Staff exchange
The various models seek to deliver services to small numbers of people scattered over vast areas. In these circumstances, population size can fail to meet the critical mass necessary to support traditional health services or hospitals and the service models may vary in their provision of care and sustainability.
ImplementabilityMedium hard to implement: may take some organizational change to implement.
Investment in developing strong relationships with stakeholders, particularly when expanding services into adjacent regions.
Success factors
A developing body of international evidence indicates that community participation in the planning and implementation of their PHC is associated with improved service accessibility, utilisation, quality and responsiveness and with improved health outcomes.
Challenges
Part of the reason for this varied success can be attributed to the lack of a comprehensive understanding of the processes and factors that enable and inhibit services to successfully expand into communities that are either inadequately serviced or at high risk of becoming inadequately serviced.
Where community participation is not accompanied by fulfilment of essential service requirements, such as adequate funding, infrastructure and workforce supply, improvements in access and health outcomes have not been observed.
Distances between settlements and settlement population sizes may result in inefficiencies that limit the sustainability of networked models of PHC delivery.
How can we be sure that our service model best meets the needs of our population, provides the most cost-effective solutions, and leverages advances in technology? The service model must best meet the needs of the population, and metrics are required to monitor the effectiveness of the service model. In addition to understanding the population’s
service needs, a strong body of evidence suggests that, especially in rural and remote environments, the most successful health-service models are explicitly tailored to the local environment.
In rural remote communities, professionals often work in isolation, without access to specialist support that they may have enjoyed in previous urban roles or in their training. Rural and remote health leaders who report that they have overcome challenges in recruitment and retention of professionals typically report that they consider supporting team cohesion to be a major part of their role. They involve their team of professionals in decisions on who to recruit to the team, they create opportunities for their team to socialize and learn together, and offer them some control over their work environments (shift scheduling, strategic planning, creation of leadership roles among professionals, such as regional professional development lead).
Supporting your professional teams to access professional development that is relevant to their rural and remote work environment can be a significant factor in enhancing the quality of services in your community and in retention of employees. A mixture of well designed “at distance or “technology enhanced” education programmes together with some “face-to-face” education and training should be offered.
Developing an academic/training mandate for an organization, and potentially seeking funds to allow professional teams to dedicate time to training the professionals of the future will lead to a strong return on investment. There is a clear and substantial body of evidence which confirms that offering health professional training in rural and remote environments leads to increased retention of those professionals. Furthermore, training and rural and remote environments ensures that professionals have the unique skills that are needed for rural practice.
Van Haaren, M., & Williams, G. (2000). CENTRAL AUSTRALIAN NURSE MANAGEMENT MODEL (CAN MODEL): A STRATEGIC APPROACH TO THE RECRUITMENT AND RETENTION OF REMOTE‐AREA NURSES. Australian Journal of Rural Health, 8(1), 1-5.