1. How did this project come about? The Central Primary Health Organisation (Central PHO) in collaboration with MidCentral District Health Board (MDHB) secondary services commenced work to establish Collaborative Clinical Pathways in 2011. The system uses the UK based ‘Map of Medicine’ (MoM) as a platform to support evidence based best practice guidelines. Radius Medical the Palms has agreed to be a pilot site to improve the utilisation of asthma pathways on Map of Medicine. Asthma in children pathways were chosen because: Ambulatory Sensitive Hospitalisations (ASH) for children during 2006-2010 in MidCentral were most frequently caused by gastroenteritis, asthma and acute respiratory tract infections; Reducing Ambulatory Sensitive Hospitalisation in the 0-4 year old age group was identified as a priority for action by the Ministry of Health in 2007; ASH is used as a measure of the effectiveness of Primary Care health care delivery; We want to reduce the impact of possible overutilization of free services for under 6 year olds in general practice; and Child Health is a priority in the Primary Health 2013/14 Annual Plan. Who can I contact about this project? For questions from Radius Medical the Palms, talk to: Carolyn Russell, Jo Saxe or Dr Wayne Hayter (CHAIP Primary Care Clinical Lead) For questions about the Child Health pathways on Map of Medicine, contact: Dr Jeff Brown, Clinical Director/Paediatrician Child Health jeff.brown@midcentraldhb.govt.nz or Sandra Lanceley CNS, MDHB CHCT sandra.lanceley@midcentraldhb.govt.nzjeff.brown@midcentraldhb.govt.nzsandra.lanceley@midcentraldhb.govt.nz For questions about the CHAIP contact: Jane Cullen, Service Improvement Leader, Central Primary Health Organisation: jane.cullen@centralpho.org.nz jane.cullen@centralpho.org.nz For questions about the Collaborative Clinical Pathways project or Map of Medicine in general contact: Shirley-Anne Gardiner, Collaborative Clinical Pathways Project Manager or email clinicalpathways@midcentraldhb.govt.nz. clinicalpathways@midcentraldhb.govt.nz Who can I contact about this project? For questions from Radius Medical the Palms, talk to: Carolyn Russell, Jo Saxe or Dr Wayne Hayter (CHAIP Primary Care Clinical Lead) For questions about the Child Health pathways on Map of Medicine, contact: Dr Jeff Brown, Clinical Director/Paediatrician Child Health jeff.brown@midcentraldhb.govt.nz or Sandra Lanceley CNS, MDHB CHCT sandra.lanceley@midcentraldhb.govt.nzjeff.brown@midcentraldhb.govt.nzsandra.lanceley@midcentraldhb.govt.nz For questions about the CHAIP contact: Jane Cullen, Service Improvement Leader, Central Primary Health Organisation: jane.cullen@centralpho.org.nz jane.cullen@centralpho.org.nz For questions about the Collaborative Clinical Pathways project or Map of Medicine in general contact: Shirley-Anne Gardiner, Collaborative Clinical Pathways Project Manager or email clinicalpathways@midcentraldhb.govt.nz. clinicalpathways@midcentraldhb.govt.nz For more information about the project including documents and latest updates, visit: http://www.centralpho.org.nz/home/collaborative_clinical_pathways/ A collaborative effort in MidCentral involving primary and secondary health team members based at Radius Medical, The Palms Who is on the CHAIP Working Group? The membership of the CHAIP Collaborative Working Group is multi-disciplinary and is made up of the following members: Carolyn Russell, Radius Medical – Nurse Manager Jane Cullen, Service Improvement Leader, Central Primary Health Organisation Dr Jeff Brown, Clinical Director/Paediatrician Child Health Joanne Saxe, Practice Manager Radius Medical. Julie Wells, Pharmacist Nicola Lean CNS Lead, MDHB Child Health Community Team (CHCT) Sandra Lanceley CNS, MDHB CHCT Shirley-Anne Gardiner, Project Director, Collaborative Clinical Pathways (CCP) (Chair) Dr Wayne Hayter, Radius Medical - Clinical Director

2. General Practice Team engagement & satisfaction Primary – Secondary collaboration and communication Patient improved outcomes & satisfaction Improve Documented evidence of evidence- based practice Accurate referrals GP Team satisfaction with CCP Patient satisfaction & improved outcomes Decrease ASH & ED presentations Observable benefits staff Ease of use Primary – Secondary collaboration in development, implementation & maintenance of pathways Evidence based practice Education and information Consistent evidence based care Improving Utilisation of Asthma Collaborative Clinical Pathways in Primary Care Unreliable or no data Current ChallengesPrimary Drivers Secondary Drivers Desired Outcomes Training & education Communication and feedback Network Groups Referral systems Improved patient outcomes Patient feedback mechanisms Aim To improve the utilisation by primary care teams of the child health (1 – 15 years) asthma collaborative clinical pathways on the Map of Medicine system to ensure that evidence- based interventions are used consistently by March 1st, 2014.