Academic literature on the topic 'Rural Practice Victoria South Gippsland'

Integrated assessment in Victoria, Australia is held to be a new and innovative process, but in Gippsland, Victoria, integrated assessment has been a reality for the past four years. The purpose of this paper is to identify the elements of integrated assessment in a rural setting. The research has found that identifying the components of such a model was a key factor in achieving the ideals of integrated assessment. The paper suggests that integrated assessment may be more easily achieved in rural areas than its metropolitan counterparts.

The Getting It Together Rural Health Promotion project was established by a group of community health providers in Gippsland, Victoria. The overall aim of Getting It Together was to extend and improve health promotion practice amongst participating organisations. This was achieved through collaboration around health promotion training and planning. Complementary strategies addressing Cardio-Vascular Disease (CVD) were developed across four Local Government Areas (LGAs). Central resourcing was provided for coordination of the project, and for marketing and network support tasks. The project was based on an integrated and coordinated health promotion model, which contained overlapping strategies combining to create a broadly based partnership of action. At the commencement of the project, health promotion workers from each LGA were provided with a three-day training course conducted by the Royal Melbourne Institute of Technology University (RMIT). Participants developed Action Plans based around the three driving strategies of community wide-strategies, targeted strategies and marketing. A special feature of Getting It Together was a common media strategy, to support and reinforce action at the local level. An overall slogan was adopted, 'Slicker Ticker - A Gippsland Healthy Heart Project'. Uniting themes included 'Stress Less Week' and 'Gippsland Get Up and Go'. Latrobe Community Health Service facilitated the project and senior managers from the partnering agencies formed a Steering Committee, which met at key intervals to monitor the project.

Objective To date, there are few data on pharmacy-specific placement programs and their impact on students’ work after graduation. The present study evaluated an innovative rural pharmacy placement program targeted at influencing students to work and live in rural areas after graduation. A secondary aim of the study was to explore the students’ intentions to come back and practice in rural areas as a result of their involvement in the rural pharmacy program. Methods A questionnaire was distributed, by hand, to a total of 58 third and fourth (final) year pharmacy students undertaking their rural placement in the Gippsland region, in rural Victoria in 2011 and 2012. Results Fifty-seven responses were returned (response rate = 98%). Students stated that understanding pharmacy practice from a rural perspective, visits to rural health professionals and sites and the attitude of their preceptors were essential to their satisfaction with their rural placements. A significant number of students (72%) intend to seek employment in rural areas if opportunities arise as a result of their increased rural awareness. The key components for a successful rural placement program were described by the surveyed students as social awareness, recognising job opportunities and interprofessional learning. Conclusion The evaluation of the rural placement program revealed that students valued their visits to rural sites and their interaction with other rural health professionals the most. What is known about the topic? Rural undergraduate student programs have been initiated as a result of several Australian government strategies to address shortages in rural health workforce. Subsequently, various rural placement programs have been integral parts of several disciplines, including medicine, dentistry, nursing, occupational therapy and pharmacy among others. To date, there are few data on pharmacy-specific placement programs and their impact on students’ work after graduation What does this paper add? The rural pharmacy program is important in influencing students’ perceptions and interest in a career in rural areas. The key components for a successful rural placement program were described by the surveyed students as social awareness, recognising job opportunities and interprofessional learning. What are the implications for practitioners? Interprofessional learning and collaboration are inevitable due to the shortage of health professionals and the move towards holistic management of patients in healthcare settings. The development of an interprofessional rural education that combines rural medical and pharmacy students together highlights the importance of an interprofessional approach to preparing students to work in rural areas.

ObjectivesTo: (1) establish the prevalence of urban, regional, rural and remote practice location of early-career general practitioners (GPs); and (2) examine demographic and training-related characteristics associated with working in regional, rural or remote areas post attainment of vocational general practice qualifications.DesignCross-sectional, questionnaire-based study, combined with contemporaneously collected data from participants’ prior vocational training.SettingAustralian general practice.ParticipantsNewly vocationally qualified GPs (ie, within 6 months–2 years post fellowship) who had completed vocational training with regional training organisations in New South Wales, Australian Capital Territory, eastern Victoria, and Tasmania between January 2016 and July 2018.Primary outcome measureRurality of post-fellowship practice location, as defined by Modified Monash Model (MMM) geographical classifications, based on current practice postcode. Prevalence of regional/rural/remote (‘rural’) practice was described using frequencies, and associations of rural practice were established using multivariable logistic regression, considering a range of demographic factors and training characteristics as independent variables.ResultsA total of 354 participants completed the questionnaire (response rate 28%) with 319 providing information for their current practice location. Of these, 100 (31.4%) reported currently practising in a rural area (MMM2-7). Factors most strongly associated with practising in a rural area included having undertaken vocational GP training in a rural location OR 16.0 (95% CI 6.79 to 37.9); p<0.001; and undertaking schooling in rural area prior to university OR 4.21 (1.98, 8.94); p<0.001.ConclusionsThe findings suggest that vocational training experience may have a role in rural general practice location post fellowship, attenuating the previously demonstrated ‘leakage’ from the rural practice pipeline.

This study explored the perceived healthcare system and process barriers and enablers experienced by GPs and Credentialled Diabetes Educators (CDEs) in Australian primary care, in the delivery of preventative and early intervention foot care to people with diabetes. A qualitative design with inductive analysis approach was utilised and reported according to the Consolidated Criteria for Reporting Qualitative Studies (COREQ). Semi-structured interviews were conducted with two GPs and 14 CDEs from rural, urban and metropolitan areas of Australia. Participants were from New South Wales, South Australia, Victoria, Western Australia, the Northern Territory and Queensland. Barriers to providing foot care constituted five broad themes: (1) lack of access to footcare specialists and services; (2) education and training insufficiencies; (3) human and physical resource limitations related to funding inadequacies; (4) poor care integration such as inadequate communication and feedback across services and disciplines, and ineffectual multidisciplinary care; and (5) deficient footcare processes and guidelines including ambiguous referral pathways. Enablers to foot care were found at opposing ends of the same spectra as the identified barriers or were related to engaging in mentorship programs and utilising standardised assessment tools. This is the first Australian study to obtain information from GPs and CDEs about the perceived barriers and enablers influencing preventative and early intervention diabetes-related foot care. Findings offer an opportunity for the development and translation of effective intervention strategies across health systems, policy, funding, curriculum and clinical practice, in order to improve outcomes for people with diabetes.

Objectives. To describe the development and evaluation of an accreditation program for Point of Care Testing (PoCT) in general practice, which was part of the PoCT in general practice (GP) Trial conducted in 2005–07 and funded by the Australian Government. Setting and participants. Thirty general practices based in urban, rural and remote locations across South Australia, New South Wales and Victoria, which were in the intervention arm of the PoCT Trial were part of the accreditation program. A PoCT accreditation working party was established to develop an appropriate accreditation program for PoCT in GP. A multidisciplinary accreditation team was formed consisting of a medical scientist, a general practitioner or practice manager, and a trial team representative. Methodology and sequence of events. To enable practices to prepare for accreditation a checklist was developed describing details of the accreditation visit. A guide for surveyors was also developed to assist with accreditation visits. Descriptive analysis of the results of the accreditation process was undertaken. Outcomes. Evaluation of the accreditation model found that both the surveyors and practice staff found the process straightforward and clear. All practices (i.e. 100%) achieved second-round accreditation. Discussion and lessons learned. The accreditation process highlighted the importance of ongoing education and support for practices performing PoCT. What is known about the topic? Currently there is no rebate for Point of Care testing in Australia. Before the Australian Government can consider a rebate it has to be shown that PoCT is safe for patient care. Implementation of a quality framework and an accreditation model for PoCT is vital to ensure that clinical care is not compromised by use of this technology. What does this paper add? This paper provides a model for PoCT accreditation that meets requirements of both the GP and scientific community. It reports on the first government-funded PoCT in general practice trial and illustrates what needs to be considered if the Government decides to fund PoCT in general practice. What are the implications for practitioners? Description of a PoCT accreditation process highlights to practitioners what is entailed in following the interim standards for PoCT currently available. This study is an important piece of work as it shows that PoCT in general practice can be performed safely within a quality framework that meets scientific accreditation requirements.

Aquaculture production in Tanzania has increased in recent years, responding to an increased demand for fish, but the scale and productivity of smallholder aquaculture remains below the level needed to support significant sector growth in Tanzania. This study assesses, through geospatial analyses, the suitability for freshwater pond farming of Oreochromis niloticus and Clarias gariepinus in Tanzania, by assessing the geographical distribution of seven criteria (water availability, water temperature, soil texture, terrain slope, availability of farm inputs, potential farm-gate sales, and access to local markets) identified as important for fish pond farming. The criteria were developed and standardized from 15 sub-criteria, which were classified into a four-level suitability scale based on physical scores. The individual weights of the different criteria in the overall GIS suitability assessment were determined through a multi-criteria evaluation. The final results were validated and compared through field observations, interviews with 89 rural and 11 urban aquaculture farmers, and a questionnaire survey with 16 regional fisheries officers. Our results indicate that there is a good potential for aquaculture in Tanzania. Almost 60% of Tanzania is assessed as being suitable and 40% as moderately suitable for small-scale subsistence pond farming, which is the dominating fish farming practice currently. The corresponding figures for medium-scale commercial farming, which many regions expect to be the dominating farming method within ten-years, were 52% and 47% respectively. The availability of water was the most limiting factor for fish pond farming, which was confirmed by both farmers and regional fisheries officers, and assessed as being “suitable” in only 28% of the country. The availability of farm-gate sales and local markets were “moderate suitable” to “suitable” and were seen as a constraint for commercial farms in rural areas. The availability of farm inputs (agriculture waste and manure) was overall good (26% very suitable and 32% suitable), but high-quality fish feed was seen as a constraint to aquaculture development, both by farmers and regional fisheries officers. Soil, terrain, and water temperature conditions were assessed as good, especially at low altitudes and in regions close to the sea and south of Lake Victoria.

Objectives The aim of the present study was to investigate differences in prevalence, as well as risk and protective factors, for exposure to workplace aggression between male and female clinicians in Australian medical practice settings. Methods In a cross-sectional, self-report study in the third wave of the Medicine in Australia: Balancing Employment and Life survey (2010–11), 16 327 medical practitioners were sampled, with 9449 (57.9%) respondents working in clinical practice. Using backward stepwise elimination, parsimonious logistic regression models were developed for exposure to aggression from external (patients, patients’ relatives or carers and others) and internal (co-workers) sources in the previous 12 months. Results Overall, greater proportions of female than male clinicians experienced aggression from external (P < 0.001) and internal (P < 0.01) sources in the previous 12 months. However, when stratified by doctor type, greater proportions of male than female general practitioners (GPs) and GP registrars experienced external aggression (P < 0.05), whereas greater proportions of female than male specialists experienced external (P < 0.01) and internal (P < 0.01) aggression. In logistic regression models, differences were identified in relation to age for males and experience working in medicine for females with external and internal aggression; working in New South Wales (vs Victoria) and internal aggression for females; a poor medical support network and external aggression, and perceived unrealistic patient expectations with internal aggression for males; warning signs in reception and waiting areas with external aggression for males; and optimised patient waiting conditions with external and internal aggression for females. Conclusions Differences in risk and protective factors for exposure to workplace aggression between male and female clinicians, including in relation to state and rural location, need to be considered in the development and implementation of efforts to prevent and minimise workplace aggression in medical practice settings. What is known about the topic? Workplace aggression is prevalent in clinical medical settings, but there are conflicting reports about sex-based differences in the extent of exposure, and little evidence on differences in risk and protective factors for exposure to workplace aggression. What does this paper add? Differences in workplace aggression exposure rates between male and female clinicians are highlighted, including when stratified by doctor type. New evidence is reported on differences and similarities in key personal, professional and work-related factors associated with exposure to external and internal aggression. What are the implications for practitioners? In developing strategies for the prevention and minimisation of workplace aggression, consideration must be given to differences between male and female clinicians, including with regard to personality, age and professional experience, as well as work locations, conditions and settings, as risk or protective factors for exposure to aggression in medical work.

Introduction Our earlier analysis during the COVID-19 surges in 2020 showed a reduction in general practitioner (GP) in-person visits to residential aged care facilities (RACFs) and increased use of telehealth. This study assessed how sociodemographic characteristics affected telehealth utilisation. Methods This retrospective cohort consists of 27,980 RACF residents aged 65 years and over, identified from general practice electronic health records in Victoria and New South Wales during March 2020-August 2021. Residents’ demographic characteristics, including age, sex, region, and pension status, were analysed to estimate the odds ratio (OR) and 95% confidence interval (CI) for the associations with telehealth utilisation (telephone/video vs. in-person consultations) and with video versus telephone consultations, in mixed-effects multiple level regression models. Results Of 32,330 median monthly GP consultations among 21,987 residents identified in 2020, telehealth visits accounted for 17% of GP consultations, of which 93% were telephone consults. In 2021, of 32,229 median monthly GP consultations among 22,712 residents, telehealth visits accounted for 11% of GP consultations (97% by telephone). Pension holders (OR: 1.14; 95% CI: 1.10, 1.17) and those residing in rural areas (OR: 1.72; 95% CI: 1.57, 1.90) were more likely to use telehealth. However, residents in rural areas were less likely to use video than telephone in GP consultations (OR: 0.41; 95% CI: 0.29, 0.57). Results were similar in separate analyses for each COVID surge. Discussion Telephone was primarily used in telehealth consultations among pension holders and rural residents in RACFs. Along with the limited use of video in virtual care in rural RACFs, the digital divide may imply potential healthcare disparities in socially disadvantaged patients.