Sustained participation in annual continuous quality improvement activities improves quality of care for Aboriginal and Torres Strait Islander children

McAullay, Daniel; McAuley, Kimberley; Bailie, Ross; Mathews, Veronica; Jacoby, Peter; Gardner, Karen; Sibthorpe, Beverly; Strobel, Natalie; Edmond, Karen

doi:10.1111/jpc.13673

Cited by 18 publications

(18 citation statements)

References 23 publications

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“…Improved delivery of health assessments over several CQI cycles may also be explained by a general trend of increasing delivery of health assessments, and investments in the promotion of health assessments, such as through the Indigenous Chronic Disease Package (Bailie et al 2013). Improved adherence to best practice care being associated with sustained CQI is consistent with other research (Matthews et al 2014;Bailie et al 2017;McAullay et al 2018). There is, however, more scope for further improvement in the delivery of health assessments to people with no identified chronic disease.…”

Section: Lesson 2 Improved Levels Of Delivery Of Indigenous-specificsupporting

confidence: 80%

Emerging evidence of the value of health assessments for Aboriginal and Torres Strait Islander people in the primary healthcare setting

Bailie

Laycock

Matthews

et al. 2019

Aust. J. Prim. Health

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The launch of the third edition of the National guide to preventive health assessment for Aboriginal and Torres Strait Islander people in March 2018 heralds a renewed commitment to improving the delivery of preventive care, and should reinvigorate discussions on the effectiveness of Indigenous-specific health assessments and how best to implement them. A substantial body of evidence on adherence to guideline-recommended care has been generated through a research-based continuous quality improvement (CQI) initiative conducted between 2010 and 2014. The research, which involved clinical audits of more than 17000 client records and 119 systems assessments relating to preventive care in 137 Indigenous primary healthcare centres across Australia, shows that a structured CQI program can improve the delivery of preventive health assessments and use of evidence-based guidelines. However, program implementation has also seen the emergence of new challenges. This paper reflects on four major lessons from this collaborative program of applied research that will lead to more effective delivery of preventive care.

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Section: Lesson 2 Improved Levels Of Delivery Of Indigenous-specificsupporting

confidence: 80%

Emerging evidence of the value of health assessments for Aboriginal and Torres Strait Islander people in the primary healthcare setting

Bailie

Laycock

Matthews

et al. 2019

Aust. J. Prim. Health

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“…Based on the reporting of child health indicators, CQi has improved the delivery of many child health milestones and brief interventions over time. 4 as a result, we anticipated that 50% of records would achieve our PoCis. However, social and emotional wellbeing (32%) fell well short of this.…”

Section: Discussionmentioning

confidence: 99%

“…internationally, the health and social wellbeing of young indigenous children are of major concern. 1 in australia, young aboriginal and torres Strait islander children (hereafter 'indigenous') remain a high-risk group for experiencing adverse health and social outcomes such as otitis media, 2 child neurodevelopment delay 3 and birth outcomes such as prematurity and low birthweight 4 compared to non-indigenous australian children. Despite this, improvements in primary health care, coupled with major policy and funding changes, has resulted in an increase of important VOLUME 10 • NUMBER 3 • SEptEMBER 2018 J OUrNal OF PrimarY HealtH Care child health indicators including child health assessments and vaccination coverage.…”

Section: Introductionmentioning

confidence: 99%

“…Despite this, improvements in primary health care, coupled with major policy and funding changes, has resulted in an increase of important VOLUME 10 • NUMBER 3 • SEptEMBER 2018 J OUrNal OF PrimarY HealtH Care child health indicators including child health assessments and vaccination coverage. [4][5][6][7] Primary health care plays an important role in the delivery of community and preventive health services. However, providing high-quality care remains an ongoing challenge.…”

Section: Introductionmentioning

confidence: 99%

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Understanding the structure and processes of primary health care for young indigenous children

et al. 2018

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INTRODUCTION Primary health care organisations need to continuously reform to more effectively address current health challenges, particularly for vulnerable populations. There is growing evidence that optimal health service structures are essential for producing positive outcomes. AIM To determine if there is an association between process of care indicators (PoCIs) for important young indigenous child health and social issues and: (i) primary health-care service and child characteristics; and (ii) organisational health service structures. METHODS This was a cross-sectional study of 1554 clinical child health audits and associated system assessments from 74 primary care services from 2012 to 2014. Composite PoCIs were developed for social and emotional wellbeing, child neurodevelopment and anaemia. Crude and adjusted logistic regression models were fitted, clustering for health services. Odds ratios and 95% confidence intervals were derived. RESULTS Overall, 32.0% (449) of records had a social and emotional wellbeing PoCI, 56.6% (791) had an anaemia PoCI and 49.3% (430) had a child neurodevelopment PoCI. Children aged 12–23 months were significantly more likely to receive all PoCIs compared to children aged 24–59 months. For every one point increase in assessment scores for team structure and function (aOR 1.14, 95% CI 1.01–1.27) and care planning (aOR 1.14, 95% CI 1.01–1.29) items, there was a 14% greater odds of a child having an anaemia PoCI. Social and emotional wellbeing and child neurodevelopment PoCIs were not associated with system assessment scores. DISCUSSION Ensuring young indigenous children aged 24–59 months are receiving quality care for important social and health indicators is a priority. Processes of care and organisational systems in primary care services are important for the optimal management of anaemia in indigenous children.

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“…Fifty-nine centres that had completed three or more audit cycles over six years were included. Statistically significant improvement in coverage for large numbers of children occurred in the third and later cycles, and was attributed to CQI participation (see figure3.1) by the authors, albeit acknowledging the greater focus on staff training 51.…”

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confidence: 86%

Relating well to people: a mixed-methods evaluation of preventive care implementation for Aboriginal and Torres Strait Islander people in mainstream, urban general practice

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This thesis is composed of my original work, and contains no material previously published or written by another person except where due reference has been made in the text. I have clearly stated the contribution by others to jointly-authored works that I have included in my thesis. I have clearly stated the contribution of others to my thesis as a whole, including statistical assistance, survey design, data analysis, significant technical procedures, professional editorial advice, financial support and any other original research work used or reported in my thesis. The content of my thesis is the result of work I have carried out since the commencement of my higher degree by research candidature and does not include a substantial part of work that has been submitted to qualify for the award of any other degree or diploma in any university or other tertiary institution. I have clearly stated which parts of my thesis, if any, have been submitted to qualify for another award. I acknowledge that an electronic copy of my thesis must be lodged with the University Library and, subject to the policy and procedures of The University of Queensland, the thesis be made available for research and study in accordance with the Copyright Act 1968 unless a period of embargo has been approved by the Dean of the Graduate School.

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Sustained participation in annual continuous quality improvement activities improves quality of care for Aboriginal and Torres Strait Islander children

Cited by 18 publications

References 23 publications

Emerging evidence of the value of health assessments for Aboriginal and Torres Strait Islander people in the primary healthcare setting

Emerging evidence of the value of health assessments for Aboriginal and Torres Strait Islander people in the primary healthcare setting

Understanding the structure and processes of primary health care for young indigenous children

Relating well to people: a mixed-methods evaluation of preventive care implementation for Aboriginal and Torres Strait Islander people in mainstream, urban general practice

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