Development and Implementation of a New Model of Care

This project focuses on the development and implementation of a new model of care, specifically primary healthcare nursing for rural and remote Aboriginal communities. The goal is to improve access to healthcare services for these populations and address the higher rates of diseases and poor hygiene.

Running head: DEVELOPMENT AND IMPLEMENTATION OF A NEW MODEL OF CARE
Development and implementation of Primary Healthcare Nursing for Rural and Remote
Aboriginal Communities
Name of the Student
Name of the University
Author note

2DEVELOPMENT AND IMPLEMENTATION OF A NEW MODEL OF CARE
Task 1A
Project topic: Development and implementation of a new model of care (Community
focused care)
Project title: Development and implementation of Primary Healthcare Nursing for Rural and
Remote Aboriginal Communities
Project problem
Australians who live in remote and rural areas tend to have shorter lives because of
higher level of diseases, injuries, neuration issues, poor hygiene and poor access to
healthcare services, especially to primary healthcare. According to government study
published by aihw.gov.au (2016), almost 3 out of 4people lives in rural area do not get
enough primary care treatment. Rate of chronic disorders such as diabetes, asthma and rate of
viral fever are significantly higher in the population of rural and remote area. More
specifically the situation is even worse in the aboriginal population due to various social and
economical determinants. In rural areas, the rate of other food consumption related issues
such as cholera, E.coli, Diarrhoea, are 24% higher than the urban population (McGrail and
Humphreys 2015). These visible differences between the urban population and remote or
rural population also reflects the inaccessibility as well as inequity of healthcare service in
Australia. Hence, to change the situation, the primary healthcare services should overcome
many challenges through which the primary healthcare system could be stronger in remote
and rural area, where majority of aboriginal people live. Lack of development and
implementation of community based care model in primary healthcare nursing services is the
major obstacle to overcome (Song et al. 2018).
Project problem solution:

3DEVELOPMENT AND IMPLEMENTATION OF A NEW MODEL OF CARE
Through community based care model the primary care facilities could become more
accessible to the aboriginal population in rural and remote areas. In incorporate the
community based care model in the primary care nursing services, both educational system
and the professional practices should be changed to make each practice nurse competent
enough to reach the rural communities and to providing primary care (Garbutt et al. 2018).
To develop the community based care model for the aboriginal population who live in remote
and rural areas, the geographical data of population distribution as well as their
demographical will be analysed. According to the result the primary care camps will be
developed facilitated with enough primary healthcare nurses, caregivers and general
practitioners. After graduation, during the internship, the new graduate nurse will go through
a special training and induction session to improve their competence for rural area based
primary care service. During the training the new graduate nurse and the existing practice
nurses will be educated regarding patient centred care approach where, patient value, ethics,
personal values, cultural perspective should be prioritised during the treatment plan (Moullin
et al. 2015). The primary care nurses will be financially supported accordingly, that will
allow them to implement the community based care model practically by developing local
primary care clinics through group based activity plan.
Question to fellow students
From above project concept it is clear that some tertiary stakeholders such as
government and trusty boards must be involved to practically implement the plan
successfully. Hence the first question is how could the tertiary stakeholders help to
implement the community based care model in primary healthcare nursing for the rural and
remote area based healthcare development?

4DEVELOPMENT AND IMPLEMENTATION OF A NEW MODEL OF CARE
Every project planning should consists of risk assessment as well which enables the
project team to minimise the probability of occurrence and to be prepared for certain
situations. Hence, the second question is: What should be the most essential concerns during
the risk assessment for this project of implementing community based care model in primary
healthcare nursing?
Responses to fellow student’s questions
Response to question: In relation to the proposed implementation of an education package of
NGT insertion how you would identify the key project stakeholders and determine their
expected outcomes of the project (Nasogastric Tube (NGT) Education Package)?
Stakeholder identification process is a major part of any project management that
allows the project team develop roles and responsibilities for each stakeholder groups and can
assign the stakeholders to different duties. The stakeholder analysis can be done by using the
power, dependency matrix. Power refers the influence of a stakeholder on a particular project,
where a powerful stakeholder can make decision and can change the project process any time
they want (Macniven et al. 2019). On the other hand, the dependency refers how dependent is
a stakeholder group on a particular project, which also determines that how that particular
stakeholder could be affected by any changes in the project. A stakeholder with higher
dependency has to face higher difficulties for any changes in project.
Hence, for Nasogastric Tube (NGT) Education Package, the stakeholder should be
identified depending on their power and dependency. In accordance with the stakeholder type
the project team has to anticipate the outcomes of key project stakeholders after making any
change or taking any decision. For an example, making change in the training schedule will
affect trainee nurses and the trainers more than the other stakeholders. Therefore, the primary
stakeholders of this project will be the project team. Other internal stakeholders will be the

5DEVELOPMENT AND IMPLEMENTATION OF A NEW MODEL OF CARE
trainee nurses and the trainers. Supplier of the equipments for training will be the secondary
as well as external stakeholder. However, the healthcare regulatory authority and ethical
boards will be the powerful tertiary stakeholder.
Response to question: How to engage stakeholders effectively to get the appropriate support
to early mobilize ICU patients (Project title- Early mobilization in ICU patients)?
Engaging stakeholder is another essential part of any project planning, development
and implementation. For early mobilization in ICU patient the major stakeholders are nurses,
support caregivers, doctors, legal authority and project management team. To involve each of
these stakeholders effective strategies need to be utilised. According to stakeholder’s strategy
of involvement matrix, four strategic involvement can be used namely involving,
collaboration, informing and consulting. Stakeholder with high power and high dependency
should be collaborated properly. In this project of early mobilization in ICU patient, project
team member should be collaborated properly. The low dependency and high power
stakeholders should be consulted properly. In this project, management and legal authority
will be these type of stakeholders that require to be consulted properly form implementing the
plan (Macniven et al. 2019).
Stakeholder groups with higher dependency and lower power must be involved
through directly involve in astriction. For the project of early mobilization in ICU patient,
these type of stakeholders are trainee nurses and trainers. Hence, both of them should be
involved in the training and development action for the nurses to make them involve in the
project implementation. Stakeholder groups with lower dependency and lower power must
be involved through informing them properly. For the project of early mobilization in ICU
patient, these type of stakeholders are patients and their family members. Hence, both of

6DEVELOPMENT AND IMPLEMENTATION OF A NEW MODEL OF CARE
them should be informed about the implementation process properly to make them involve in
the project implementation.
Task 1B
Project Problem Statement
Because of higher level of diseases, injuries, neuration issues, poor hygiene and poor
access to primary healthcare services Australians who live in remote and rural areas tend to
have shorter lives. Almost 3 out of 4people lives in rural area do not get enough primary care
treatment. With higher rate of disorders such as diabetes, asthma the rate of nutrition and
hygiene related diseases such as viral fever are significantly higher in the population of rural
and remote area (Thomas, Wakerman and Humphreys 2015). In the aboriginal population,
the poor accessibility to the primary healthcare services the situation is even worse. Several
social and economical determinants are also caused this issues such as lack of education, poor
sense of hygiene, malnutrition, lifestyle and others. As a result, in rural areas, the rate of
malnutrition and hygiene related issues such as cholera, E.coli, Diarrhoea, are 24% higher
than the urban population (McGrail and Humphreys 2015).
Project Goal
Hence the purpose of this project is to incorporate the community based care model in
the primary care nursing services so that the aboriginal population in rural and remote areas
can easily access the primary healthcare services. Therefore the major goal of this project is
to develop the community based care model for the aboriginal population who live in remote
and rural areas through analysing the geographical data of population distribution as well as
their demographical details. Another goal of this project is to improve both educational

7DEVELOPMENT AND IMPLEMENTATION OF A NEW MODEL OF CARE
system and the professional practices should be changed to make each practice nurse
competent enough to reach the rural communities and to providing primary care. The purpose
of this identification process is to set up numerous primary care camps across the rural and
remote areas of Australia facilitated with enough primary healthcare nurses, caregivers and
general practitioners.
Project Justification
These visible differences between the urban population and remote or rural population
also reflects the inaccessibility as well as inequity of healthcare service in Australia. Hence,
to change the situation, the primary healthcare services should overcome many challenges
through which the primary healthcare system could be stronger in remote and rural area,
where majority of aboriginal people live (Gwynne et al. 2016). Through community based
care model the primary care facilities could become more accessible to the aboriginal
population in rural and remote areas. Implementation of a new care model needs proper
change in education system as well, which could enable the caregivers to understand the
process of utilising the new care model. During the training the new graduate nurse and the
existing practice nurses will be educated regarding patient centred care approach where,
patient value, ethics, personal values, cultural perspective should be prioritised during the
treatment plan (Moullin et al. 2015). Community focused care will make the nurses more
culturally competent, so that they can provide a holistic care by showing respect to the people
of local community while prioritising their cultural perspective, ethical values and perception.
Project Objectives
The project objectives are formulated as the milestones to be achieved based on the
goals of the project. Therefore, three major objectives for this project of Development and

8DEVELOPMENT AND IMPLEMENTATION OF A NEW MODEL OF CARE
implementation of Primary Healthcare Nursing for Rural and Remote Aboriginal
Communities are follows.
Specific Measurable Attainable Realistic Timely
Implement the community
care model in primary
healthcare nursing
By measuring the
number of
involved practice
nurses
Involving at
least 250
practice nurses
Through
providing them
training
Within
next 1
year
Finding the rural and remote
area
through measuring
the area coverage
Covering 25%
of rural or
remote areas of
Australia
Through
considering their
health status
Within
next 6
months
Facilitating the rural and
remote area
Through
measuring the
percentage of
people treated
Increasing the
accessibility by
50%
By facilitating the
local clinics with
practice nurses
Within
next 2
years
Project Outputs / Deliverables
The major deliverables of the project of Development and implementation of Primary
Healthcare Nursing for Rural and Remote Aboriginal Communities are:
 More than 250 primary care practice nurses who will be capable to deliver community
focused care properly to the remote and rural places. After graduation, during the
internship, the new graduate nurse will go through a special training and induction
session to improve their competence for rural area based primary care service.
 Covering majority of rural areas in Australia by making more than 70 local health
clinics for primary healthcare

9DEVELOPMENT AND IMPLEMENTATION OF A NEW MODEL OF CARE
 Each local primary health clinic will consist of at least 3 practice nurses from primary
care nursing background. The primary care nurses will be financially supported
accordingly, that will allow them to implement the community based care model
practically by developing local primary care clinics through group based activity plan.
 The nursing care model of these primary care clinics will be community centred
which allows the caregivers to prioritise the social, cultural and economical
perception, values and ethics of the target population.
 Increased level of accessibility to the primary healthcares with lower rate of food and
water consumption based diseases.

10DEVELOPMENT AND IMPLEMENTATION OF A NEW MODEL OF CARE
References:
aihw.gov.au (2016). Rural & remote health, Health conditions & remoteness - Australian
Institute of Health and Welfare. [online] Australian Institute of Health and Welfare. Available
at: https://www.aihw.gov.au/reports/rural-health/rural-remote-health/contents/health-
conditions-remoteness [Accessed 27 Apr. 2019].
Dent, E., Hoon, E., Karnon, J., Newbury, J., Kitson, A. and Beilby, J., 2016. Frailty and
health service use in rural South Australia. Archives of gerontology and geriatrics, 62, pp.53-
58.
Garbutt, J.M., Dodd, S., Walling, E., Lee, A.A., Kulka, K. and Lobb, R., 2018. Theory-based
development of an implementation intervention to increase HPV vaccination in pediatric
primary care practices. Implementation Science, 13(1), p.45.
Gwynne, K., Irving, M.J., McCowen, D., Rambaldini, B., Skinner, J., Naoum, S. and
Blinkhorn, A., 2016. Developing a sustainable model of oral health care for disadvantaged
aboriginal people living in rural and remote communities in NSW, using collective impact
methodology. Journal of health care for the poor and underserved, 27(1), pp.46-53.
Macniven, R., Hunter, K., Lincoln, M., O’Brien, C., Jeffries Jr, T.L., Shein, G., Saxby, A.,
Taylor, D., Agius, T., Finlayson, H. and Martin, R., 2019. Accessibility of Primary,
Specialist, and Allied Health Services for Aboriginal People Living in Rural and Remote
Communities: Protocol for a Mixed-Methods Study. JMIR research protocols, 8(2),
p.e11471.
McGrail, M.R. and Humphreys, J.S., 2015. Spatial access disparities to primary health care in
rural and remote Australia. Geospatial health.

11DEVELOPMENT AND IMPLEMENTATION OF A NEW MODEL OF CARE
Moullin, J.C., Sabater-Hernández, D., Fernandez-Llimos, F. and Benrimoj, S.I., 2015. A
systematic review of implementation frameworks of innovations in healthcare and resulting
generic implementation framework. Health Research Policy and Systems, 13(1), p.16.
Song, Y., Tan, Y., Song, Y., Wu, P., Cheng, J.C., Kim, M.J. and Wang, X., 2018. Spatial and
temporal variations of spatial population accessibility to public hospitals: A case study of
rural–urban comparison. GIScience & remote sensing, 55(5), pp.718-744.
Thomas, S.L., Wakerman, J. and Humphreys, J.S., 2015. Ensuring equity of access to
primary health care in rural and remote Australia-what core services should be locally
available?. International journal for equity in health, 14(1), p.111.