The feasibility and potential use of case-tracked client journeys in primary healthcare: a pilot study

OBJECTIVES: To determine the feasibility of case-tracking methods in documenting client journeys at primary healthcare (PHC) services in order to investigate the comprehensiveness of service responses and the experiences of clients. DESIGN: Prospective pilot study. Quantitative and qualitative case management data were collected from staff via questionnaire or interview. SETTING: Five Australian multidisciplinary PHC services were involved including four South Australian state-managed and one Northern Territory Aboriginal community-controlled PHC service. PARTICIPANTS: Clients using services for depression (95) or diabetes (185) at the PHC services were case tracked over a 12-month period to allow construction of client journeys for these two conditions. Clients being tracked were invited to participate in two semi-structured interviews (21) and complete a health log. RESULTS: Though a number of challenges were encountered, the case-tracking methods were useful in documenting the complex nature of client journeys for those with depression or diabetes accessing PHC services and the need to respond to the social determinants of health. A flexible research design was crucial to respond to the needs of staff and changing organisational environments. CONCLUSIONS: The client journeys provided important information about the services’ responses to depression and diabetes, and about aspects unique to comprehensive PHC such as advocacy and work that takes into account the social determinants of health.