Health service changes to address diabetes in pregnancy in a complex setting

perspectives of health professionals

Renae Kirkham, Jacqueline Anne Boyle, Cherie Whitbread, Michelle Dowden, C CONNORS, Sumaria Corpus, Leisa Mccarthy, Jeremy Oats, McIntyre Harold David, Elizabeth Moore, Kerin O’Dea, A Brown, Louise Maple-Brown

Research output: Contribution to journalArticleResearchpeer-review

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Abstract

Background: Australian Aboriginal and Torres Strait Islander women have high rates of gestational and pre-existing type 2 diabetes in pregnancy. The Northern Territory (NT) Diabetes in Pregnancy Partnership was established to enhance systems and services to improve health outcomes. It has three arms: a clinical register, developing models of care and a longitudinal birth cohort. This study used a process evaluation to report on health professional’s perceptions of models of care and related quality improvement activities since the implementation of the Partnership.

Methods: Changes to models of care were documented according to goals and aims of the Partnership and reviewed annually by the Partnership Steering group. A ‘systems assessment tool’ was used to guide six focus groups (49
healthcare professionals). Transcripts were coded and analysed according to pre-identified themes of orientation and guidelines, education, communication, logistics and access, and information technology.

Results: Key improvements since implementation of the Partnership include: health professional relationships, communication and education; and integration of quality improvement activities. Focus groups with 49 health professionals provided in depth information about how these activities have impacted their practice and models of care for diabetes in pregnancy. Co-ordination of care was reported to have improved, however it was also identified as an opportunity for further development. Recommendations included a central care coordinator, better integration of information technology systems and ongoing comprehensive quality improvement processes.

Conclusions: The Partnership has facilitated quality improvement through supporting the development of improved systems that enhance models of care. Persisting challenges exist for delivering care to a high risk population however
improvements in formal processes and structures, as demonstrated in this work thus far, play an important role in work towards improving health outcomes.
Original languageEnglish
Article number524
Pages (from-to)1-12
Number of pages12
JournalBMC Health Services Research
Volume17
Issue number524
DOIs
Publication statusPublished - 3 Aug 2017

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Pregnancy in Diabetics
Health Services
Quality Improvement
Health
Focus Groups
Communication
Northern Territory
Technology
Education
Information Systems
Type 2 Diabetes Mellitus
Parturition
Guidelines
Pregnancy
Population

Cite this

Kirkham, Renae ; Boyle, Jacqueline Anne ; Whitbread, Cherie ; Dowden, Michelle ; CONNORS, C ; Corpus, Sumaria ; Mccarthy, Leisa ; Oats, Jeremy ; Harold David, McIntyre ; Moore, Elizabeth ; O’Dea, Kerin ; Brown, A ; Maple-Brown, Louise. / Health service changes to address diabetes in pregnancy in a complex setting : perspectives of health professionals. In: BMC Health Services Research. 2017 ; Vol. 17, No. 524. pp. 1-12.
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abstract = "Background: Australian Aboriginal and Torres Strait Islander women have high rates of gestational and pre-existing type 2 diabetes in pregnancy. The Northern Territory (NT) Diabetes in Pregnancy Partnership was established to enhance systems and services to improve health outcomes. It has three arms: a clinical register, developing models of care and a longitudinal birth cohort. This study used a process evaluation to report on health professional’s perceptions of models of care and related quality improvement activities since the implementation of the Partnership.Methods: Changes to models of care were documented according to goals and aims of the Partnership and reviewed annually by the Partnership Steering group. A ‘systems assessment tool’ was used to guide six focus groups (49healthcare professionals). Transcripts were coded and analysed according to pre-identified themes of orientation and guidelines, education, communication, logistics and access, and information technology.Results: Key improvements since implementation of the Partnership include: health professional relationships, communication and education; and integration of quality improvement activities. Focus groups with 49 health professionals provided in depth information about how these activities have impacted their practice and models of care for diabetes in pregnancy. Co-ordination of care was reported to have improved, however it was also identified as an opportunity for further development. Recommendations included a central care coordinator, better integration of information technology systems and ongoing comprehensive quality improvement processes.Conclusions: The Partnership has facilitated quality improvement through supporting the development of improved systems that enhance models of care. Persisting challenges exist for delivering care to a high risk population howeverimprovements in formal processes and structures, as demonstrated in this work thus far, play an important role in work towards improving health outcomes.",
author = "Renae Kirkham and Boyle, {Jacqueline Anne} and Cherie Whitbread and Michelle Dowden and C CONNORS and Sumaria Corpus and Leisa Mccarthy and Jeremy Oats and {Harold David}, McIntyre and Elizabeth Moore and Kerin O’Dea and A Brown and Louise Maple-Brown",
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day = "3",
doi = "10.1186/s12913-017-2478-7",
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Kirkham, R, Boyle, JA, Whitbread, C, Dowden, M, CONNORS, C, Corpus, S, Mccarthy, L, Oats, J, Harold David, M, Moore, E, O’Dea, K, Brown, A & Maple-Brown, L 2017, 'Health service changes to address diabetes in pregnancy in a complex setting: perspectives of health professionals', BMC Health Services Research, vol. 17, no. 524, 524, pp. 1-12. https://doi.org/10.1186/s12913-017-2478-7

Health service changes to address diabetes in pregnancy in a complex setting : perspectives of health professionals. / Kirkham, Renae; Boyle, Jacqueline Anne; Whitbread, Cherie; Dowden, Michelle; CONNORS, C; Corpus, Sumaria; Mccarthy, Leisa; Oats, Jeremy; Harold David, McIntyre; Moore, Elizabeth; O’Dea, Kerin; Brown, A; Maple-Brown, Louise.

In: BMC Health Services Research, Vol. 17, No. 524, 524, 03.08.2017, p. 1-12.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Health service changes to address diabetes in pregnancy in a complex setting

T2 - perspectives of health professionals

AU - Kirkham, Renae

AU - Boyle, Jacqueline Anne

AU - Whitbread, Cherie

AU - Dowden, Michelle

AU - CONNORS, C

AU - Corpus, Sumaria

AU - Mccarthy, Leisa

AU - Oats, Jeremy

AU - Harold David, McIntyre

AU - Moore, Elizabeth

AU - O’Dea, Kerin

AU - Brown, A

AU - Maple-Brown, Louise

PY - 2017/8/3

Y1 - 2017/8/3

N2 - Background: Australian Aboriginal and Torres Strait Islander women have high rates of gestational and pre-existing type 2 diabetes in pregnancy. The Northern Territory (NT) Diabetes in Pregnancy Partnership was established to enhance systems and services to improve health outcomes. It has three arms: a clinical register, developing models of care and a longitudinal birth cohort. This study used a process evaluation to report on health professional’s perceptions of models of care and related quality improvement activities since the implementation of the Partnership.Methods: Changes to models of care were documented according to goals and aims of the Partnership and reviewed annually by the Partnership Steering group. A ‘systems assessment tool’ was used to guide six focus groups (49healthcare professionals). Transcripts were coded and analysed according to pre-identified themes of orientation and guidelines, education, communication, logistics and access, and information technology.Results: Key improvements since implementation of the Partnership include: health professional relationships, communication and education; and integration of quality improvement activities. Focus groups with 49 health professionals provided in depth information about how these activities have impacted their practice and models of care for diabetes in pregnancy. Co-ordination of care was reported to have improved, however it was also identified as an opportunity for further development. Recommendations included a central care coordinator, better integration of information technology systems and ongoing comprehensive quality improvement processes.Conclusions: The Partnership has facilitated quality improvement through supporting the development of improved systems that enhance models of care. Persisting challenges exist for delivering care to a high risk population howeverimprovements in formal processes and structures, as demonstrated in this work thus far, play an important role in work towards improving health outcomes.

AB - Background: Australian Aboriginal and Torres Strait Islander women have high rates of gestational and pre-existing type 2 diabetes in pregnancy. The Northern Territory (NT) Diabetes in Pregnancy Partnership was established to enhance systems and services to improve health outcomes. It has three arms: a clinical register, developing models of care and a longitudinal birth cohort. This study used a process evaluation to report on health professional’s perceptions of models of care and related quality improvement activities since the implementation of the Partnership.Methods: Changes to models of care were documented according to goals and aims of the Partnership and reviewed annually by the Partnership Steering group. A ‘systems assessment tool’ was used to guide six focus groups (49healthcare professionals). Transcripts were coded and analysed according to pre-identified themes of orientation and guidelines, education, communication, logistics and access, and information technology.Results: Key improvements since implementation of the Partnership include: health professional relationships, communication and education; and integration of quality improvement activities. Focus groups with 49 health professionals provided in depth information about how these activities have impacted their practice and models of care for diabetes in pregnancy. Co-ordination of care was reported to have improved, however it was also identified as an opportunity for further development. Recommendations included a central care coordinator, better integration of information technology systems and ongoing comprehensive quality improvement processes.Conclusions: The Partnership has facilitated quality improvement through supporting the development of improved systems that enhance models of care. Persisting challenges exist for delivering care to a high risk population howeverimprovements in formal processes and structures, as demonstrated in this work thus far, play an important role in work towards improving health outcomes.

U2 - 10.1186/s12913-017-2478-7

DO - 10.1186/s12913-017-2478-7

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VL - 17

SP - 1

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JO - BMC Health Services Research

JF - BMC Health Services Research

SN - 1472-6963

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