By Tina Eriksson
The background for the Practice Coordinator System was a whish to acknowledge the problems that often occur in the cooperation between physicians working at hospitals and GPs when in patient transition between sectors. The idea of GPAH was launched in Fynen in 1991.
The practice coordinator system is a network of GPs who seek to ensure and strengthen the cooperation between hospital, general practitioners and the local home care to the benefit of the individual patient
Practice coordinators have taken upon them a vide variety of tasks, such as securing that referrals and discharge letters meet standards, creating common county guidelines for all major diseases and arranging cross sectional audits, but their most important role is probably in seeking to create a common medical culture. As a consequence of this work, there has been increasing focus on quality problems concerning cooperation between hospitals and GPs and The Danish National Quality Programme for health care has made shared care one of the main themes
In the beginning the dialogue between doctors at the hospitals and the GPs had high priority, as recognition of the fact that increased knowledge of the daily routines of the colleagues was a prerequisite for development of the cooperation. Meetings are held at the hospitals and in the practices and agreements on office hours, lists of telephone- and fax numbers and email addresses has been made.
This often leads to common educational activities between hospital physicians and GPs. The practice coordinator stimulates changes of working procedures both in hospital departments and in general practice. In this context it a good cooperation with the local committee of The Association of General Practitioners has been crucial in order to secure acceptance of new initiatives, leading to changes in the general practitioner’s working methods and use of time. The practice coordinators have been seeking to implement centrally published guidelines from the Danish College of General Practitioners locally.
There is practice coordinators employed in all Danish counties covering most hospital departments. The system is financed by the counties. In recent years, practice coordinators have felt a growing need of a central organisation to support the local activities, but so far, that has not been achieved. The system has been taken up by other Scandinavian countries, such as Norway and Sweden. The latest development is the suggestion of a practice coordinator system for the municipalities, who soon are taking over health care tasks, such as prevent ional and rehabilitation tasks from the counties as a part of the reform of the Danish health care system to be launched in 2006.
