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Impact of policy support on uptake of evidence-based continuous quality improvement activities and the quality of care for Indigenous Australians: a comparative case study

OBJECTIVES: To examine the impact of state/territory policy support on (1) uptake of evidence-based continuous quality improvement (CQI) activities and (2) quality of care for Indigenous Australians. DESIGN: Mixed-method comparative case study methodology, drawing on quality-of-care audit data, docu...

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Autores principales: Bailie, Ross, Matthews, Veronica, Larkins, Sarah, Thompson, Sandra, Burgess, Paul, Weeramanthri, Tarun, Bailie, Jodie, Cunningham, Frances, Kwedza, Ru, Clark, Louise
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5639983/
https://www.ncbi.nlm.nih.gov/pubmed/28982818
http://dx.doi.org/10.1136/bmjopen-2017-016626
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author Bailie, Ross
Matthews, Veronica
Larkins, Sarah
Thompson, Sandra
Burgess, Paul
Weeramanthri, Tarun
Bailie, Jodie
Cunningham, Frances
Kwedza, Ru
Clark, Louise
author_facet Bailie, Ross
Matthews, Veronica
Larkins, Sarah
Thompson, Sandra
Burgess, Paul
Weeramanthri, Tarun
Bailie, Jodie
Cunningham, Frances
Kwedza, Ru
Clark, Louise
author_sort Bailie, Ross
collection PubMed
description OBJECTIVES: To examine the impact of state/territory policy support on (1) uptake of evidence-based continuous quality improvement (CQI) activities and (2) quality of care for Indigenous Australians. DESIGN: Mixed-method comparative case study methodology, drawing on quality-of-care audit data, documentary evidence of policies and strategies and the experience and insights of stakeholders involved in relevant CQI programmes. We use multilevel linear regression to analyse jurisdictional differences in quality of care. SETTING: Indigenous primary healthcare services across five states/territories of Australia. PARTICIPANTS: 175 Indigenous primary healthcare services. INTERVENTIONS: A range of national and state/territory policy and infrastructure initiatives to support CQI, including support for applied research. PRIMARY AND SECONDARY OUTCOME MEASURES: (i) Trends in the consistent uptake of evidence-based CQI tools available through a research-based CQI initiative (the Audit and Best Practice in Chronic Disease programme) and (ii) quality of care (as reflected in adherence to best practice guidelines). RESULTS: Progressive uptake of evidence-based CQI activities and steady improvements or maintenance of high-quality care occurred where there was long-term policy and infrastructure support for CQI. Where support was provided but not sustained there was a rapid rise and subsequent fall in relevant CQI activities. CONCLUSIONS: Health authorities should ensure consistent and sustained policy and infrastructure support for CQI to enable wide-scale and ongoing improvement in quality of care and, subsequently, health outcomes. It is not sufficient for improvement initiatives to rely on local service managers and clinicians, as their efforts are strongly mediated by higher system-level influences.
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spelling pubmed-56399832017-10-19 Impact of policy support on uptake of evidence-based continuous quality improvement activities and the quality of care for Indigenous Australians: a comparative case study Bailie, Ross Matthews, Veronica Larkins, Sarah Thompson, Sandra Burgess, Paul Weeramanthri, Tarun Bailie, Jodie Cunningham, Frances Kwedza, Ru Clark, Louise BMJ Open Health Services Research OBJECTIVES: To examine the impact of state/territory policy support on (1) uptake of evidence-based continuous quality improvement (CQI) activities and (2) quality of care for Indigenous Australians. DESIGN: Mixed-method comparative case study methodology, drawing on quality-of-care audit data, documentary evidence of policies and strategies and the experience and insights of stakeholders involved in relevant CQI programmes. We use multilevel linear regression to analyse jurisdictional differences in quality of care. SETTING: Indigenous primary healthcare services across five states/territories of Australia. PARTICIPANTS: 175 Indigenous primary healthcare services. INTERVENTIONS: A range of national and state/territory policy and infrastructure initiatives to support CQI, including support for applied research. PRIMARY AND SECONDARY OUTCOME MEASURES: (i) Trends in the consistent uptake of evidence-based CQI tools available through a research-based CQI initiative (the Audit and Best Practice in Chronic Disease programme) and (ii) quality of care (as reflected in adherence to best practice guidelines). RESULTS: Progressive uptake of evidence-based CQI activities and steady improvements or maintenance of high-quality care occurred where there was long-term policy and infrastructure support for CQI. Where support was provided but not sustained there was a rapid rise and subsequent fall in relevant CQI activities. CONCLUSIONS: Health authorities should ensure consistent and sustained policy and infrastructure support for CQI to enable wide-scale and ongoing improvement in quality of care and, subsequently, health outcomes. It is not sufficient for improvement initiatives to rely on local service managers and clinicians, as their efforts are strongly mediated by higher system-level influences. BMJ Publishing Group 2017-10-05 /pmc/articles/PMC5639983/ /pubmed/28982818 http://dx.doi.org/10.1136/bmjopen-2017-016626 Text en © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted. This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
spellingShingle Health Services Research
Bailie, Ross
Matthews, Veronica
Larkins, Sarah
Thompson, Sandra
Burgess, Paul
Weeramanthri, Tarun
Bailie, Jodie
Cunningham, Frances
Kwedza, Ru
Clark, Louise
Impact of policy support on uptake of evidence-based continuous quality improvement activities and the quality of care for Indigenous Australians: a comparative case study
title Impact of policy support on uptake of evidence-based continuous quality improvement activities and the quality of care for Indigenous Australians: a comparative case study
title_full Impact of policy support on uptake of evidence-based continuous quality improvement activities and the quality of care for Indigenous Australians: a comparative case study
title_fullStr Impact of policy support on uptake of evidence-based continuous quality improvement activities and the quality of care for Indigenous Australians: a comparative case study
title_full_unstemmed Impact of policy support on uptake of evidence-based continuous quality improvement activities and the quality of care for Indigenous Australians: a comparative case study
title_short Impact of policy support on uptake of evidence-based continuous quality improvement activities and the quality of care for Indigenous Australians: a comparative case study
title_sort impact of policy support on uptake of evidence-based continuous quality improvement activities and the quality of care for indigenous australians: a comparative case study
topic Health Services Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5639983/
https://www.ncbi.nlm.nih.gov/pubmed/28982818
http://dx.doi.org/10.1136/bmjopen-2017-016626
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