Table – Detailed evaluation questions and measures relating to Key question 2 Key question 2: Detailed questions Key question 2: Measures Inputs Activities Outputs Outcomes ST Outcomes MT Level: Practice 2.01 What did practices do to implement HCH, and how did this differ between practices, including changes to policies, procedures, systems, administrative processes, changes to manage payment for HCH patients, processes for risk stratification, and patient enrolment? 2.01.01 Most frequent changes to policies, procedures and systems as a result of HCH implementation (together with descriptions). 2.01.02 Proportion of practices that reported changes to administrative processes (grouped to categories) to manage payments as a result of HCH implementation (together with descriptions of processes). 2.01.03 Proportion of practices that reported undertaking activities (grouped to categories) for risk stratification and patient enrolment processes (together with descriptions of processes). 2.02 How did practices approach provision of chronic disease care prior to the implementation of HCH? What chronic disease management and quality improvement initiatives were in place within the practice at the commencement of the HCH program? Which of these were used and/or enhanced for the HCH implementation? 2.02.01 Most frequent chronic disease management/quality improvement initiatives and processes that were a focus during Stage one. Initiatives will be assigned to categories based on coding of textual descriptions. 2.02.02 Proportion of practices that reported focussing on specific categories of chronic disease management/quality improvement initiatives. 2.03 How did the mix, roles and activities of primary health care staff change following the HCH program implementation? 2.03.01 Mean number of staff (head count and FTE) by staff type (GP, practice nurse/other nurse, nurse practitioner, allied health staff, Aboriginal Health Worker, administrative staff) at commencement and at the end of Stage one. 2.03.02 Proportion of practices that reported undertaking changes in staff roles (grouped to categories) following the HCH commencement (together with descriptions of changes). 2.03.03 Proportion of practices that reported undertaking changes in staff activities (grouped to categories) following the HCH commencement (together with descriptions of changes). 2.04 How did the relationship between the practice and other health care and service providers change during the HCH implementation? Did the HCH program provide opportunities for 2.04.01 Most frequent changes in care coordination reported by external health service providers with which HCH practices interact (together with descriptions).
4 A paper version of shared care plan is forwarded to relevant clinicians. 5 There is no process to share the care plan outside the practice/service. 6 Other. Please describe: How useful has My Health Record been for sharing care plans with patients and/ or their carer/ family? 1 Very useful 2 Moderately useful 3 Limited 4 Not useful 5 Can’t say/don’t know How useful has My Health Record been for sharing care plans with other clinical staff outside the practice involved with the clinical care delivered to the patient? 1 Very useful 2 Moderately useful 3 Limited 4 Not useful 5 Can’t say/don’t know The following questions are about patient engagement and activation. Do clinical staff in the practice use a standardised tool to assess the level of patient engagement/ activation? If yes, what is the name of the tool? 1 Yes 2 No Name of tool/s: Since the commencement of the HCH program, what is your assessment of changes in the levels of patient engagement/ activation at this practice/ service? 1 Significant improvement in the level of engagement/activation of patients 2 Moderate improvement in the level of engagement/activation of patients 3 Small improvement in the level of engagement/activation of patients 4 No improvement/reduction in the level of engagement/activation of patients 5 Can’t say/don’t know What have been the (up to) top three factors that have contributed improvements in the level of patient engagement/ activation? 1. 2. 3.
(1) Engaged leadership (1) Patient enrolment (2) Quality improvement activities (3) Continuity of care with nominated GP and team (4) Teamwork within practice (5) Care planning and review (6) Involvement of patients in decision making and care (7) Self-management support (8) Linking patients to supportive community based resources (9) Improved access to primary care services (10) 1 2 3 … 3. Is there other information that you consider important for the evaluators to be aware of in assessing the implementation of the HCH program in these practices? Practice name Other information that may be important in assessing the implementation of the HCH program 1 2 3 … 4. Do you wish to submit the results of this survey now? If you wish to finalise and submit the survey data, select Yes below, then select the Next Arrow below. This will submit your data. If you wish to return to this survey later, do not select Yes. Just leave this page and return later using the URL link supplied. The details you have entered above will be saved, and when you return, you can complete the survey. When you return to the survey you will be taken to the first missing response. Yes (4)
participant will not be named in any reporting of results to any parties, and that the participants responses will not be shared with / disclosed to any other person in the practice. Outline how the practice will be informed of the results of the research when it is finished. Provide details on who to contact in case of any or concerns or questions that may arise after the interview. Seek permission to audio record the interview. Check whether the participant has any questions. Seek verbal consent for participation. Role What is your role within the practice? How long have you been working in the practice? (In the same role, or a different role?) Initiatives under HCH (R2) What involvement did you have in establishing the changes/ initiatives in relation to HCH at your practice? (R2) If no involvement, what changes were you told about or noticed occurring at the practice? (R2) How have the changes/ initiatives impacted on the way that care is delivered to HCH patients? Prompts: Changes to care plan/ planning process. Changes to access/ flexibility of access to practice services by patients. Patient engagement in their care/ care planning. Assistance provided to patients to self-manage. Approach to chronic disease management. Changes to referrals / use of other services? Changes to patients’ access to aides/ devices? Impact on patients How effective have the changes implemented been for patients? If effective, in what way have they been effective? How do you know? If not effective, what are your thoughts about why they haven’t been effective? Impact on staff member Have the changes/ initiatives impacted on how you interact with other staff at the practice? If so, what have been the impacts? What impacts, if any, have the changes had on your role? Prompts: Depth (e.g. extending skills). Breadth (e.g. wider range of tasks, and/or working with a broader range of organisations). Ability to delegate to others. Having more responsibility delegated. What impact have the changes had on your satisfaction with your job? Anything else? Is there anything else that we haven’t discussed that you would like to mention?