Please use this identifier to cite or link to this item: http://docs.prosentient.com.au/prosentientjspui/handle/1/11256
Title: Impact of policy support on uptake of evidence-based continuous quality improvement activities and the quality of care for Indigenous Australians: a comparative case study.
Authors: Bailie, Ross
Matthews, Veronica
Larkins, Sarah
Thompson, Sandra
Burgess, Paul
Weeramanthri, Tarun
Bailie, Jodie
Cunningham, Frances
Kwedza, Ru
Clark, Louise
Affiliation: University Centre for Rural Health-North Coast, School of Rural Health, University of Sydney, Lismore, New South Wales, Australia..
University Centre for Rural Health-North Coast, School of Rural Health, University of Sydney, Lismore, New South Wales, Australia..
College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia..
Western Australian Centre for Rural Health, University of Western Australia, Geraldton, Western Australia, Australia..
Northern Territory Department of Health and Families, Darwin, Australia..
Department of Health, Government of Western Australia, Perth, Western Australia, Australia..
University Centre for Rural Health-North Coast, School of Rural Health, University of Sydney, Lismore, New South Wales, Australia..
Menzies School of Health Research, Charles Darwin University, Brisbane, Australia..
School of Public Health and Community Medicine, University of New South Wales, Sydney, New South Wales, Australia..
Menzies School of Health Research, Charles Darwin University, Brisbane, Australia..
Issue Date: 5-Oct-2017
Citation: BMJ open 2017-10-05; 7(10): e016626
Abstract: To examine the impact of state/territory policy support on (1) uptake of evidence-based continuous quality improvement (CQI) activities and (2) quality of care for Indigenous Australians. Mixed-method comparative case study methodology, drawing on quality-of-care audit data, documentary evidence of policies and strategies and the experience and insights of stakeholders involved in relevant CQI programmes. We use multilevel linear regression to analyse jurisdictional differences in quality of care. Indigenous primary healthcare services across five states/territories of Australia. 175 Indigenous primary healthcare services. A range of national and state/territory policy and infrastructure initiatives to support CQI, including support for applied research. PRIMARY AND SECONDARY OUTCOME MEASURES: (i) Trends in the consistent uptake of evidence-based CQI tools available through a research-based CQI initiative (the Audit and Best Practice in Chronic Disease programme) and (ii) quality of care (as reflected in adherence to best practice guidelines). Progressive uptake of evidence-based CQI activities and steady improvements or maintenance of high-quality care occurred where there was long-term policy and infrastructure support for CQI. Where support was provided but not sustained there was a rapid rise and subsequent fall in relevant CQI activities. Health authorities should ensure consistent and sustained policy and infrastructure support for CQI to enable wide-scale and ongoing improvement in quality of care and, subsequently, health outcomes. It is not sufficient for improvement initiatives to rely on local service managers and clinicians, as their efforts are strongly mediated by higher system-level influences.
URI: http://docs.prosentient.com.au/prosentientjspui/handle/1/11256
DOI: 10.1136/bmjopen-2017-016626
Type: Journal Article
Subjects: Aboriginal and Torres Strait Islander health
continuous quality improvement
health policy
primary health care
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