Strengthening primary health care: achieving health gains in a remote region of Australia

Reeve, Carole; Humphreys, John Stirling; Wakerman, John; Carter, Maureen; Carroll, Vicki; Reeve, David

doi:10.5694/mja14.00894

Cited by 36 publications

(104 citation statements)

References 16 publications

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“…Only with strong community engagement in all aspects of health service provision will services be congruent with needs and expectations, especially in Indigenous communities, in which cultural safety considerations are foremost. Evidence from studies in remote Western Australia and rural Victoria demonstrated the health benefits of direct community involvement, and showed how a community‐led, culturally safe PHC service significantly increased access for both preventive and acute health needs …”

Section: Evidence‐based Approaches To Rural Health Problemsmentioning

confidence: 99%

“Better health in the bush”: why we urgently need a national rural and remote health strategy

Wakerman

Humphreys²

2019

Medical Journal of Australia

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Section: Evidence‐based Approaches To Rural Health Problemsmentioning

confidence: 99%

“Better health in the bush”: why we urgently need a national rural and remote health strategy

Wakerman

Humphreys²

2019

Medical Journal of Australia

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Section: Establish Formal Agreements To Support the Strategic Planmentioning

confidence: 99%

“…For example, in remote Western Australia, a partnership agreement between an ACCHS and state government health services was associated with a reversal of the increasing trend in hospital emergency department attendances among other substantial health improvements in only 6 years (Box 2). 12 Partnership agreements between PHNs, ACCHSs and other agencies should support Aboriginal leadership, quality care, accountability and patient-centredness, and should be formalised from non-binding memoranda of understanding to binding contracts (Box 1 and Box 2) to support a long term vision for core activity that is flexible to local priorities.…”

Section: Establish Formal Agreements To Support the Strategic Planmentioning

confidence: 99%

Primary Health Networks and Aboriginal and Torres Strait Islander health

Couzos

Delaney-Thiele²,

Page

2016

Medical Journal of Australia

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The Australian Government has established that the health of Aboriginal and Torres Strait Islander peoples is a priority for the newly established 31 Primary Health Networks (PHNs). Efforts to reduce the high hospitalisation rates of Aboriginal people will require PHNs to build formal participatory structures with Aboriginal health organisations to support best practice service models. There are precedents as to how PHNs can build formal partnerships with Aboriginal community controlled health services (ACCHSs), establish an Aboriginal and Torres Strait Islander steering committee to guide strategic plan development, and work towards optimising comprehensive primary care. All health services within PHN boundaries can be supported to systematically and strategically improve their responsiveness to Aboriginal and Torres Strait Islander people by assessing systems of care, adopting best practice models, embedding quality assurance activity, and participating in performance reporting. PHNs can be guided to adopt an Aboriginal and Torres Strait Islander-specific quality improvement framework, agree to local performance measures, review specialist and other outreach services to better integrate with primary health care, enhance the cultural competence of services, and measure and respond to progress in reducing potentially preventable hospitalisations. Through collaborations and capacity building, PHNs can transition certain health services towards greater Aboriginal community control. These proposals may assist policy makers to develop organisational performance reporting on PHN efforts to close the gap in Aboriginal health disparity.

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“…• Community-based reform: Four of the seven evaluations reported on community-based services: two innovative comprehensive PHC services -one in a remote Western Australian Indigenous community [9][10][11] and the other in a small rural community in Victoria 7,8 , and one aged care service and one social and emotional wellbeing service -in remote Indigenous communities from the Northern Territory and Kimberley region of Western Australia respectively 12,13 .…”

Section: Contextmentioning

confidence: 99%

“…• Regional service reform: Two regional outreach service models were evaluated: provision of diabetes cycle of care to patients through the Royal Flying Doctor Service (South Eastern Section) network of fly-in fly-out clinics in far west New South Wales (NSW) 14,15 , and a virtual outreach, telehealth service established by a local health district (LHD) to improve access to emergency mental healthcare across western NSW [16][17][18][19][20] .…”

Section: Contextmentioning

confidence: 99%

What do evaluations tell us about implementing new models in rural and remote primary health care? Findings from a narrative analysis of seven service evaluations conducted by an Australian Centre of Research Excellence

Lyle

Saurman

Kirby

et al. 2017

Rural Remote Health

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A B S T R A C TIntroduction: A Centre of Research Excellence (CRE) in Rural and Remote Primary Healthcare was established in 2012 with the goal of providing evidence to inform policy development to increase equity of access to quality health care and the identification of services that should be available to the diverse communities characterising Australia. This article reports on the key findings from seven CRE service evaluations to better understand what made these primary health care (PHC) models work where they worked, and why. Methods: We conducted a narrative synthesis of 15 articles reporting on seven CRE service evaluations of different PHC models published between 2012 and 2015.Results: Three different contexts for PHC reform were evaluated: community, regional and clinic based. Themes identified were factors that enabled changes to PHC delivery, processes that supported services to improve access to PHC and requirements for © D Lyle, E Saurman, S Kirby, D Jones, J Humphreys, J Wakerman 2017. A Licence to publish this material has been given to James Cook University, http://www.jcu.edu.au 2 service adaptation to promote sustainability. In both Indigenous and mainstream community settings, the active engagement with local communities, and their participation in, or leadership of, shared decision-making was reported across the three themes. In addition, local governance processes, informed by service activity and impact data, enabled these service changes to be sustained over time. The considerations were different for the outreach, regional and clinic services that relied on internal processes to drive change because they did not require the cooperation of multiple organisations to succeed. Conclusions:The review highlighted that shared decision-making, negotiation and consultation with communities is important and should be used to promote feasible strategies that improve access to community-based PHC services. There is a growing need for service evaluations to report on the feasibility, acceptability and fit of successful service models within context, in addition to reach and effectiveness in order to provide evidence for local dissemination, adaption and implementation strategies.

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Strengthening primary health care: achieving health gains in a remote region of Australia

Cited by 36 publications

References 16 publications

“Better health in the bush”: why we urgently need a national rural and remote health strategy

“Better health in the bush”: why we urgently need a national rural and remote health strategy

Primary Health Networks and Aboriginal and Torres Strait Islander health

What do evaluations tell us about implementing new models in rural and remote primary health care? Findings from a narrative analysis of seven service evaluations conducted by an Australian Centre of Research Excellence

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