Recognising the need for greater access to quality care in the Northern Territory, Top End Medical Centre is there for the Darwin community.

Top End Medical Centre (TEMC) consists of multiple medical practices spanning over three locations in Darwin, Northern Territory. TEMC’s mission is to provide  quality, affordable medical services to the local community.

Darwin, Australia’s smallest capital city, has a population of only 135,000 people from more than 70 ethnic backgrounds with Indigenous Australians making up ten percent of the population.
Darwin’s population is notable for the highest proportional population of Indigenous Australians of any Australian capital city.

TEMC faces unique challenges owing to Darwin’s geographic isolation and diverse demographic composition. Patients are often residents of remote areas, who travel to Darwin for short periods of time and require multiple appointments and tests during that time. As a result, specialists, particularly neurologists and cardiologists, have extensive wait times for patients.
Additionally, not all treatments are available in the Northern Territory, such as paediatric oncology. This proves problematic for those suffering, who consequently need to travel to southern states to receive treatment.

Currently owned by eight parties, the modern, bulk billing practices provide family health services and support the long term care patients require.
Services include chronic health management of diabetes, cardiovascular disease and asthma, minor surgeries, preventative medicine, travel education, skin cancer care, and Aboriginal, Torres Strait Islander and Refugee healthcare.

AGPAL and QIP staff member Bennet Aladin, Manager Health and Human Services, National Development Team met with Practice Manager, Mrs Jackie Brandner, to gain insight into how Top End Medical Centre operates up in the top end.

Can you tell us a little bit about your practices’ history?
Top End Medical started because the five doctors who were the Directors at the time decided that Darwin needed quality, affordable medical service.
A lot of patients were going to the hospital for non-emergencies and these doctors saw an opportunity to capture and engage that audience, while taking strain off the hospital. Our first practice started in Casuarina in 2011 with a six room practice, and now has a total of 13 rooms.
In 2014 we opened our second practice located in Stuart Park which is very central to the CBD in Darwin with 12 rooms.
In May 2016 we opened our third practice in Rosebery, which has a ratio of 1 doctor for every 500 patients, and later this year (2017)  we will open a fourth practice in Palmerston.

Congratulations to TEMC’s on achieving your fourth collective accreditation cycle with AGPAL. Can you share your tips on preparing for each cycle of accreditation?
Jackie: Ensure that your policies and procedures are in place, that your staff know where to find the policies and procedures, know and understand them, and that they are not just a book that is created, put aside and never looked at again until your next accreditation assessment. Once you have done this, working toward your accreditation is easy because you know what the RACGP Standards are requiring of you and you know you have it in place.

Have you recently had an achievement or improvement outcome in your practice that you would like to share?
Jackie: I was recently a finalist for the SA/NT AAPM Practice Manager of the Year Awards for 2016; I was nominated by one of my doctors which was a nice surprise.
Top End Medical Centre were the winners of the NT Telstra Small Business Award for 2016, this was a massive amount of work small business-wise due to the amount of preparation and documentation you have to produce and submit to be validated for this award. Telstra gives you a great snapshot as to where your business is standing financially, where its weaknesses and strengths are, and initially that is the rewarding payback you receive – getting this extensive report that tells you where your business is going. It is difficult to express what it means to me and our practice team to have actually won that. It really means a lot to know that when you come to work you are working for a business that runs well and has the capacity to win an award like the NT Telstra Small Business Award.

Would you say some of your achievements have been linked to accreditation against the RACGP Standards?
Jackie: I think we improve every day. We have lots of little things that we do, and you don’t even recognise that it is an improvement really. Putting locks on doors, installing a back door bell for ambulance and delivery. Although these are little things, they are all about safety and accessibility, and tiny little things like that are improvements that contribute to our continuous quality improvement journey, to make our practice run better.

What quality improvement or innovative ideas has your practice implemented as a result of accreditation?
Jackie: The major turnaround from our last accreditation was making sure our reminder and recall system  were working well. We have recently introduced an online reminder and recall system using an external source. The patient will receive an SMS text message, and we will then get a record in the patients file saying what was sent at a particular time and on a particular date. The system then records another message in the patients when the SMS is read, and an additional record in the file when that SMS has been actioned by the patient.

Do you have any tips for other general practice teams to assist them with their own accreditation?
Jackie: My first accreditation experience was at a private hospital. I learnt from their quality assurance person that it is essential to be incredibly organised. Before the accreditation assessment, run through AccreditationPro, see what is requested of you, work out what you need to do to improve, go away and do those things, and then come back and mark those items as complete.
On the day of the on-site accreditation assessment, be really prepared. Produce the main policies that surveyors are likely to want to see, keep certificates like staff CPR and first aid training, and practice insurance in an easily accessible file so that you can just put a whole folder on the surveyor’s desk ready to go. Always be happy to answer any questions they might have about anything in that file, as it makes their job just that little bit easier. It also means they do not have to search for things all over the practice on the day, which makes everyone else in the practice a bit more comfortable with what they are doing.

I also find it really helpful to do a mock-survey with the practice staff about a week before the actual on-site assessment. I might ask something like where can you find the privacy policy or what does the privacy policy say about this subject? I find it gives the staff a bit of extra knowledge and confidence to support them with preparing for the arrival of the survey team.

What were the main resources and information that helped you prepare for your latest accreditation cycle?
Jackie: I find that there are three places that assist with resources, AGPAL, your PHN and the RACGP. These three together are a great help when you are doing any accreditation project at all. AGPAL has different resources available including templates and information documents to help you set up items required within the Standards. The RACGP website also provides useful resources where you can see what you need to do in case of an emergency and I have just looked at their privacy policy. It’s great to be able to access these with the simple click of a button because you don’t have to know everything, you just need to know where you can find the updated policies.

Has your practice used patient feedback or community consultation to promote quality, innovation or positive health initiatives?
Jackie: We listen to our patients and take feedback very seriously. I feel that people who take their time to tell you that something is not right, you need to respect that time and really listen to what they are saying. We had feedback recently regarding not having play equipment in one of our practices. This practice has a very small waiting room, and while we would love to be able to offer play equipment for children, unfortunately it is just too small. Our alternative solution has been to provide books so we hope that in the meantime this will occupy some of the waiting time.

We are also investigating how we may be able to renovate the small waiting area to try and expand it in some way so we can actually add a play area, as we know how important this is. Improvements we can make to better cater to patients and our staff are very important to us. We want this to be a great practice and we also want this to be a great place to work and a great place for patients to come to.

AGPAL would like to thank Jackie and the Top End Medical Centre team for opening up their practice to us.

For further information about Top End Medical Centre, visit their website at: www.topendmedicalcentre.com.au