Continuous Quality Improvement and Comprehensive Primary Health Care: A Systems Framework to Improve Service Quality and Health Outcomes

Continuous quality improvement (CQI) processes for improving clinical care and health outcomes have been implemented by primary health-care services, with resultant health-care impacts. But only 10–20% of gain in health outcomes is contributed by health-care services; a much larger share is determin...

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Main Authors: Janya McCalman, Ross Bailie, Roxanne Bainbridge, Karen McPhail-Bell, Nikki Percival, Deborah Askew, Ruth Fagan, Komla Tsey
Format: Article
Language:English
Published: Frontiers Media S.A. 2018-03-01
Series:Frontiers in Public Health
Subjects:
Online Access:http://journal.frontiersin.org/article/10.3389/fpubh.2018.00076/full
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author Janya McCalman
Janya McCalman
Ross Bailie
Roxanne Bainbridge
Roxanne Bainbridge
Karen McPhail-Bell
Nikki Percival
Deborah Askew
Deborah Askew
Ruth Fagan
Komla Tsey
Komla Tsey
author_facet Janya McCalman
Janya McCalman
Ross Bailie
Roxanne Bainbridge
Roxanne Bainbridge
Karen McPhail-Bell
Nikki Percival
Deborah Askew
Deborah Askew
Ruth Fagan
Komla Tsey
Komla Tsey
author_sort Janya McCalman
collection DOAJ
description Continuous quality improvement (CQI) processes for improving clinical care and health outcomes have been implemented by primary health-care services, with resultant health-care impacts. But only 10–20% of gain in health outcomes is contributed by health-care services; a much larger share is determined by social and cultural factors. This perspective paper argues that health care and health outcomes can be enhanced through applying CQI as a systems approach to comprehensive primary health care. 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 local decision making by primary health-care 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 health-care service investment is required to support and extend integration and evaluation of CQI efforts vertically and horizontally.
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spelling doaj.art-bb053fa67c7e4152ab3f924d5c64c7de2022-12-21T23:23:44ZengFrontiers Media S.A.Frontiers in Public Health2296-25652018-03-01610.3389/fpubh.2018.00076326678Continuous Quality Improvement and Comprehensive Primary Health Care: A Systems Framework to Improve Service Quality and Health OutcomesJanya McCalman0Janya McCalman1Ross Bailie2Roxanne Bainbridge3Roxanne Bainbridge4Karen McPhail-Bell5Nikki Percival6Deborah Askew7Deborah Askew8Ruth Fagan9Komla Tsey10Komla Tsey11Centre for Indigenous Health Equity research, Central Queensland University, Cairns, AustraliaThe Cairns Institute, James Cook University, Townsville, QLD, AustraliaCentre for Research Excellence in Integrated Quality Improvement, University Centre for Rural Health, University of Sydney, Sydney, NSW, AustraliaCentre for Indigenous Health Equity research, Central Queensland University, Cairns, AustraliaThe Cairns Institute, James Cook University, Townsville, QLD, AustraliaPoche Centre for Indigenous Health, Sydney Medical School, University of Sydney, Sydney, NSW, AustraliaUniversity of Technology Sydney, Ultimo, NSW, AustraliaThe University of Queensland, Brisbane, QLD, AustraliaInala Indigenous Health Service, Queensland Health, Inala, QLD, AustraliaGurriny Yealamucka Health Service, Yarrabah, QLD, AustraliaThe Cairns Institute, James Cook University, Townsville, QLD, AustraliaCollege of Arts, Social Science and Education, James Cook University, Townsville, QLD, AustraliaContinuous quality improvement (CQI) processes for improving clinical care and health outcomes have been implemented by primary health-care services, with resultant health-care impacts. But only 10–20% of gain in health outcomes is contributed by health-care services; a much larger share is determined by social and cultural factors. This perspective paper argues that health care and health outcomes can be enhanced through applying CQI as a systems approach to comprehensive primary health care. 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 local decision making by primary health-care 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 health-care service investment is required to support and extend integration and evaluation of CQI efforts vertically and horizontally.http://journal.frontiersin.org/article/10.3389/fpubh.2018.00076/fullcontinuous quality improvementsystems approachIndigenousprimary health careintegrationsocial determinants of health
spellingShingle Janya McCalman
Janya McCalman
Ross Bailie
Roxanne Bainbridge
Roxanne Bainbridge
Karen McPhail-Bell
Nikki Percival
Deborah Askew
Deborah Askew
Ruth Fagan
Komla Tsey
Komla Tsey
Continuous Quality Improvement and Comprehensive Primary Health Care: A Systems Framework to Improve Service Quality and Health Outcomes
Frontiers in Public Health
continuous quality improvement
systems approach
Indigenous
primary health care
integration
social determinants of health
title Continuous Quality Improvement and Comprehensive Primary Health Care: A Systems Framework to Improve Service Quality and Health Outcomes
title_full Continuous Quality Improvement and Comprehensive Primary Health Care: A Systems Framework to Improve Service Quality and Health Outcomes
title_fullStr Continuous Quality Improvement and Comprehensive Primary Health Care: A Systems Framework to Improve Service Quality and Health Outcomes
title_full_unstemmed Continuous Quality Improvement and Comprehensive Primary Health Care: A Systems Framework to Improve Service Quality and Health Outcomes
title_short Continuous Quality Improvement and Comprehensive Primary Health Care: A Systems Framework to Improve Service Quality and Health Outcomes
title_sort continuous quality improvement and comprehensive primary health care a systems framework to improve service quality and health outcomes
topic continuous quality improvement
systems approach
Indigenous
primary health care
integration
social determinants of health
url http://journal.frontiersin.org/article/10.3389/fpubh.2018.00076/full
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