Hints and tips for primary health networks (PHNs)
Module 1: Commit
- Introducing quality improvement to your practice is an opportunity to update and promote breast, bowel and cervical cancer screening, referral and treatment HealthPathways. When considering your work plan, allow time to update HealthPathways so they are ready to promote on the launch of your cancer screening quality improvement activities.
- Providing your HealthPathways team with a link to this toolkit may help them to consider inclusions for cancer screening HealthPathways.
- It’s important that your practice support and cancer screening staff are confident in supporting the primary care providers within your PHN area to use this toolkit. The Cancer Institute NSW will provide training for PHN representatives who can then provide training and guidance to practices within their PHNs.
- When work planning, PHNs may like to consider factoring in staff training activities to ensure your team has the confidence and skills they need to promote and support the cancer screening quality improvement toolkit.
- PHNs are encouraged to embed the cancer screening toolkit within existing approaches to quality improvement and practice engagement. You may wish to consider how cancer screening quality improvement can be integrated and cross-promoted with:
- existing quality improvement processes and activities including:
- the Practice Incentive Program Quality Improvement Incentive
- methods used by your organisations for presenting quality improvement data to practices in an interesting and accessible way (e.g. data ‘dashboards’)
- existing cancer and cancer screening initiatives and activities within your region
- ‘patient-centred medical home’ programs and principles.
- existing quality improvement processes and activities including:
- If your PHN has tailored tools and methods that it uses to present and support quality improvement activities, you may wish to implement the toolkit using your own templates, data collection and reporting approaches. Think about how you will present and support cancer screening quality improvement so that it can be a sustainable activity within your organisation.
Assess and report toolkit effectiveness using the pre and post surveys
It is important that the Cancer Institute NSW, PHNs and practices can understand if the implementation of the toolkit was effective at delivering against the learning objectives and the overall goal of increased participation in bowel, breast and cervical cancer screening.
The Cancer Institute NSW has developed a pre and post survey to support this process. These surveys are provided in word format in recognition that PHNs will have established and preferred methods for delivery of surveys in electronic format to their practices.
Prior to introduction of the toolkit, PHNs should plan:
- how they will deliver the survey to practices
- when they will deliver the pre survey and the post survey
- if they want to add any questions to the survey (PHNs are requested to retain the existing questions for consistency of results across NSW)
- how and when they will assess and report the survey findings to practices, within their organisation and to Cancer Institute NSW.
PHNs who introduce the toolkit to their practices are asked to provide a summary of their findings from the pre and post surveys to the Cancer Institute NSW. Please contact the Primary Care Portfolio Manager for further information.
- PHNs may wish to consider developing a graphic representation of cancer screening participation in their region from their Reporting for Better Cancer Outcomes data.
- Understanding cancer screening participation in their area, and how it compares with surrounding areas, is often engaging and motivating for practices.
Module 2: Clean
Benchmarking is a very important part of quality improvement in the primary care setting. It provides motivation and direction for practice teams, and allows teams to track progress over time.10
Prior to launching the toolkit, PHNs should consider:
- how and when they will request participating practices to submit cancer screening participation data
- how they will present data back to practices in a way that allows them to track their performance over time and against other practices.
Some PHNs use data audit tools to regularly extract and present benchmark data to their practices in ‘dashboard’ formats.
Module 3: Connect
Consider how your PHN can support practices to develop and implement tools for gathering, analysing and implementing patient feedback.
Consider how your PHN can identify and share the experience of practices who have implemented:
- the cancer screening workflow (either modified or unmodified)
- updated reminder systems
- systematic family history taking
- health assessment and GPMP templates that integrate cancer screening
- software to strengthen point-of-care reminders.
Module 4: Care
The National Framework for Continuous Quality Improvement in Primary Health Care for Aboriginal and Torres Strait Islander People 2018–2023 (35) provides useful guidance on the actions PHNs can take to support cancer screening quality improvement activities.
The Australian Health and Safety Commission’s National statement on health literacy provides guidance on what support organisations, such as PHNs, can offer to improve health literacy.
- PHNs may wish to consider what research, data extraction, analysis and dissemination they can undertake to build practices’ insight into under-screened populations.
- PHNs can request BreastScreen NSW participation rates, by location and language group, using the BreastScreen NSW data request form.
- Working with primary care providers, relevant stakeholders and the community to undertake consumer research with under-screened populations can support practices to better understand barriers and enablers to screening in the local context. Read an example of this type of research, undertaken by North Coast Primary Health Network
Mapping and strengthening the cancer screening neighbourhood is an important support function that PHNs can undertake. This can improve collaboration and coordination between practices, BreastScreen NSW, Local Health Districts, Aboriginal Community Controlled Health Organisations (ACCHOs) and other relevant community organisations and services (e.g. multicultural groups, disable peoples organisations, community transport providers, cancer advocacy groups, breast care nurses, etc).
Module 5: Continue
It is important to plan how your PHN will do the following:
- Support practices to sustain the organisational and system changes they have made as part of the cancer screening toolkit. For example,
- build support and follow up the action plans of participating practices into your practice support team’s work plans and key performance indicators
- establish mechanisms for sharing good practice between your participating practices.
- Continue to grow engagement in cancer screening quality improvement by communicating the experience of practices in your footprint. This will require a good understanding of how you will monitor, report and communicate the impact of the toolkit.