Core concepts in primary health care and continuous quality improvement

All people have the right to high-quality health care, delivered through high-quality health systems. High-quality health systems are those that consistently deliver care that improves or maintains health. They are equitable, valued and trusted by people and are responsive to changing population needs.1 For most people, the first point of access to the health system is through primary health care (PHC).

Not all health care is high quality and one way of improving the quality of PHC is to use continuous quality improvement (CQI). CQI has been widely used in the healthcare system for more than two decades, and in 2005 the World Health Organization (WHO) identified quality improvement as one of the five core competencies needed by all of the healthcare workforce to meet the challenge of chronic illness care in the 21st century.2 Despite considerable developments in the theory and practice of CQI,3 there is no detailed explanation of how its concepts can be applied in the context of comprehensive PHC. This book aims to address this need and to support the PHC workforce, including policymakers, funders, health services and support organisations, in understanding and applying CQI.

Part I explains the concepts that underpin CQI approaches in PHC. We define comprehensive PHC and population health, and explain key concepts with reference to international and Australian contexts. Quality and CQI are defined and the origins of CQI are traced to explain some fundamental concepts and characteristics, how they translate in PHC settings and why CQI approaches in PHC differ from other parts of the health system. We focus on CQI research and practice in Aboriginal and Torres Strait Islander health settings in Australia to argue the importance of a comprehensive systems approach to CQI for improving PHC and healthcare equity.

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