Australian Primary Care Collaboratives (APCC)

The objective of the Australian Primary Care Collaboratives program is to encourage and support general practices throughout Australia in delivering, rapid, measurable, systematic and sustainable improvements in the care they provide to patients, through the sound understanding and effective application of quality improvement methods and skills.

The Topic Aims

The APCC program focuses its efforts on three topics: diabetes, secondary prevention of coronary heart disease (CHD) and access and care redesign.

The aims for Access and Care Redesign:

90% of patients should be able to access their primary healthcare professional of choice on the day of their choice

The aims for Diabetes:

50% of patients with diabetes type 1 or diabetes type 2 within participating practices should have an HbA1c of 7.0% or less

The aims for coronary heart disease (CHD):

30% reduction in the mortality of patients with CHD in three years

For the new measures, see the downloads below.

Collaborative Methodology

The Collaborative Methodology is an improvement method that relies on the distribution and adaptation of existing knowledge to multiple settings to achieve a common aim.

The Collaborative Methodology promotes rapid change, allowing practices to experience the benefits in short time frames. The Collaborative Methodology works because it is straightforward, there is hands-on support, and the framework promotes protected time for participants to spend together solving problems as a team.

Healthcare Collaboratives are built on a tried and tested method, developed in the USA , which has been applied to a wide range of management challenges. It was originally applied to healthcare systems by the Institute of Healthcare Improvement (IHI) in the USA , and has been adopted in other countries, most recently and effectively through the National Primary Care Development Team in the UK.

The Improvement Model

The Improvement Model is a simple yet effective tool for improvement. It consists of two parts. The first part, the "thinking part", consists of three fundamental questions to guide improvement work:

What are we trying to accomplish?
How will we know that a change is an improvement?
What changes can we make that will result in an improvement?

The second part, the "doing part", is made up of rapid, small Plan, Do, Study, Act (PDSA) cycles to test and implement change in real work settings. The PDSA cycle guides the test of a change to determine if the change is an improvement.

What is a PDSA?

PDSA stands for Plan, Do, Study, Act. It's a model for testing ideas that you think may create an improvement. It can be used to test ideas for improvement quickly and easily based on existing ideas, research, feedback, theory, review, audit, etc or practical ideas that have been proven to work elsewhere.

What is the Collaborative process?

A collaborative consists of a series of learning workshops, informal meetings and communications. They are interspersed with ‘action periods’ during which participants’ progress is measured and shared.

The topic is selected e.g. improving diabetes care, improving care of people with hypertension, or reducing cardiovascular mortality.
Key experts have identified the changes in each topic area that are to be achieved and how they are to be measured. Changes are applied in the practice to achieve these and progress is tracked monthly.
2 - 3 people from each practice (GP, practice nurse, practice manager, or receptionist) attend the workshops to share ideas and share successes.

Planned workshops offer a unique opportunity to hear from experts in the topic areas, quality improvement, and chronic disease self management approaches. The workshops include smaller break-out sessions and team times to allow the participants to learn from fellow practices about how they have sought to improve their own care for patients, and provide protected time to formulate plans for action.

While the learning workshops are very much about drawing to attention stimulating ideas and approaches, the action periods are where the participants and their practices get the chance to make a real difference. This is where they have the opportunity to implement the ideas they have been exposed to and formulated during the workshops.

Updated: May 2010