Stoneman, A and Atkinson, D and Davey, M and Marley, JV, Quality improvement in practice: improving diabetes care and patient outcomes in Aboriginal Community Controlled Health Services, BMC Health Services Research, 14 Article 481. ISSN 1472-6963 (2014) [Refereed Article]
Copyright 2014 Stoneman et al. Licenced under Creative Commons Attribution 4.0(CC BY 4.0) http://creativecommons.org/licenses/by/4.0/
Methods: Retrospective audit of records for Aboriginal and Torres Strait Islander primary care patients aged ≥15 years with a confirmed diagnosis of T2DM at four Kimberley ACCHSs from 1 July 2011 to 30 June 2012. Interviews with health service staff and focus group discussions with patients post audit.
Results: A total of 348 patients from the four ACCHSs were included in the study. Clinical care activities were generally high across three of the four health services (at least 71% of patients had cholesterol recorded, 89% blood pressure, 84% HbA1c). Patients from DAHS had lower median cholesterol levels (4.4 mmol/L) and the highest proportion of patients meeting clinical targets for HbA1c (31% v 16% ACCHS-3; P = 0.02). Features that facilitated good care included clearly defined staff roles for diabetes management, support and involvement of Aboriginal Health Workers, efficient recall systems, and well-coordinated allied health services. Effective CQI features included seamless and timely data collection, local ownership of the process, openness to admitting deficiencies and willingness to embrace change.
Conclusions: Well-designed health care delivery and CQI systems, with a strong sense of ownership over diabetes management led to increased service delivery rates and improved clinical outcome measures in ACCHSs. Locally run CQI processes may be more responsive to individual health services and more sustainable than externally driven systems.
|Item Type:||Refereed Article|
|Keywords:||indigenous, Aboriginal, Torres Strait Islander, diabetes, quality improvement cycles, primary health care|
|Research Division:||Medical and Health Sciences|
|Research Group:||Public Health and Health Services|
|Research Field:||Health and Community Services|
|Objective Group:||Indigenous Health|
|Objective Field:||Aboriginal and Torres Strait Islander Health - Health System Performance (incl. Effectiveness of Interventions)|
|Author:||Stoneman, A (Associate Professor Alice Stoneman)|
|Author:||Davey, M (Dr Maureen Davey)|
|Web of Science® Times Cited:||6|
|Deposited By:||Medicine (Discipline)|
|Downloads:||419 View Download Statistics|
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