Quality Improvement and PIP QI

Quality improvement in general practice

Practices need to engage in activities to improve quality and safety for patients in areas such as practice structures, systems, processes and clinical care.

The RACGP standards for general practice indicate focusing on quality improvement should be based on evidence produced from the practice's own data.

One way this can be gathered is data audit and analysis from the practice’s clinical database, using a clinical audit data extraction tool. Measuring quality focuses on a multi-dimensional approach of the interactions between structure, process and outcomes.

Quality Improvement generally follows these simple steps:

• Utilise data extraction tool to conduct clinical audit
• Record outcomes of clinical audit
• Document proposed actions following clinical audit, including delegated responsibilities
• Keep evidence of implementation
• Document follow up plans

The Quality Improvement PIP Incentive commenced on 1 August 2019.

This PIP is designed to encourage improvements in quality care, enhance capacity, improve access to care and improve health outcomes for patients.

As part of the new PIP QI Incentive, you’ll have to undertake continuous quality improvement (CQI) activities through the collection and review of your practice data or information.

The PIP QI will replace the following incentives:

• Asthma Incentive
• Cervical Screening Incentive
• Diabetes Incentive
• Quality Prescribing Incentive

The following incentives will stay the same: 

• eHealth Incentive
• After Hours Incentive
• Teaching Payment
• Indigenous Health Incentive
• Procedural General Practitioner Payment
• Rural Loading Incentive
• General Practitioner Aged Care Access Incentive

The 10 Quality Improvement Measures (QIMs)

As part of the new PIP QI, participating practices must share the following data with the CESPHN.  This data is known as the Quality Improvement Measures (QIM).

Practices must also commit to CQI that is based on data from the practice electronic medical records (EMR)

The 10 QIMs are:

1. Proportion of patients with diabetes with a current HbA1c result
2. Proportion of patients with a smoking status
3. Proportion of patients with a weight classification
4. Proportion of patients aged 65 and over who were immunised against influenza
5. Proportion of patients with diabetes who were immunised against influenza
6. Proportion of patients with COPD who were immunised against influenza
7. Proportion of patients with an alcohol consumption status
8. Proportion of patients with the necessary risk factors assessed to enable CVD assessment
9. Proportion of female patients with an up-to-date cervical screening
10. Proportion of patients with diabetes with a blood pressure result

To participate in PIP QI, practices must:

• Be an accredited practice
• Have a data extraction tool installed in the practice (CESPHN supports Pen CAT & POLAR)
• Share de-identified data with CESPHN (for PEN this includes a scheduler)
• Sign applicable Data Management Agreements (DMAs) ( pdf Pen CAT (429 KB) / document POLAR (65 KB) ) and have the appropriate posters ( pdf Pen CAT (599 KB) / pdf POLAR (2.74 MB) ) visible in the practice
• Register from 1 August via PRODA and HPOS
• Complete an annual confirmation statement each year
• Notify CESPHN you have applied for the PIP QI incentive and provide your PIP Identifier Number (PIPIN) – this is so we can assist the department in processing payments
• Provide the main contact person for the program including 2 email address to receive the quarterly benchmarking report
• Submit the PIP Eligible Data set to CESPHN on a quarterly basis (CESPHN will extract submission data on a monthly basis)
• Work in partnership with CESPHN on practice relevant Quality Improvement activities (QIAs)
• Retain evidence (for 6 years) of the QI activities you have undertaken in the practice

pdf Click here (517 KB)  for the latest fact sheet regarding what practices need to know - August 2019

Click here for the latest information regarding the new Quality Improvement PIP

pdf Click here (1.44 MB)  for our manual on registering for PRODA and PIP QI

Your patients have the right to request that their information is permanently excluded from the practice’s de-identified data set. Simple step-by-step guides on how to exclude the patient are available:

pdf Pen CS - How to opt out patients (172 KB)

pdf POLAR - How to opt out patients (515 KB)

Not an accredited practice but would like to enrol in PIP QI?

If you would like to participate in the new Quality Improvement (PIP QI) Incentive but are not an accredited practice, our Practice Support and Development team can help you through the accreditation process. The Practice Support team can be contacted on practicesupport@cesphn.com.au or call 1300 986 991 and press 3.

 Practice support can also support your practice with: 

• Staff orientation of general practice staff including GPs, GP Registrars and Practice Nurses 
• Practice Incentive Programs (PIPs), Service Incentive Program (SIPs), MBS items and Chronic Disease Management (CDM) items.
• Undertaking quality management practices in accordance with best practice and appropriate accreditation standards
• Advice based upon industry knowledge and legislative changes and emerging trends.

Time Limit Exemption

General practices who wish to participate in the PIP QI incentive but do not wish to use Pen CAT or POLAR as their preferred tool to share data can submit a pdf Time Limit Exemption form (484 KB) to the Department of Health for review and approval.  This gives practices 12 months to work in partnership with their local PHN to meet the other requirements of the PIP QI Incentive without the need to share any data, and they will still receive quarterly payments.

For more information please read the attached pdf factsheet (377 KB) .