REFUGEE HEALTH CONNECTBuilding patient centred primary

health care through partnerships and research

Donata Sackey (Senior Program Manager) Mater UQ Centre for Primary Health InnovationLuke Moloney (Coordinator) Primary Care Project, Greater Metro South Brisbane Medicare Local

Background and context• Between 2000 and 2014, Australia has

permanently resettled approximately 200,000 people from refugee and humanitarian backgrounds from Africa, Middle East and South Asia

Background and context

• It is well documented that people from refugee backgrounds experience difficulties in accessing health services due to cultural and linguistic barriers.

• Primary health care is the best setting for the delivery of timely and quality health care and assessments.

Background and context

• Qld has no state-wide refugee health care model and no refugee health policy.

• APHCRI funded study (2010-12) – identified key components for a best practice model of refugee health care delivery.

• MHS and GMSBML in partnership with key stakeholders are implementing an innovative, evidence based model of care for new arrivals in the Brisbane South area

The Model -partnerships

• PAG (Partnerships Advisory Group) includes 22 organisations across Gold Coast, Logan, Brisbane North and South including academic and community representatives, HHS, MLs, clinicians and settlement.

• CAG (Clinical Advisory Group) provides clinical leadership and resource development. Chaired by GMSBML clinical lead.

• Mental Health Working Group with a focus on developing resources and capacity in primary care and reports to PAG

• Community Advisory Group – G8 (MHS) project

The Model: Refugee Health Connect• Refugee Health Connect: o referral facilitation of new arrivals to Brisbane South

based at GMSBML with close collaboration with Mater Integrated Refugee Health Service and MDA.

o Building capacity in primary care through a “Beacon” model using Tier 1 practices to provide refugee health assessments and care.

o In practice support (clinical leads GP/nurse) for Tier 2 practices

o Practice systems support to build sustainability o Close collaboration with settlement services and support

to build health system knowledge.

Refugee Health– A new mode for delivering primary health care .

GeneralPracticeTier 2

GeneralPracticeTier 2

GeneralPracticeTier 2

Linkage with General Practice:

• Summary of Current Care

• Formal education of multi-disciplinary team

• Practice staff /Nurse/ GP/ Allied Health

• Knowledge of resources in local community

• Informal guidance

Advisory body Aligned Primary Care Organisations

Other Health Care

Providers

Enhances capacityFacilitates EngagementDistributes Best Practice Guidelines Enables AdvocacySupports teaching and educationUp-skills GPs with special interest

Stakeholderswith a

Shared Vision PartnershipAdvisoryGroup

Outcomes FocusedProvides Initial Health AssessmentsProvides Care for Complex CasesDetermines Best Practice Guidelines

Provides data for planning of interventionsProvides evidence for best practiceEvaluates needs of communities and providersEvaluates effectiveness of interventions

Underpinned by

Research

Care

Provides:

SpecificMeasurableAchievableRealisticTime appropriate

Reduces:

Barriers to careService duplicationGaps in service provisionCommunication errors

Cross-sector collaborationEnlists collective strengthsEnsures sustainabilityEnhances communication Facilitates ICT Integration

Tier 1 Practices

Refugee Health Connect

Underpinned by

Community Engagement Mater Refugee Health Advisory Group

Clinical AdvisoryGroup

Outcomes• RHC: facilitated 447 new referrals between Jan-

Oct 2014 (100% of all new arrivals to Brisbane South).

• Four Tier 1 practices providing health assessments and with agreements with MHS for colocation of refugee health nurses/ data sharing

• Resources: online Mental Health Referral tool, immunisation hints and tips, recommended pathology

Outcomes

• Two peer research projects (ethics approved) RaPH and Youth research

• Three education events per annum on diverse topics including: mental health, Hepatitis, TB

What next?

• Evaluation of the Brisbane Sth model – quantitative and qualitative approach – evaluation plan, data set and ethics

• Using a co-creation approach – a patient centred model with a participant research framework

• Opportunities to expand the peer led research projects

What next?• Collection of prevalence data • Multi-site (Tier 1 practices and other refugee health

services – Logan – Brisbane North)• National approach – APHCRI – development of a national

evaluation framework – partnerships with Monash, UNSW, RHeaNA

• Qualitative– Refugee communities (peer led interviews – focus

groups)– Health providers (interviews)

• Empowerment of community members through health literacy – Women as Health Leaders project

Benefits of our approach

• Priorities are negotiated and agreed• Quality enhanced and not dependent on funding• Findings are translated• Dissemination

– System– Providers– Communities

• Enhanced capacity within the communities, clinicians (and others)

• Less research waste

Aknwoledgements

• Dr Margaret Kay (UQ)• Dr Ignacio Correa-Velez (QUT)• Caroline Nicholson and Paula Peterson

(MHS)• Andrea Vancia and Sylvia Penhaligon

(GMSBML)• Chris Allotta and MIRHS Team (MHS)• The communities and all key stakeholders

THANK YOU