Evaluation of the GP Super Clinics Program 2007-2008

3.2.3 Methods for Operations Aspect

Page last updated: 2012

The operations aspect of the evaluation involved a number of methods to capture data from a range of stakeholders involved across the seven sites. Participation was voluntary. Patients and clinicians were informed that there would be no adverse consequences as a result of not agreeing to participate in completion of the survey or in semi-structured interviews.

GP Super Clinic Directors On-line Self-assessment Form

An on-line self-assessment form was developed to enable each Director to detail the extent of implementation of approaches aligned to the GP Super Clinics Program objectives. Each Director was sent an email with a unique link to an on-line self-assessment form. The email included a letter of invitation to the evaluation. Completion of the on-line self-assessment form was considered to be consent. The online-survey system automatically provided prompts for those who did not respond. Two reminder emails were sent to non-responders.

Patient Survey

Patients over 18 years of age attending any of the seven GP Super Clinics two weeks prior to the site visit were asked by reception staff to complete pen-and-paper surveys. All seven GP Super Clinics were sent 150 surveys in envelopes. The GP Super Clinics were also sent an instruction sheet for the provision of the surveys, for use by reception staff. This sheet addressed procedures for:
  • Providing patients with the envelope containing the survey and letter of invitation
  • Assessing eligibility
  • Identifying patients from Non-English-speaking backgrounds (NESB)
  • Answering questions patients may ask about the survey and its completion
  • Returning all sealed surveys to the evaluation team.
Eligibility criteria related to whether patients were considered cognitively able and physically well enough to complete the survey. Patients considered cognitively able were those who could converse at a level equivalent to year 10 education. In line with standard patient categorisation methods used in general practice, patients with conditions identified by reception staff as non-urgent or not requiring immediate medical attention were classified as physically well enough. Staff at the GP Super Clinics placed notices regarding the evaluation in the waiting rooms and on the reception counters.
Patients were advised about the survey by reception staff and shown where they could access unsealed brown envelopes which contained the patient letter of invitation and the patient survey. Those identified as NESB patients were offered white envelopes containing the survey, an information sheet for their family members to support the patients completing the surveys, and stamped self-addressed envelopes which allowed the patients to post the completed surveys to the evaluators. Reception staff asked the NESB patients to discuss the survey with their families and if completed, to return it in the supplied reply-paid envelopes.

The aims of the patient survey were to:

  • Assess patient perceptions of the GP Super Clinics in relation to
    • accessibility
    • affordability
    • cultural and linguistic relevance
  • Examine whether perception is associated with age group, gender, employment status, country of birth and health insurance status
  • Assess patient self-report of clinician discussion of lifestyle risks, screening and management of health conditions
The survey included items on demographics, access to primary health care, and experiences related to the GP Super Clinics Program objectives. The data from the survey were entered into Excel and transferred to Stata statistical software for analysis.

Clinician Survey

The Director of each of the seven GP Super Clinics was asked to provide the names, positions and contact emails for each of the clinicians who provide services at the GP Super Clinics. Clinicians included general practitioners, medical specialists, and nursing and allied health staff. To encourage participation in the survey, information notices were provided for display in the staff rooms at the GP Super Clinics and for inclusion in staff newsletters. Clinicians had the option of declining the request for their details being sent to the evaluation team. Participation was voluntary, and staff were informed that there would be no adverse consequences as a result of not agreeing to have their contact details sent to the evaluation team.

The aims of the clinician survey were to:

  • Assess clinicians’ perceptions of:
    • the importance of key elements of the GP Super Clinics Program in providing high quality primary care
    • how well elements of high quality primary care were being implemented in their GP Super Clinics
    • the factors which support multidisciplinary care in their GP Super Clinics.
  • Compare patient report and clinician report of clinician discussion of lifestyle risks, screening and management of health conditions.
The evaluation team was provided with the names of 131 clinicians. The clinicians were sent emails requesting their participation in an online survey by completing the survey within two weeks of its receipt. The email included links to a letter of invitation outlining the evaluation and the survey. The on-line survey system automatically sent non-responders or partial responders reminder emails after five, nine and twelve days. The survey focused on their experiences in providing services at the GP Super Clinics in line with the Program objectives.

Site Visits

Site visits to each of the seven operating sites were undertaken. Semi-structured interviews were conducted for each of the stakeholder groups including:
  • GP Super Clinic Directors
  • Clinicians
  • Patients
  • Community stakeholders
Notices about the interviews for clinicians, staff and patients were provided in waiting and staff rooms. Information sheets and consent forms were provided to the consenting participants. For this evaluation the community stakeholders were those who had been involved in the early stages of the development of the GP Super Clinics. The names of these community stakeholders were provided by the GP Super Clinic Directors to the evaluation team. These community stakeholders were contacted by telephone by a member of the evaluation team. Information about the evaluation was provided to each stakeholder verbally. If stakeholders indicated willingness to participate in interviews they were sent information about the evaluation and consent forms by email.
The interviews were tailored to each of the stakeholder groups relevant to their discipline and/or their role in the development and operation of the GP Super Clinics. The interviews were held in separate (private) rooms at the GP Super Clinics. A log of the interviews for each stakeholder group was recorded with data on age, gender and discipline of clinicians. Each interview was recorded, and all interviews were analysed for common themes.