Furthering the quality agenda in Aboriginal community controlled health services: understanding the relationship between accreditation, continuous quality improvement and national key performance indicator reporting

Abstract

Abstract.A rapidly expanding interest in quality in the Aboriginal-community-controlled health sector has led to widespread uptake of accreditation using more than one set of standards, a proliferation of continuous quality improvement programs and the introduction of key performance indicators. As yet, there has been no overarching logic that shows how they relate to each other, with consequent confusion within and outside the sector. We map the three approaches to the Framework for Performance Assessment in Primary Health Care, demonstrating their key differences and complementarity. There needs to be greater attention in both policy and practice to the purposes and alignment of the three approaches if they are to embed a system-wide focus that supports quality improvement at the service level.

Sustained participation in annual continuous quality improvement activities improves quality of care for Aboriginal and Torres Strait Islander children

“…It involves frequent, routine plan‐do‐study‐act cycles that provide a structure for iterative changes to improve the quality of service systems . Importantly, CQI focuses on changing priorities, reflecting the different needs of clients and communities over time …”

“…4 Importantly, CQI focuses on changing priorities, reflecting the different needs of clients and communities over time. 5…”

Indicators for continuous quality improvement for otitis media in primary health care for Aboriginal and Torres Strait Islander children

“…This framework has been successfully used for other indicator development processes, including for the now superseded National Quality and Performance Indicators for Divisions of General Practice. So that the indicators were consistent with the approach of the National Key Performance Indicators, it was agreed by the group that the indicators would all relate to regular clients, as defined by the Australian Institute of Health and Welfare (see http://meteor.aihw.gov.au/content/index.phtml/itemId/43 6653, accessed 1 August 2016) and be confined to Levels 3 and 4 (Sibthorpe et al 2016).…”

“…A soon-to-be-released National CQI Framework for Aboriginal and Torres Strait Islander Primary Health Care identifies regular Plan-Do-Study-Act cycles, as an essential component of continuous quality improvement. Through the development of the National Key Performance Indicators for Aboriginal and Torres Strait Islander primary health care, there are now robust indicators for use by services for continuous quality improvement for antenatal care, immunisations, smoking, alcohol consumption, type 1 and type 2 diabetes, cardiovascular disease and cervical screening (Sibthorpe et al 2016). Separately, indicators have been developed within the community-controlled sector for sexually transmitted infections.…”

Relating well to people: a mixed-methods evaluation of preventive care implementation for Aboriginal and Torres Strait Islander people in mainstream, urban general practice

“…Accreditation and standards provides a longer term influence on organisational structure and processes including practice environment, staffing, information systems and community networking. CQI is internally managed, more directly affecting patient activities and outcomes 46…”