Type 2 Diabetes Pathway

1. Type 2 Diabetes Pathway Vicki McGowan Program Officer

2. CHIC Type 2 Diabetes Project Aims: • Improve awareness and understanding of the roles, responsibilities and services provided by individual health care providers across primary and secondary care • Implement structures to support a ‘virtual network’ of local service providers to work collaboratively and support General Practice as the centre of care-co-ordination. • Promote implementation of effective business models (for all stakeholders) that support integrated diabetes care

3. CHIC Type 2 Diabetes Project Objectives: • Develop ‘Network’ of local providers linked by uniform information systems • Implement appropriate & coordinated systems of care across network with General Practice as the central point • Identify and promote effective business models that support integrated care • Increase utilization of Practice Nurses in team based EPC/ care planning (diabetes) • Promote a patient centered, self-management approach in care planning and service delivery

4. ABHI PCIP Aims: Improve communication and linkages between GPs and other primary care providers Promote better use of existing primary and community care services Utilise tools and strategies to assist in chronic disease management Contribute to the development of local chronic disease care pathways and referral tools

5. CHIC Clinical Advisory Group Clinical Advisory Group comprised of: • General Practitioners • Practice Nurses • private Allied Health Providers • Credentialled Diabetes Educators (CDEs) • from QEII Diabetes Service and the Queensland Diabetes Centre at the Mater • Endocrinologist

6. CHIC Clinical Advisory Group Under the Objective: “Implement appropriate & coordinated systems of care across network with General Practice as the central point” Advisory Group looked at: The development of a Care and Referral Pathway for Type 2 Diabetes being developed to facilitate implementation of best practice integrated primary care.

7. T2D Care and Referral Pathway • Maps the process for evidenced based structured, systematic primary care for T2D • Identifies patient self management support as a key element of standard care • It identifies the link between DoHA KPI activities and best practice chronic disease management

8. T2D Care and Referral Pathway • Steps in the Pathway link to: • Relevant Medicare items • Supporting services and resources • Self management information and education that is consistent across the network • Register of local Health Providers, formally aligned with the T2D. Pathway

9. Links with GPQ QH Standard Care Pathway for T2D • The GPQ QH Pathway is a decision making pathway for GPs for the clinical care of patients with T2D. • The SEA-GP Pathway describes the systems and structures that need to be put in place to deliver this care.