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Some publications from the CRE in Integrated Quality Improvement

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    6 July 2017

    Laycock A, Bailie J, et al.  Interactive dissemination: engaging stakeholders in the use of aggregated quality improvement data for system-wide change in Australian Indigenous primary health care. http://journal.frontiersin.org/article/10.3389/fpubh.2016.00084/full 

    How can we engage stakeholders to co-produce and use evidence for wide scale improvement in quality of primary care? This paper describes a wide-scale interactive strategy used to widely disseminate aggregated quality improvement data collected in important areas of primary healthcare. Through online reporting and feedback, stakeholders in a wide range of roles and organisations interpret the data to identify priority gaps in care, what hinders or supports improvement, and strategies for system change to improve care. 


     Bailie J, Laycock A, et al. System level action required for wide-scale improvement in quality of primary health care: synthesis of feedback from an interactive process to promote dissemination and use of aggregated quality of care data


    What are the common barriers, enablers and strategies to improving health outcomes in Indigenous chronic illness care and child health?  Stakeholders interpreted aggregated quality improvement data on Indigenous chronic illness care and child health, enabling the research team to identify important ‘drivers’ and strategies for better health outcomes.  These included effective staff recruitment and retention; staff capacity to deliver high quality care; effective use of clinical information systems and tools, use of quality improvement processes and data based decision-making; and a high level of community involvement in primary healthcare.


    Percival N, O’Donoghue L et al. Improving health promotion using quality improvement techniques in Australian Indigenous Primary Health Care http://dx.doi.org/10.3389/fpubh.2016.00053  Can we improve health promotion by adopting a quality improvement approach? This paper demonstrates that using a CQI processes can support improvement in evidence based health promotion and in health centre systems in the Indigenous primary health care context. Broader engagement of management, senior staff and members of the local community is needed to address barriers and sustain improvements in health promotion.


    Bailie C, Matthews V et al. Determinants and Gaps in Preventive Care Delivery for Indigenous Australians: A Cross-sectional Analysis. http://dx.doi.org/10.3389/fpubh.2016.00034

    How well are health services delivering preventive care services to Indigenous communities? This paper describes levels of delivery of preventive health care services for Indigenous people. It identifies gaps in preventive care and suggests ways to reduce the wide variation in quality of care between health centres and improve poor follow-up of abnormal findings.


     Vasant B, Matthews V et al. Wide Variation in Absolute Cardiovascular Risk Assessment in Aboriginal and Torres Strait Islander People with Type 2 Diabetes. http://dx.doi.org/10.3389/fpubh.2016.00037 How are health services going with the delivery and recording of absolute cardiovascular risk assessment (CVRA)? What major factors influence that service delivery? The authors found wide variation in the delivery of CVRA to Indigenous people with diabetes. The majority of assessments were conducted in the Northern Territory, where health systems factors, including an electronic CVRA calculator and a reporting process, may have facilitated delivery of CVRAs.


    Ralph A, Read C et al. Improving delivery of secondary prophylaxis for rheumatic heart disease in remote Indigenous communities: study protocol for a stepped-wedge randomised trial.

    http://trialsjournal.biomedcentral.com/articles/10.1186/s13063-016-1166-y This paper describes the protocol for the first randomised trial internationally to test a model of care to improve delivery of secondary prophylaxis for acute rheumatic fever and rheumatic heart disease. The trial will be conducted in the Northern Territory.


    Larkins S, Woods C et al. Responses of Aboriginal and Torres Strait Islander Primary Health-Care Services to Continuous Quality Improvement Initiatives. http://dx.doi.org/10.3389/fpubh.2015.00288 Are particular health service characteristics linked with positive or negative trends in quality of care? This study examined trends in quality of care and patterns of change over time for services participating in the ABCD National Research Partnership.  Trends did not appear to relate to health service characteristics that could be easily measured. The findings point to the need for a deeper understanding of factors that moderate the effect of CQI on health service performance, so that health services can strengthen enablers and overcome barriers to improving care.