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Woods C, Carlisle K, Larkins S, et al. Exploring Systems That Support Good Clinical Care in Indigenous Primary Health-care Services: A Retrospective Analysis of Longitudinal Systems Assessment Tool Data from High-Improving Services. Front Public Health. 2017;5:45doi: 10.3389/fpubh.2017.00045.
Woods, C., Carlisle, K., Larkins, S., Thompson, S. C., Tsey, K., Matthews, V., & Bailie, R. (2017). Exploring Systems That Support Good Clinical Care in Indigenous Primary Health-care Services: A Retrospective Analysis of Longitudinal Systems Assessment Tool Data from High-Improving Services. Frontiers in public health, 545. https://doi.org/10.3389/fpubh.2017.00045
Woods, Cindy, et al. "Exploring Systems That Support Good Clinical Care in Indigenous Primary Health-care Services: A Retrospective Analysis of Longitudinal Systems Assessment Tool Data from High-Improving Services." Frontiers in public health vol. 5 (2017): 45. doi: https://doi.org/10.3389/fpubh.2017.00045
Woods C, Carlisle K, Larkins S, Thompson SC, Tsey K, Matthews V, Bailie R. Exploring Systems That Support Good Clinical Care in Indigenous Primary Health-care Services: A Retrospective Analysis of Longitudinal Systems Assessment Tool Data from High-Improving Services. Front Public Health. 2017 Mar 24;5:45. doi: 10.3389/fpubh.2017.00045. eCollection 2017. PMID: 28393064; PMCID: PMC5364947.
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Front Public Health. 2017 Mar 24;5:45. doi: 10.3389/fpubh.2017.00045. eCollection 2017.

Exploring Systems That Support Good Clinical Care in Indigenous Primary Health-care Services: A Retrospective Analysis of Longitudinal Systems Assessment Tool Data from High-Improving Services.

Frontiers in public health

Cindy Woods, Karen Carlisle, Sarah Larkins, Sandra Claire Thompson, Komla Tsey, Veronica Matthews, Ross Bailie

Affiliations

  1. School of Health, University of New England , Armidale, NSW , Australia.
  2. College of Medicine and Dentistry, James Cook University, Townsville, QLD, Australia; Anton Breinl Research Centre for Health Systems Strengthening, James Cook University, Townsville, QLD, Australia; Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, QLD, Australia.
  3. Western Australian Centre for Rural Health, University of Western Australia , Geraldton, WA , Australia.
  4. Anton Breinl Research Centre for Health Systems Strengthening, James Cook University, Townsville, QLD, Australia; Cairns Institute and College of Art, Society and Education, James Cook University, Cairns, QLD, Australia.
  5. Menzies School of Health Research , Brisbane, QLD , Australia.
  6. University Centre for Rural Health , Lismore, NSW , Australia.

PMID: 28393064 PMCID: PMC5364947 DOI: 10.3389/fpubh.2017.00045

Abstract

BACKGROUND: Continuous Quality Improvement is a process for raising the quality of primary health care (PHC) across Indigenous PHC services. In addition to clinical auditing using plan, do, study, and act cycles, engaging staff in a process of reflecting on systems to support quality care is vital. The One21seventy Systems Assessment Tool (SAT) supports staff to assess systems performance in terms of five key components. This study examines quantitative and qualitative SAT data from five high-improving Indigenous PHC services in northern Australia to understand the systems used to support quality care.

METHODS: High-improving services selected for the study were determined by calculating quality of care indices for Indigenous health services participating in the Audit and Best Practice in Chronic Disease National Research Partnership. Services that reported continuing high improvement in quality of care delivered across two or more audit tools in three or more audits were selected for the study. Precollected SAT data (from annual team SAT meetings) are presented longitudinally using radar plots for quantitative scores for each component, and content analysis is used to describe strengths and weaknesses of performance in each systems' component.

RESULTS: High-improving services were able to demonstrate strong processes for assessing system performance and consistent improvement in systems to support quality care across components. Key strengths in the quality support systems included adequate and orientated workforce, appropriate health system supports, and engagement with other organizations and community, while the weaknesses included lack of service infrastructure, recruitment, retention, and support for staff and additional costs. Qualitative data revealed clear voices from health service staff expressing concerns with performance, and subsequent SAT data provided evidence of changes made to address concerns.

CONCLUSION: Learning from the processes and strengths of high-improving services may be useful as we work with services striving to improve the quality of care provided in other areas.

Keywords: Indigenous health; primary health care; primary health services; quality improvement; systems improvement

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