Hauraki Plains Health Centre – On the path - A Health Care Home case study

The owners of Hauraki Plains Health Centre were considering walking away from their practice rather than face burn out when the Health Care Home offered them a vision of a sustainable way forward.

Dr Antony Smit, who owns the practice with his wife Bronwyn, said: “We face all the same issues any other practices face as well as the overwhelming health needs of an ageing population.

“Our current responses to coping with it were beginning to compromise the sustainability of the practice and we could see a future where we were just going to give up and go away.

“Learning about the Health Care Home has presented us with a positive plan to make a better practice for patients and make a better working environment for ourselves. I can see myself being an old GP in this practice and not giving up and going elsewhere.

“It offers a bit more space in my life to think, and by thinking I mean both clinically and about the practice, it’s structure and its future. At the moment I’m in that terrible cycle where all I can do is see patients, I can’t think about changing and improving, all I can do is see patients.

“Doing that year in year out and seeing that I’m working slightly harder each year without any financial reward. Effectively I have a slightly decreasing income as I try different methods to fix the problem which doesn’t make a difference.”

Bronwyn said: “I came with our nurses to a conference about the Health Care Home and we instantly thought that it was what we needed to help deal with the stress of our practice.

“Prior to this, we’ve been a very inefficient practice. Patients are just used to coming in off the street asking for a prescription and leaving and coming in off the street seeing a nurse and not being charged for it.

“A lot of these models seems to be only applicable to the big, complex clinics, but then we could see the health care home model working in small practices, just like ours.”

Ant added: “We’ve begun that process of cleaning out and ‘leaning’ the practice already. Through the process we can already see the maddening inefficiencies in our operation, saying ‘where’s this where’s that’ as I wander around, tearing my hair out trying to find an otoscope.

“It seems so obvious, but we don’t do it. This is giving us a structure that makes us do it, stick with it and maintain it over time.

“Our use of technology is just beginning to crank up but already it’s nice to be able to look at a result, see what needs to be done and fire a secure email off to the patients straight away.

“It doesn’t involve that cumbersome process of messaging the nurses, nurses phoning multiple times, not being able to get hold of the patient. All that complexity is removed. I can just message them directly and if it comes too complex I can control that process and say, hey, just come and see me. I can see that is going to be fantastic.”