Abstract
BackgroundThe ability to sustain comprehensive primary health care (PHC) services in the face of change is crucial to the health of rural communities. This paper illustrates how one service has proactively managed change to remain sustainable.MethodsA 6-year longitudinal evaluation of the Elmore Primary Health Service (EPHS) located in rural Victoria, Australia, is currently underway, examining the performance, quality and sustainability of the service. Threats to, and enablers of, sustainability have been identified from evaluation data (audit of service indicators, community surveys, key stakeholder interviews and focus groups) and our own observations. These are mapped against an overarching framework of service sustainability requirements: workforce organisation and supply; funding; governance, management and leadership; service linkages; and infrastructure.ResultsFour years into the evaluation, the evidence indicates EPHS has responded effectively to external and internal changes to ensure viability. The specific steps taken by the service to address risks and capitalise on opportunities are identified.ConclusionsThis evaluation highlights lessons for health service providers, policymakers, consumers and researchers about the importance of ongoing monitoring of sentinel service indicators; being attentive to changes that have an impact on sustainability; maintaining community involvement; and succession planning.
Highlights
The ability to sustain comprehensive primary health care (PHC) services in the face of change is crucial to the health of rural communities
By 200910 there were eight general practitioners (GPs), three nurses, three allied health practitioners and nine administrative staff working in Elmore serving a catchment population of 2760 patients from the Elmore township and its hinterland attending the service at least once during the year [21]
Our research identified four key success factors underpinning the development of this comprehensive, single-point-of-entry PHC service model. i
Summary
Elmore (population 700) is located 170 km from Melbourne in central Victoria, Australia. The Elmore Primary Health Service (EPHS) longitudinal evaluation (2008-14) was initiated with the specific purpose of monitoring (i) the provision of appropriate, quality health care to the Elmore community and surrounding region, (ii) the impact of ongoing changes on service sustainability, and (iii) community satisfaction with, and utilisation of, the health service. Evaluation data include an annual audit of sentinel service indicators, community surveys (conducted in 2008 and 2010), in-depth interviews with key stakeholders, and focus groups [18,19]. In this paper we draw on those data relevant to service sustainability and our own detailed observations to synthesise a narrative about how the service is continuing to meet local health care needs, despite significant internal and external changes that threaten its sustainability. Ethics The study obtained approval from Monash University Human Research Ethics Committee (CF08/04192008000176; CF08/0238 - 2008000089; CF08/2434 2008001256; CF10/2540 - 20100001423)
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
