TY - JOUR
T1 - Reorienting primary health care for addressing chronic conditions in remote Australia and the South Pacific
T2 - Review of evidence and lessons from an innovative quality improvement process
AU - Gardner, Karen
AU - Bailie, Ross Stewart
AU - Si, Damin
AU - O'DONOGHUE, L
AU - Kennedy, Catherine
AU - LIDDLE, H
AU - Cox, Rhonda
AU - Kwedza, Ru
AU - Fittock, Marea Therese
AU - Hains, Jennifer Anne
AU - Dowden, Michelle
AU - Connors, Christine
AU - Burke, Hugh
AU - Beaver, Carol
PY - 2011/6
Y1 - 2011/6
N2 - This paper reviews what is known about the challenges of implementing quality improvement programs and draws on data from a systematic continuous quality improvement (CQI) project in remote communities in Australia and Fiji, known as Audit and Best practice for Chronic Disease, to synthesise lessons and discuss the potential for broader application in low and middle income countries, including Pacific Island countries and territories. Although a number of systematic reviews have indicated that quality improvement programs can be effective in changing professional practice and improving the quality of care and patient outcomes, little is known about the key ingredients for change or how services use and implement different strategies to achieve improvements. We identify key features of an innovative CQI model and factors related to implementation that support improvement in diabetes service delivery and intermediate outcomes. Requirements for supporting CQI are identified and the potential for wider application discussed. It is argued that the participatory action research approach supports innovation and broad-based change and the evidence it has produced extends the current knowledge base and facilitates the translation of knowledge into action, for both policy and practice.
AB - This paper reviews what is known about the challenges of implementing quality improvement programs and draws on data from a systematic continuous quality improvement (CQI) project in remote communities in Australia and Fiji, known as Audit and Best practice for Chronic Disease, to synthesise lessons and discuss the potential for broader application in low and middle income countries, including Pacific Island countries and territories. Although a number of systematic reviews have indicated that quality improvement programs can be effective in changing professional practice and improving the quality of care and patient outcomes, little is known about the key ingredients for change or how services use and implement different strategies to achieve improvements. We identify key features of an innovative CQI model and factors related to implementation that support improvement in diabetes service delivery and intermediate outcomes. Requirements for supporting CQI are identified and the potential for wider application discussed. It is argued that the participatory action research approach supports innovation and broad-based change and the evidence it has produced extends the current knowledge base and facilitates the translation of knowledge into action, for both policy and practice.
KW - Australia
KW - chronic disease
KW - diabetes mellitus
KW - evidence based practice
KW - health care quality
KW - health service
KW - human
KW - mass communication
KW - organization and management
KW - Pacific islands
KW - participatory research
KW - patient care
KW - review
KW - standard
KW - total quality management
KW - treatment outcome
KW - Chronic Disease
KW - Community-Based Participatory Research
KW - Continuity of Patient Care
KW - Diabetes Mellitus
KW - Diffusion of Innovation
KW - Evidence-Based Practice
KW - Health Services, Indigenous
KW - Humans
KW - Outcome and Process Assessment (Health Care)
KW - Pacific Islands
KW - Quality Improvement
KW - Quality Indicators, Health Care
KW - Total Quality Management
UR - http://www.scopus.com/inward/record.url?scp=79956279485&partnerID=8YFLogxK
U2 - 10.1111/j.1440-1584.2010.01181.x
DO - 10.1111/j.1440-1584.2010.01181.x
M3 - Article
VL - 19
SP - 111
EP - 117
JO - Australian Journal of Rural Health
JF - Australian Journal of Rural Health
SN - 1038-5282
IS - 3
ER -