title: Australian issues in the provision of after-hours primary medical care services in rural communities.
abstract: OBJECTIVE
  In 2003 the Rural Doctors Workforce Agency in South Australia (SA) facilitated the 'SA Rural Hospital After Hours Triage Education and Training Program'. It was designed to improve communication between rural general practitioners (GPs) and nurses undertaking after-hours triage, provide training in triage for rural nurses and develop local collaborative after-hours primary medical care models that can be applied in other settings.
  
  
  METHODS
  The program consisted of a series of three workshops. The first workshop provided an opportunity for GPs and nurses to discuss local issues relating to after-hours primary medical care service delivery. This was followed by a one-day workshop on triage for nurses. A follow-up refresher workshop was conducted approximately six months later.
  
  
  METHODS
  Twenty-three rural communities in SA.
  
  
  METHODS
  Rural GPs and nurses working in rural communities.
  
  
  RESULTS
  This paper reports on the issues highlighted by clinicians in providing after-hours primary medical care in rural and remote communities. These included community expectations, systems of care, scope of practice, private practice/public hospital interface, and medico legal issues.
  
  
  CONCLUSIONS
  The issues facing after-hours health services in rural communities are not new. There are many opportunities for improvement of systems. A formal program including workshops and training has provided a useful forum to commence service improvements.
authors.affiliation: Zeitz Enterprises, South Australia. zeitzk@telstra.com.au
authors.forename: Kathryn
authors.initials: K
authors.lastname: Zeitz
authors.forename: Geri
authors.initials: G
authors.lastname: Malone
authors.forename: Paul
authors.initials: P
authors.lastname: Arbon
authors.forename: Jenny
authors.initials: J
authors.lastname: Fleming
mesh_terms: D039602:After-Hours Care / Q000458:organization & administration*; D003152:Community Health Nursing / Q000458:organization & administration; D003159:Community-Institutional Relations; D006801:Humans; D017146:Models, Organizational; D020380:Needs Assessment; D024802:Nurse's Role; D010348:Patient Care Team / Q000458:organization & administration; D019035:Rural Health Services / Q000458:organization & administration*; D013021:South Australia; D014218:Triage / Q000458:organization & administration