Responses of Aboriginal and Torres Strait Islander Primary Health-Care Services to Continuous Quality Improvement Initiatives
| Autor: | Cindy Woods, Tania Patrao, Annette Panzera, Ross Bailie, Sandra C. Thompson, Veronica Matthews, Gill Schierhout, Maxwell Mitropoulos, Sarah Larkins |
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| Rok vydání: | 2016 |
| Předmět: |
Torres Strait Islander
Clinical audit medicine.medical_specialty Quality management Best practice best practice Audit Logistic regression Indigenous quality improvement 03 medical and health sciences 0302 clinical medicine quality of care Environmental health medicine 030212 general & internal medicine Aboriginal Original Research Accreditation business.industry lcsh:Public aspects of medicine 030503 health policy & services Australia Public Health Environmental and Occupational Health lcsh:RA1-1270 3. Good health primary health care Family medicine General partnership Public Health 0305 other medical science business Indigenous health services |
| Zdroj: | Frontiers in Public Health Frontiers in Public Health, Vol 3 (2016) |
| ISSN: | 2296-2565 |
| Popis: | Background Indigenous primary health-care (PHC) services participating in continuous quality improvement (CQI) cycles show varying patterns of performance over time. Understanding this variation is essential to scaling up and sustaining quality improvement initiatives. The aim of this study is to examine trends in quality of care for services participating in the ABCD National Research Partnership and describe patterns of change over time and examine health service characteristics associated with positive and negative trends in quality of care. Setting and participants PHC services providing care for Indigenous people in urban, rural, and remote northern Australia that had completed at least three annual audits of service delivery for at least one aspect of care (n = 73). Methods/design Longitudinal clinical audit data from use of four clinical audit tools (maternal health, child health, preventive health, Type 2 diabetes) between 2005 and 2013 were analyzed. Health center performance was classified into six patterns of change over time: consistent high improvement (positive), sustained high performance (positive), decline (negative), marked variability (negative), consistent low performance (negative), and no specific increase or decrease (neutral). Backwards stepwise multiple logistic regression analyses were used to examine the associations between health service characteristics and positive or negative trends in quality of care. Results Trends in quality of care varied widely between health services across the four audit tools. Regression analyses of health service characteristics revealed no consistent statistically significant associations of population size, remoteness, governance model, or accreditation status with positive or negative trends in quality of care. Conclusion The variable trends in quality of care as reflected by CQI audit tools do not appear to be related to easily measurable health service characteristics. This points to the need for a deeper or more nuanced understanding of factors that moderate the effect of CQI on health service performance for the purpose of strengthening enablers and overcoming barriers to improvement. |
| Databáze: | OpenAIRE |
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