CDMPP Practice Nurses
The Chronic Disease Management and Prevention Program (CDMPP) includes a Practice enrolment and Nurse Support strategy. The strategy includes the resourcing of 21 identified General Practices throughout the WNSW Primary Health Network region to engage Practice Nurses to undertake a Chronic Disease Nurse role. The General Practices have been identified on the basis of highest need for Practice support to care for patients and communities at highest risk within the region, including Aboriginal and Torres Strait Islander, disadvantaged (SEIFA rating), and people living in isolated, remote communities where there is a higher prevalence of Chronic Disease and lower access to health care services.
Practices participating in this strategy will have access to additional nursing support to increase their capacity and optimise the identification and management of patients targeted under the CDMPP. Funding will be available to support additional nursing hours, and practices will be supported by the CDMPP Practice Support team and participate in a quality improvement approach to assist uptake and adoption of key enablers - including development and maintenance of chronic disease registers, resources and templates, data cleaning and data accuracy, and patient recall and reminder systems.
The Chronic Disease Nurses provide support to identified Practices with additional specialist resources to lead and implement the CDMPP Model of Care. ‘Care Coordination’ is one of the core functions of the Chronic Disease Management Practice Nurse role. 21 Chronic Disease Nurse positions are funded under the CDMPP Practice Nurse strategy.
Benefits of the Program
- Additional Nursing workforce support
- Improved idenification and enrolment of patients in planned care
- Increased knowledge and understanding of the practice populations and risk profile
- Support to clean data and undertake stratification and patient registers
- Improved systems to support multidisciplinary team based care
- Collaboration with other practices as part og the Quaility Improvement (QI) program
- Improved practice productivity