The Trial

An education session was conducted at each general practice by the QUPP Project Officers (Simone Patterson & Kylie Rhook) to outline the processes of the pre-test period. Education sessions covered the following details:

• Use of the colour laser printer, which was provided and installed in each participating practice.
• Use of manual pathology pro forma
• Ongoing support throughout the trial period provided by DCH to the participated practices in regard to installing and printing the templates.
• Consent & consumer confidentiality
• Trialling of the template with 10-20 patients (@ $80 per patient) in clinical consultations
• Consumer and GP feedback surveys

General practice nurses/diabetes educators entered data and test results of the patients via an excel spreadsheet to produce a pro forma template with the patient prior to consultation with the doctor. Then, the doctor provided consultation and advice to the patients based on the patient’s results as shown in the template and discussed the action plan for the following three months with patients. A paper questionnaire for doctors and nurses/diabetes educators was developed to evaluate the pathology template.

Medical practice nurses/diabetes educators gave a copy of the printed colour template to the patient prior to consultation. Then, the patient saw the doctor to further discuss results with him/her. A paper questionnaire for patients was developed to evaluate the pathology template.

Following each consultation with the doctors, doctors, nurses/diabetes educators and patients were asked to provide feedback on the usefulness of the template via the questionaries. The patients were phoned after 3-4 weeks to answer the questionnaire again to test if results and understanding of results were remembered.

Some of the difficulties encountered at the commencement of the pre-test period communicated by GP practices included:

• Technical issues when installing colour laser printers, necessitating involvement from external practice IT support services.
• Varying versions of Excel programs, resulting in the abandonment of the electronic pro forma. Two practices continued to use the electronic Excel version of the pro forma.
• Varying levels of IT skills. Some general practice staff had never used Excel.
• Staffing restraints at two participating GP practices - restricting timely completion of the pre-test.

Strategies implemented to manage risk:

• Change of the pathology pro forma to PDF version
• Provision of step by step instruction sheet for practice nurses to triage potential participating patients
• Provision of pro forma consumer packs to two practices – including consent, pathology pro forma, patients’ questionnaire and GP questionnaire.
• Regular telephone contact and practice visits.