الاثنين، 10 سبتمبر 2012

Improving primary care in Australia through the Australian Primary Care Collaboratives Program: a quality improvement report

Improving primary care in Australia through the Australian Primary Care Collaboratives Program: a quality improvement report -- Knight et al. -- BMJ Quality and Safety Search the BMJ BMJ BMJ Journals BMJ Careers BMJ Learning Evidence Centre doc2doc BMJ Group Search this site

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The international journal of healthcare improvement Online First Current issue Archive About the journal Submit a paper Subscribe Help Online First Current issue Archive Supplements eLetters Topic collections RSS Home > Online First > Article rss BMJ Qual Saf doi:10.1136/bmjqs-2011-000165 Quality improvement report Improving primary care in Australia through the Australian Primary Care Collaboratives Program: a quality improvement reportThis article has been UnlockedFree via Creative Commons: OPEN ACCESS Andrew W Knight1, Claire Caesar2, Dale Ford2, Alison Coughlin2, Colin Frick2
1The Australian Primary Care Collaboratives Program, The Improvement Foundation (Australia), Katoomba, New South Wales, Australia
2The Improvement Foundation (Australia), South Australia, Australia Correspondence to Dr Andrew Walter Knight, The Australian Primary Care Collaboratives Program, The Improvement Foundation (Australia), PO Box 3645 Adelaide South Australia 5000 Australia; awknight{at}aapt.net.au Contributors AK wrote the article. CC, DF, AC and CF provided comments and edited during writing. All authors provided approval to publish.

Accepted 22 May 2012 Published Online First 12 July 2012 Abstract Problem Effective and affordable health systems have good primary care. Access, equity, care of chronic conditions and quality are key priorities in primary care in Australia.

Design A large-scale quality improvement collaborative addressing diabetes, coronary heart disease (CHD), access, chronic obstructive pulmonary disease (COPD), patient self-management, Aboriginal health and diabetes prevention.

Setting General practices and Aboriginal medical services across Australia.

Key Measures for Improvement Sample measures are reported.

Strategy for Change The Improvement Foundation (Australia) adapted collaborative strategies used in the UK. Health service teams attended three workshops, separated by activity periods and followed by 12 months of further work. Teams were supported by local collaborative program managers to make changes and report measures. Services received feedback about improvement compared with their wave.

Effects of Change 1185 health services participated in 13 waves between 2005 and 2011. 83% of Australian divisions of general practice participated, and 262 support staff received quality improvement training. Key measures show improvement in all topics except access. 397?111 patients were on the disease registers of participating health services.

Lessons learnt The collaborative methodology is transferable to primary care in Australia. Results may reflect improved data recording and disease coding, as well as changes in clinical care. Team dynamics and local support are important success factors. Collaboratives are a useful tool in a program of clinical quality improvement. The APCC will work with the new primary healthcare organisations which are part of health reforms in Australia to improve data reporting, improve diabetes care and entrench quality improvement in the emerging environment.

General practice quality improvement Footnotes Funding The Australian Primary Care Collaboratives Program is funded by the Australian Government Department of Health and Ageing and delivered by the Improvement Foundation (Australia) Ltd.

Competing interests None.

Provenance and peer review Not commissioned; externally peer reviewed.

Data sharing statement This article publishes a small indicative subset of the data collected by the APCC Program in the course of its improvement work. The complete dataset is held by the Improvement Foundation and is subject to agreements with participating health services which restrict its use. Researchers wishing to access the data may make direct contact with the Improvement Foundation (Australia).

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/2.0/ and http://creativecommons.org/licenses/by-nc/2.0/legalcode.

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This article has been Unlocked Free via Creative Commons: OPEN ACCESS This Article Abstract Full text PDF All Versions of this Article: bmjqs-2011-000165v1 bmjqs-2011-000165v2 most recent Services Email this link to a friend Alert me when this article is cited Alert me if a correction is posted Alert me when eletters are published Article Usage Statistics Similar articles in this journal Similar articles in PubMed Add article to my folders Download to citation manager Request permissions Add to portfolio Responses Submit a response No responses published Citing articles Load citing article information Citing articles via Scopus Google Scholar Articles by Knight, A. W. Articles by Frick, C. Search for related content PubMed PubMed citation Articles by Knight, A. W. Articles by Frick, C. Related Content Unlocked Load related web page information Social bookmarking Add to CiteULikeCiteULike Add to ConnoteaConnotea Add to DeliciousDelicious Add to DiggDigg Add to FacebookFacebook Add to Google+Google+ Add to MendeleyMendeley Add to RedditReddit Add to TechnoratiTechnorati Add to TwitterTwitter What's this?

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