PCD Strategy Evaluation 2007.pdf - NT Health Digital Library ...
PCD Strategy Evaluation 2007.pdf - NT Health Digital Library ... PCD Strategy Evaluation 2007.pdf - NT Health Digital Library ...
The NT is leading the way with the establishment of the key performance indicators forAboriginal health, which all services will report on. In addition to this many services participatingin the Healthy For Life Program will be required to report on progress against key indicators.These indicators should be linked to the priorities and direction outlined in the PCDSimplementation plan. It is also important to establish review and monitoring systems at the localservice level as this will assist with strengthening local service provision. Services such as CAACand the Barunga clinic have been applying these principles over a number of years and candemonstrate definite improvements and robust systems as a result of implementing thesepractices.In addition to health outcome indicators it would be useful to report on capacity indicators suchas the vacancy rates and how long positions are vacant as this will also help explain outcomesbeing achieved and if funding for designated chronic disease activity is bitting the target activity.6.3 Best Practice Clinical GuidelinesThe use of clinical guidelines to guide service delivery is integrated as core practice with remotehealth services and Aboriginal Community Controlled Organisations. They use the CARPAguidelines, and general practice use a variety of different guidelines and protocols. In the futurethere is a need for policy direction for urban based NTDH&CS staff as to which clinical guidelinesthey should follow for chronic disease care. The scope of practice for urban services is differentto remote services. Therefore the CARPA guidelines are not always appropriate in the urbansetting, nor are they consistent with general practice. Agreeing to a standard set of guidelinesfor urban service delivery will provide the basis for a common language when working inpartnership with general practice and community controlled health services.6.4 Patient information systemsChronic disease care is complex when a large number of patients need to be managed.Therefore the only efficient way to do this is through the use of an electronic patient informationsystem. The lack of an information system in most remote and urban communities is asignificant barrier to high quality care. This was as a major issue that arose as part of thestakeholder interviews.Chapter 6: Discussion – Evaluation of the NT Preventable Chronic Disease Strategy 2007 96
PCIS was developed by NTDH&CS as the corporate patient information and recall system forremote health services in the Northern Territory. However the PCIS will not be implemented intoall sites due to technical and infrastructure issues. It is unclear what the solution will be for thoseservices where it will not be possible to implement PCIS.In Central Australia there is a complete dearth of electronic information systems. The communityphysician and other service providers reported a high level of frustration with this situation and alack of any alternatives to support clinical practice. Planning is underway to implement PCIS intosome PHCAP zone communities, but not all communities within these zones. It is important thatall services within a zone use consistent patient information and recall systems to facilitate datasharing and the training of the workforce.At the present time there is no information system that supports urban service providers, or therenal units, to manage patient recalls and care plans. The type of information system needed tosupport chronic disease management and patient recall in urban community health services willbe dependent on the model of care implemented for collaborative practice. The renal unit willneed a similar system to remote health services as many of their clients on care plans will comefrom remote areas and hence a consistent system will facilitate information sharing. However thesystem will also need to be working and able to communicate with general practice. Thereforediscussions will be required between these groups to identify what patient informationmanagement systems are needed and processes developed to put these into place.Initiatives such as the point-2-point project, sponsored by the Divisions of General Practice aredesigned to improve communication and information sharing between service providers. Tofacilitate a collaborative approach to patient care with general practitioners the NTDH&CSservices need to be able to use these systems to improve communication with generalpractitioners in the management of patient care.Stakeholder interviews revealed poor compliance with the use of recall systems. Reasons givenfor this relate to both workforce capacity and training. It will be sometime before electronicsystems are implemented more widely. Therefore developing strategies to improve the use ofmanual recall systems is essential to ensure patients are receiving high quality care.Chapter 6: Discussion – Evaluation of the NT Preventable Chronic Disease Strategy 2007 97
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The <strong>NT</strong> is leading the way with the establishment of the key performance indicators forAboriginal health, which all services will report on. In addition to this many services participatingin the <strong>Health</strong>y For Life Program will be required to report on progress against key indicators.These indicators should be linked to the priorities and direction outlined in the <strong>PCD</strong>Simplementation plan. It is also important to establish review and monitoring systems at the localservice level as this will assist with strengthening local service provision. Services such as CAACand the Barunga clinic have been applying these principles over a number of years and candemonstrate definite improvements and robust systems as a result of implementing thesepractices.In addition to health outcome indicators it would be useful to report on capacity indicators suchas the vacancy rates and how long positions are vacant as this will also help explain outcomesbeing achieved and if funding for designated chronic disease activity is bitting the target activity.6.3 Best Practice Clinical GuidelinesThe use of clinical guidelines to guide service delivery is integrated as core practice with remotehealth services and Aboriginal Community Controlled Organisations. They use the CARPAguidelines, and general practice use a variety of different guidelines and protocols. In the futurethere is a need for policy direction for urban based <strong>NT</strong>DH&CS staff as to which clinical guidelinesthey should follow for chronic disease care. The scope of practice for urban services is differentto remote services. Therefore the CARPA guidelines are not always appropriate in the urbansetting, nor are they consistent with general practice. Agreeing to a standard set of guidelinesfor urban service delivery will provide the basis for a common language when working inpartnership with general practice and community controlled health services.6.4 Patient information systemsChronic disease care is complex when a large number of patients need to be managed.Therefore the only efficient way to do this is through the use of an electronic patient informationsystem. The lack of an information system in most remote and urban communities is asignificant barrier to high quality care. This was as a major issue that arose as part of thestakeholder interviews.Chapter 6: Discussion – <strong>Evaluation</strong> of the <strong>NT</strong> Preventable Chronic Disease <strong>Strategy</strong> 2007 96