An evolving primary care nurse role in KCC GOPCs- PPP Office: from clinical to local community

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Authors (including presenting author) :
Yip KYL, Tang SY, Law TC, Leung S H, Li YC
Affiliation :
Department of Family Medicine and General Out Patient Clinic (GOPC), Kowloon Central Cluster (KCC)
Introduction :
Nurse roles in HA GOPCs keeps evolving, enhancing in diversity and complexity. With growing need in primary care service in HK, nurses in HA GOPCs extended professional skills both in clinical and service coordination, coping with the HA primary care strategies in community healthcare collaboration. Nurse roles in KCC GOPC Public-private partnership program office would be a dominant example.
Objectives :
1. To promote HA public-private partnership in Primary health care service in local community 2. To facilitate patient enrolment in GOPC-PPP service 3. To coordinate continuity of care among public and private primary care partners
Methodology :
HA General outpatient clinics provide medical consultation for patients with chronic medical conditions or episodic illnesses. Major roles of nurses in GOPCS are supporting clinical operations, clinical patient care, dressing and injection services. Since the healthcare reform from 2008, apart from general clinical care and administrative support, nurses in HA GOPCs enhanced primary prevention roles in complication screening and management programs for Patients with diabetes and hypertension conditions follow- up in GOPCs, together with multidisciplinary healthcare professionals. Besides, nursing support in smoking cessation program, second tier wound clinics in primary care, respiratory and other nurse and allied health primary care programs, achieving goals in public health direction. The comprehensiveness of nursing role keeps evolving since HA took over the management of GOPCs from DH in 2003. In the primary healthcare sector, public services only cover around 30% of the market. However, community needs on public primary care services are far beyond. HA implemented Public -private partnership ??GOPC program (GOPC-PPP) in 2015. Nurses have a specific role in coordinating GOPC-PPP patient recruitment forums, recruiting eligible patients with stable hypertension or diabetes currently follow-up in GOPCs, coordinate investigations or appointments with GOPCs and participating HA hospitals, maintain communication with private service providers to facilitate continuity of patient care, assist patients on related enquires and feedbacks. The nurse coordinator role is dominant and essential to maintain communication of all internal and external service partners. Nurses also need to utilize electronic platforms in multiple clinical and IT systems in facilitating patient care and program administration.
Result & Outcome :
GOPC-PPP service started in KCC in October 2016. 3 districts, Kowloon City (Kln City), Wong Tai Sin (WTS) and Yau Tsim Mong (YTM) are included up till 2018. The number of participating service providers, i.e., GPs, joining the program was 23 in WTS, 13 in Kln City and 28 in YTM district. Monthly or bimonthly patient invitation forums were held in various community locations for program briefing and on site program enrollment. Total 4704 patients, including 1376 in Kln city, 2890 in WTS and 438 in YTM district, enrolled the program in KCC by the end of 2018. In the KCC PPP-GOPC, the cluster PPP office include nursing and clerical colleagues. Nurses in KCC PPP office serve in local GOPCs general clinical service, primary care programs and also bridging primary care service with community healthcare service partners, involving both public and private sectors. The evolving role of primary care nurse in KCC PPP office redefined health care collaboration in local community. Enabling patients to more healthcare options in primary care in local community and facilitating the process by nurses would be fundamental in public health development.

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