Part III
Part III describes an approach to implementing continuous quality improvement (CQI) in primary health care (PHC) settings. We have tried and tested this approach over almost two decades and are able to show the data on clinical performance and change over time in a range of Australian Aboriginal and Torres Strait Islander PHC services. It is not the only approach, but it is one for which there is a strong evidence base – stronger than for any other approach to CQI in PHC as far as we are aware. Chapter 9 describes the approach.
Chapters 10 to 19 each focus on an area of PHC that has been identified as a priority in the Aboriginal and Torres Strait Islander PHC context: diabetes prevention and management; preventive health; child health; maternal health; youth health; mental health and wellbeing; cardiovascular disease; rheumatic fever and rheumatic heart disease; sexually transmissible infections; and eye health. Each chapter describes the background and rationale for focusing on the area of care and presents and discusses CQI findings, based on data collected using clinical audit tools. Chapter 14 differs from other chapters as it describes how a youth health audit tool was developed and applied; as a case study, it offers insights and guidance for teams undertaking these processes in areas of PHC with less developed guidelines.
The findings are largely based on CQI data collected between 2005 and 2014, which more than ten years later remain the most recent and comprehensive set of CQI data available in Australia, with ongoing relevance for improving the quality of PHC.