Part II
Quality improvement is now a driving force in health care, and an essential aspect of primary healthcare service organisation and management at all levels. Put simply, CQI is everyone’s business.
In PHC, this principle is put into action through participatory and inclusive CQI processes (see Part I, Chapter 3). Our approach to CQI in PHC engages all members of the PHC workforce, not just clinicians and their managers. Administrators, receptionists, staff who transport clients, cleaners and others in healthcare support roles may be the key to identifying weaknesses in care systems and the driving force in making positive change. The involvement of clients, their families and carers and community agencies is also key to identifying issues that matter, and harnessing community strengths and resources to improve health.1
PHC organisations with a genuine culture of CQI provide opportunities for all staff to learn and be involved in CQI. They engage clients and communities in improving care. They work with researchers, planners and educators to improve system performance and professional learning.2
In Part I, we defined key concepts in PHC and CQI, and how they come together in efforts to improve health. In this second part of the book, we explain how CQI can be used in a comprehensive approach to PHC. We consider the purpose of CQI data. We describe the quality indicators used in CQI tools and how evidence is used to guide clinical practice, the types and sources of data for CQI, and the principles that guide decisions about generating information to measure care quality. We present a modified CQI cycle for PHC, based on the PDSA cycle, and discuss CQI facilitation. Tools, techniques and tips for facilitating CQI cycles are illustrated with examples and stories from PHC settings, particularly Aboriginal and Torres Strait Islander settings in Australia. The final chapter in Part II discusses what PHC services can do to embed and sustain a culture of CQI.
Bailie, R.S., D. Si, L. O’Donoghue and M. Dowden (2007). Indigenous health: effective and sustainable health services through continuous quality improvement. Medical Journal of Australia 186(10): 525–7. DOI: 10.5694/j.1326-5377.2007.tb01028.x.
Batalden, P.B. and F. Davidoff (2007). What is “quality improvement” and how can it transform healthcare? Quality and Safety in Health Care 16(1): 2–3. DOI: 10.1136/qshc.2006.022046.