A uniform data set for determining outcomes in allied health primary contact services in Australia

Abstract

The project aim was to develop and implement a set of metrics to capture and demonstrate the performance of newly established allied health primary contact services. Selection of the metrics and performance indicators was guided by an existing state-wide data collection system and from a review of the published literature. The metrics were refined after consultation with a working group of health service managers and clinicians. The data collection and reporting framework were developed for use in allied health primary contact services and implemented at public health facilities in Queensland, Australia. The set of metrics consists of 18 process and outcome measures. Patient-reported metrics include the global rating of change scale and patient satisfaction. Service metrics include wait times; referral source; triage category; diagnosis; occasions of service; referrals and investigations initiated; effects; care duration; discharge status; waitlist reinstatement reasons; treatment non-completion reasons; and expedited care. Safety, patient demographics and service improvement metrics were included. The metrics will enable analysis of the effectiveness of allied health primary contact services and will facilitate reporting, advocacy, service improvement, service continuity and research. The metrics are suitable for use by all providers of allied health primary contact services in hospital and primary care settings.

Perceptions of primary care dietitians regarding the collection and use of outcomes data in practice: A qualitative study.

“…The clinical outcome measures identified in this study are consistent with the standardised clinical outcomes assessments recommended in international practice guidelines (33,34) and in other studies of dietetics practice (24,29) . However, this study also identified how some dietitians use that data to demonstrate the relationship between dietitian activity (i.e., number of consultations) and resultant changes in client diet quality, improvement clinical measures (e.g., changes in weight or biochemical parameters) and subsequently satisfaction.…”

“…Primary care dietitians have identified sophisticated processes to identify, generate, retain and expand the services they provide. Although business acumen (30) and aspects of identification and retention of clients to a clinical service has been discussed by others (29,31) , this study has identified the intricate relationship these aspects have to fundamental financial measures to ensure practice viability. Although, most participants had no formalised business training, many had upskilled by seeking specific training or mentoring.…”

“…Standardised outcomes data training is a need recognised by others previously (24,28,29) and a better understanding of the essential elements for such training requires further investigation.…”

“…However, this study also identified how some dietitians use that data to demonstrate the relationship between dietitian activity (i.e., number of consultations) and resultant changes in client diet quality, improvement clinical measures (e.g., changes in weight or biochemical parameters) and subsequently satisfaction. Routine collection of satisfaction indices is evident in other areas of allied health (29,31,35) , including some aspects of dietetics (36) . In this study, the use of such tools in practice was more ad hoc and isolated to specific clinics with specific dietary foci.…”

“…This study demonstrates the need for a framework for critical thinking and decision-making in primary care in Australia, similar to the nutrition care process developed by the then American Dietetic Association in 2003 (34) . The use of outcomes data for benchmarking service effectiveness has been recognised by others (24,29) and would be an essential element of the NDA (10) . Although the exact specifications of such a tool would require further investigation, elements such as ease of use, automation and integration with other systems were identified in this study.…”