PCD Strategy Evaluation 2007.pdf - NT Health Digital Library ...

disease care in urban areas regarding the guidelines to be used, recall systems, care planningand team care arrangements involving urban community health services.The scope of the NT PCDS was canvassed with stakeholders and the response was mixed. Manyservices could see the benefit of expanding the scope of the NTPCDS to include mental healthand preventable cancers, while others felt that services should focus on getting the systems rightfor addressing the 5 conditions currently covered by the strategy. This issue is really one ofresources and capacity. Yet on balance, most people felt that it was logical to expand the scopeof the NT PCDS to include preventable cancers because the risk factors and prevention strategiesare similar to preventable chronic disease conditions and selected mental health conditions.Though secondary and specialist cancer services should be excluded. The review team also feltthat it is logical to include rheumatic heart disease because the systems of care required tomanage this condition are similar to chronic disease.The lack of an implementation plan for the NT PCDS means there is no basis for communicatingdirection, gaining commitment from other service providers to identify priorities or monitoringprogress. Some of the objectives in the PCDS have clearly been achieved without animplementation plan. However this is largely due to all service providers having recognised theneed to adopt a quality improvement and best practice approach to service delivery throughprograms that support these principles. To improve the efficiency and effectiveness of servicedelivery across the NT, there is a need for consistency in the use of clinical protocols, theapproaches to service delivery and the coordination of service providers to deliver comprehensivescreening, intervention and chronic disease care services.6.2 Ongoing monitoring and reviewA key barrier to undertaking the NTPCDS evaluation was the lack of systematic data collectionprocesses to inform the progress of the NT PCDS. Part of this is due to the lack of informationsystems in the community, but it also relates to the lack of a systematic approach to reporting ofhealth activities and outcomes. The ABCD project is supporting services participating in theproject to establish a quality improvement cycle based on a cycle of audit, planning and review.These principles need to be implemented into all health services, as they will serve a dualpurpose of making review and reporting relevant at the community level, while also providinginformation to feed into the bigger picture of chronic disease systems development across theNorthern Territory.Chapter 6: Discussion – Evaluation of the NT Preventable Chronic Disease Strategy 2007 95