Continuous quality improvement and comprehensive primary healthcare: a systems framework to improve service quality and health outcomes

McCalman, Janya, Bailie, Ross, Bainbridge, Roxanne, McPhail-Bell, Karen, Percival, Nikki, Askew, Deborah, Fagan, Ruth, and Tsey, Komla (2018) Continuous quality improvement and comprehensive primary healthcare: a systems framework to improve service quality and health outcomes. Frontiers in Public Health, 6.

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Abstract

Continuous quality improvement (CQI) processes for improving clinical care and health outcomes have been implemented by primary healthcare services, with resultant healthcare impacts. But only 10% to 20% of gain in health outcomes is contributed by healthcare services; a much larger share is determined by social and cultural factors. This perspective paper argues that healthcare and health outcomes can be enhanced through applying CQI as a systems approach to comprehensive primary healthcare. Referring to the Aboriginal and Torres Strait Islander Australian context as an example, the authors provide a systems framework that includes strategies and conditions to facilitate evidence-based and locally-responsive decision making by primary healthcare services. The framework describes the integration of CQI vertically to improve linkages with governments and community members, and horizontally with other sectors to influence the social and cultural determinants of health. Further government and primary healthcare service investment is required to support and extend integration and evaluation of CQI efforts vertically and horizontally.

Item ID: 52791
Item Type: Article (Refereed Research - C1)
Keywords: continuous quality improvement, systems approach, indigenous, primary healthcare, integration, social determinants of health
Additional Information:

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

ISSN: 2296-2565
Funders: National Health and Medical Research Council (NHMRC) Centre Of Research Excellence (CRE)
Projects and Grants: NHMRC CRE AAP1078927, NHMRC Early Career Fellowship APP1113392
Date Deposited: 06 Apr 2018 02:01
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1117 Public Health and Health Services > 111701 Aboriginal and Torres Strait Islander Health @ 40%
11 MEDICAL AND HEALTH SCIENCES > 1117 Public Health and Health Services > 111714 Mental Health @ 10%
11 MEDICAL AND HEALTH SCIENCES > 1117 Public Health and Health Services > 111717 Primary Health Care @ 50%
SEO Codes: 92 HEALTH > 9203 Indigenous Health > 920303 Aboriginal and Torres Strait Islander Health - Health System Performance (incl. Effectiveness of Interventions) @ 60%
92 HEALTH > 9202 Health and Support Services > 920207 Health Policy Evaluation @ 20%
92 HEALTH > 9204 Public Health (excl. Specific Population Health) > 920410 Mental Health @ 20%
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