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 ...
There is good evidence of the implementation of early detection and screening processes inprojects such as the coordinated care trials and the ABCD program, and pleasing results in theuse of systems to improve chronic care (7) . The changes in Medicare in 2004, through theintroduction of an Enhanced Primary Care item for Aboriginal adult health checks, were reportedsignificantly under-utilised, however this is envisaged to change as programs further develop.Adult immunisation rates have increased for influenza vaccine and pneumococcal since 2000.Two specific programs report on different best practice management approaches to reduce bloodpressure, to prevent renal disease and the complications of diabetes – The Menzies RenalTreatment Program and the Tiwi Coordinated Care Trials. Results suggest that the PCDS is notpreventing renal failure as effectively as an MRTP-type program would, as renal failure ratescontinue to rise. However, there are unresolved questions about whether an MRTP programwould be sustainable across the Territory in the long term. There was an increase in podiatryoutreach services in remote communities due to PHCAP funds between 2003-05.There have been a number of limitations to this evaluation process. The main limitation was theabsence of an implementation plan for the NTPCDS, upon which this evaluation could be based.This meant that it was difficult to identify the intent of the implementation process and ifoutcomes were due to the PCDS or other national initiatives. Also a Statistical Report for theNTPCDS was produced in 2000 that provides an excellent baseline upon which to measure theimpact of the NTPCDS (8) . There has however not been another report and very limited recentdata exists in some of the reporting clinical areas. Since 1999 there were three NTDH&CSrestructures and within the time constraints and the internal and external evaluation process itwas not possible to gain a sense of the impact of corporate policy directions.While this evaluation has identified advancements and a general movement in the right directionof the NTPCDS, there is also significant room for improvement. This is particularly so in the areasof prevention and health promotion activities, Indigenous employment within the PCDS staff, andthe simplification, standardisation and coordination of information systems that can communicateacross regions. Additionally, the organisational structures that facilitate easy communicationbetween those providing chronic disease programs and education require improvement.The following recommendations are made to assist the NTDH&CS to improve their efforts in theprevention, early detection and management of chronic disease in what is no doubt one of themost challenging environments to do so in Australia. We wish them every success.Evaluation of the NT Preventable Chronic Disease Strategy 2007xiv
RECOMMENDATIONSGeneral recommendationsRepresentative Committee1. The NTDH&CS establish a representative committee of the providers of health careservices across the whole of the Northern Territory to review the PCDS using therecommendations of the evaluation report as the basis for discussion and planning.Implementation Strategy2. The representative committee oversee the development an implementation strategy. Thiswill include: Revising the objectives of the PCDS to include clearly defined benchmarks andperformance indicators against each objective and a timeline and process for theirimplementation. Developing a model for chronic disease prevention and care in urban areas to linkservice providers. Establishing a system for collecting information against each benchmark and aprocess to do so, as a priority.Linking NT Aboriginal Health Key Performance Indicator measures to the Key ResultAreas of the NTPCDS to provide a framework for ongoing evaluation.Linking position vacancies and turnover rates to health outcomes dataIncluding preventable cancers, rheumatic heart disease, mental illness anddepression in this revision of the NTPCDS.Including ischaemic heart disease and hypertension under cardiovascular disease asone reporting area.This revision is supported with an investment from NTDH&CS as a priority, andincludes a realistic evaluation budget to review progress.Statistical report3. The reproduction of the 2000 Statistical Report is undertaken on a regular five yearlybasis, to assist in the monitoring of progress in the achievement of the PCDS.4. A dedicated and recurrent budget allocation is identified and committed to do so.Evaluation of the NT Preventable Chronic Disease Strategy 2007xv
- Page 1 and 2: Pty LtdABN 82 147 637 101AN EVALUAT
- Page 3 and 4: TABLE OF CONTENTSList of figuresLis
- Page 5 and 6: 6.6 Indigenous workforce 996.7 Prev
- Page 7 and 8: List of AbbreviationsABCDACCHOsACIC
- Page 9 and 10: ACKNOWLEDGEMENTSWe would like to ac
- Page 11 and 12: However the extraordinary number of
- Page 13: the establishment of the Sunrise He
- Page 17 and 18: Exploration of joint funding arrang
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- Page 21 and 22: Choosing the 5 chronic conditionsTh
- Page 23 and 24: Table 1.1Key Result Areas + Best Bu
- Page 25 and 26: prior to the launch of NTPCDS, such
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- Page 31 and 32: CHAPTER 2.EVALUATION METHODOLOGYThe
- Page 33 and 34: 2.2 Evaluation StagesThe NTPCDS eva
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- Page 37 and 38: internal project team. It was very
- Page 39 and 40: Situation at Baseline1. The Guideli
- Page 41 and 42: 3.1.2 Patient information and recal
- Page 43 and 44: Ferret Miwatj, Numbulwar, Marngarr,
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RECOMMENDATIONSGeneral recommendationsRepresentative Committee1. The <strong>NT</strong>DH&CS establish a representative committee of the providers of health careservices across the whole of the Northern Territory to review the <strong>PCD</strong>S using therecommendations of the evaluation report as the basis for discussion and planning.Implementation <strong>Strategy</strong>2. The representative committee oversee the development an implementation strategy. Thiswill include: Revising the objectives of the <strong>PCD</strong>S to include clearly defined benchmarks andperformance indicators against each objective and a timeline and process for theirimplementation. Developing a model for chronic disease prevention and care in urban areas to linkservice providers. Establishing a system for collecting information against each benchmark and aprocess to do so, as a priority.Linking <strong>NT</strong> Aboriginal <strong>Health</strong> Key Performance Indicator measures to the Key ResultAreas of the <strong>NT</strong><strong>PCD</strong>S to provide a framework for ongoing evaluation.Linking position vacancies and turnover rates to health outcomes dataIncluding preventable cancers, rheumatic heart disease, mental illness anddepression in this revision of the <strong>NT</strong><strong>PCD</strong>S.Including ischaemic heart disease and hypertension under cardiovascular disease asone reporting area.This revision is supported with an investment from <strong>NT</strong>DH&CS as a priority, andincludes a realistic evaluation budget to review progress.Statistical report3. The reproduction of the 2000 Statistical Report is undertaken on a regular five yearlybasis, to assist in the monitoring of progress in the achievement of the <strong>PCD</strong>S.4. A dedicated and recurrent budget allocation is identified and committed to do so.<strong>Evaluation</strong> of the <strong>NT</strong> Preventable Chronic Disease <strong>Strategy</strong> 2007xv
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