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Effective links: Helping research to grow

Effective links are the result of successful partnerships between Divisions and researchers. This is one of a series of interviews that aim to capture the real life stories and examples of these collaborative partnerships. In this issue we interviewed Shauna Gaebler, Deputy CEO of the Perth and Hills Division of General Practice, about the research her Division has participated in and the relationships that have been built through the projects.

"We were open to be involved - I think that was the important part."

Perth and Hills Division began their research journey when the Western Australian Sleep Disorders Research Institute asked them to be involved in a project on obstructive sleep apnoea. This project built on some existing links with the University of Western Australia, and enabled them to build their relationship with Dr Douglas Pritchard, a researcher supported by PHCRED and a GP in the Division. Shauna said that having Doug Pritchard involved was extremely beneficial and "demonstrated the expertise that was there, he was really able to contribute to the research methodology."

"We've established a relationship that I'm sure has been mutually beneficial."

Since then their list of research endeavours has continued to grow. A second project was initiated by a staff member with a keen interest in evaluating an intervention the Division is running, which aims to reduce the risk of a cardiovascular event in people with recently diagnosed impaired glucose tolerance (IGT). The Division successfully applied for the Cardiovascular Research Grant. The investigation involved 50 GPs and was run in partnership with PHCRED and the University of Western Australia. This research is reaching the end of data analysis and the results will provide evidence to support the decision for Perth and Hills Division of General Practice on whether to continue with the brief intervention for people with IGT. An article on the findings is being prepared for publication and the results will be provided to GPs in the Australian Division Network.

After that project, the Division's interest in looking at strategic planning and operation planning led to them applying successfully on behalf of one of the Division's GPs for a GP Informatics Scholarship from the RACGP, with the aim of improving the systems management of electronic registers of people with diabetes in general practice using an action evaluation framework of the current systems. The findings of this research will be disseminated nationally through the National Primary Care Collaboratives Program and will be used locally to plan the best way for Perth and Hills Division to support GPs and practice staff to improve health outcomes for people with diabetes.

PHCRED has been actively involved in both projects, "Yes, they were part of the consortia on both of them and certainly Caroline Bulsaro [PHCRED supported researcher] has been involved with the informatics. For example she was there at the original planning meeting when we mapped out what we were going to do, and she's been very actively involved in assisting developing of patient questionnaires, and collating results."

Shauna described how important their relationship with PHCRED is to the Division, "It's been critical, the link that we've had through PHCRED. I think part of that has been PHCRED's ability to not get too caught up with research to the detriment of evaluation. I think there has been some delineation in some people's minds of evaluation being quite separate to research, which frustrates the Divisions, because that isn't necessarily what divisions see. And Divisions have a real need for some expertise, some consultant expertise in evaluation and setting up evaluation frameworks. So PHCRED has been very helpful in that regard."

Shauna described some of the factors which have assisted the growth of collaborative links "We've got someone on the staff who has some research knowledge. I think being able to speak the same language can be helpful, it then puts you on an equal footing with the researchers, I might be wrong with that - but I think if you went in there with no research knowledge then it can be a bit daunting to actually actively contribute and certainly the first bit of research where they were well we'll call them 'hard-core' researchers, it actually took a little bit of time and trust on their part to really include the Division."

Shauna attributes the success of the collaborative ventures to trust, commitment, and the support of senior management - the Division Board and CEO.

"I know when I started at the Division it was explicitly stated that it's not Divisions' work to be involved in research. But that has changed and certainly our Board has been very supportive and so has the CEO and all of that has really helped."

One of the barriers to the Division undertaking their own research projects and being involved in effective links is obtaining ethics approval, according to Shauna. "That's our main issue, and it's a bit of barrier, we don't have a formal ethics committee that we can easily tap into, there isn't one in the Division for example, we can get approval from the uni ethics committee but it is not always possible to access them and can sometimes bring in some funding issues ... That's probably something that would be really useful to look at from PHCRED end."

Shauna said that the support of her Division has been an essential part of continuing with effective links. "We have required commitment from the Division that we can at times use some of the core funding for research, which fits under what we're funded for, it fits under quality and evidence based medicine. That's again part of the Division seeing research as core business."

Shauna also had this advice for other Divisions who at the moment don't have links with a tertiary institution, but who wish to embark on this sort of endeavour, "Some of it's being open; again it comes back to either having some expertise within the Division, or contracting some expertise. Some of it's just taking the small steps, I think the main thing is forming partnerships and relationships, each small step that we've taken means that we've built up recognition on what we can offer - from small things bigger things can develop."