 36% One-in-three patients leaving PMBH who were advised to visit their GP within a given timeframe failed to do so. Consultation revealed that a significant reason for this problem is a lack of communication. Patients may request a GP appointment without conveying to the receptionist the urgency of the appointment or the fact that they have been requested to make the appointment by a hospital doctor. Source: Telephone interviews with 36 patients aged >65 yrs for which the timeframe for GP follow-up was recorded in their hospital medical record.

3 Delays in GP follow-up can often result in patients becoming unwell and/or running out of necessary medications. The patients that did not have a timely GP follow-up were approximately three times more likely to make an Emergency representation in the following month than those that did visit their GP in the recommended time. Average number of subsequent episodes of care per patient to a NCAHS service in the month following hospital separation/discharge (sample = 36) Timely visit to GP post-hospital

4 G.P Green Card PORT MAQUARIE BASE HOSPITAL Please contact your G.P. practice to make an appointment to see a doctor by __/__/__ (Date) _________ (Staff Initials) When making the appointment please inform the receptionist that you have been at the hospital and have a GP Green Card. If you are unable to make an appointment within the timeframe please contact the ward below between 8am and 3pm Monday to Friday: Phone 6580…….. Ward…….. GP Green Card To overcome this issue, PMBH has started distributing GP Green Cards to those patients that require GP follow-up. This initiative is intended as a tool to help GPs manage their patients care.

5 GP Green Card Effect of Green Card Pre- Green CardWith Green Card Source: Telephone interviews with 36 patients aged 65yrs+ that departed PMBH ED during Sep 2007 or PMBH inpatient ward Jan 2008, and had the need to follow-up with their GP recorded in the medical record. In some cases, the timing of follow.-up was confirmed with the GP practice. Source: Telephone interviews with 33 patients aged 65yrs+ that departed PMBH ED or PMBH inpatient ward Apr/May 2008, and had the need to follow-up with their GP recorded in the medical record. In some cases, the timing of follow.-up was confirmed with the GP practice.

6 GP Green Card The results of the patient telephone interviews may not prove a change in terms of statistical reliability, but the signs are promising: –The proportion of late GP follow-ups is diminished. –The reasons for late GP follow-ups are more commonly based upon patient choice rather than other constraints. –Patient’s were positive about the card. –GP practice managers and receptionists indicated strong support for the process and without exception, those called indicated that they treat patients with the cards as ‘urgent’ fitting them in within 1 to 2 days. –We received useful feedback that some patients are waiting until the recommended appointment date to call their GP practice. We are currently updating the wording on the card to mitigate risk of this misunderstanding, and hopefully make further improvement to the rates of timely follow-up. Progress