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 ...
In the Top End, the NTDH&CS Remote Health staff reported that the recall systems werepresent, and with regular support from the Public Health Nurse, they worked well. Training in theuse of recall systems is incorporated into orientation and the Chronic Disease Pathways module.The PCD team take responsibility for systems training of new staff. However the NTDH&CSDarwin Urban Community Health services, and the Chronic Kidney Disease nurses in the TopEnd, do not use chronic disease recall systems.The stakeholder interviews in Central Australia reported that recall systems were operatingeffectively in the late 1990‟s, however in recent years they had not been as well maintained. Theinformation provided during the stakeholder interviews was consistent with the findings of theSchatz study (40) . The reasons given for this include the withdrawal of practice nurse positionsthat supported quality improvement activities in the health centres and the lack of an electronicinformation system to assist with managing clients. In addition to these systems issues, it wasreported that some health staff working in remote areas hold the view that chronic disease careis not their core business and as such chronic disease recall is not part of the work practice in allfacilities.The Preventable Chronic Disease team is actively trying to re-establish recall systems and view itas part of their role to train new staff. A number of mechanisms to ensure a systematicapproach to training in the use of recall systems were identified by the Remote Health Services,including orientation programs, AHW training programs and training provided by the PublicHealth Nurses from the PCD team.Activity and Outcome reportingThe Community Controlled Health Services provide 6 monthly reports about service in theirService Activity Reports, and about organizational activities through the Service Development andReporting Framework (SDRF) six-monthly progress reports. A summary of this information is alsoincluded in Annual Reports. Through the Healthy for Life program Communicare and Ferret arebeing upgraded to improve their reporting functions around the Healthy for Life performanceindicators. With the exception of Central Australian Aboriginal Congress (CAAC), which has a welldevelopedreporting system, most services indicated they were in the process of developing theirchronic disease reporting systems, which they expected to be operating in the next 6 months.During the stakeholder interviews NTDH&CS did not identify any regular reporting for chronicdisease prevention and care activities. Reporting of EPC items that reflect outcomes from servicedelivery is occurring and uptake rates for NTDH&CS services are being monitored. HoweverChapter 3: Progress Against PCDS Objectives – Evaluation of the NT Preventable Chronic Disease Strategy 2007 26
Medicare information is not for publication for the NT and no new data could be identified since2004. Therefore could not be reported in this evaluation, although it is expected to haveincreased.In 2005 an agreement was signed to commit all Aboriginal primary health care service providersin the Northern Territory to report against one set of Aboriginal Health Key PerformanceIndicators (AHKPI). Regular monitoring of outcomes is an essential quality improvement activityand a website has been set up to facilitate data entry and analysis. In 2007 the first reportingagainst these indicators will occur.Quality Improvement activities related to chronic diseaseAcross the Northern Territory 12 community services are participating in the Audit and BestPractice in Chronic Disease (ABCD). Services participating in ABCD undertake a clinical audit anda systems assessment survey to establish a baseline position, to inform development of an actionplan to start addressing the systems issues identified for chronic disease prevention andmanagement. This Plan, Do, Study, Act (PDSA) cycle is completed over 3 annual cycles toestablish the practice of audit and review. The 2007 ABCD Report found that there had beenimprovements in all key aspects of systems to support chronic illness care for almost allparticipating centres (7) . ACCHS participating in ABCD that were interviewed stated that theyreported their annual ABCD audit results to their Boards.A significant proportion of general practitioners in the Northern Territory and many of the ACCHOhealth teams have participated in the National Primary Care Collaborative (NPCC). This initiativehas assisted with establishing PDSA cycles to improve access to services and chronic diseasemanagement. Services participating in the NPCC report that they provide monthly reportsagainst NPCC indicators.DiscussionThe extraordinary number of recall systems across the NT is a major barrier to theimplementation of effective chronic disease prevention and management. Staff who work acrossa number of clinics, or who move from one clinic to another, are unable to access patient recordsor prescribe without extensive orientation to the new systems. The systems do not talk to eachother, and require faxing of patient records between clinics when people move.The Territory Government is committed to introducing PCIS into all NTDH&CS remote clinicswhich will be approximately 54 sites over the next 2-3 year subject to funding and humanChapter 3: Progress Against PCDS Objectives – Evaluation of the NT Preventable Chronic Disease Strategy 2007 27
- 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 and 14: the establishment of the Sunrise He
- Page 15 and 16: RECOMMENDATIONSGeneral recommendati
- Page 17 and 18: Exploration of joint funding arrang
- Page 19 and 20: CHAPTER 1. INTRODUCTION1.1 Backgrou
- 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
- Page 27 and 28: Year * Action Outcome1999 S NT Prev
- Page 29 and 30: Year * Action Outcome2005 P Aborigi
- Page 31 and 32: CHAPTER 2.EVALUATION METHODOLOGYThe
- Page 33 and 34: 2.2 Evaluation StagesThe NTPCDS eva
- Page 35 and 36: chronic disease activities funded t
- 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: Ferret Miwatj, Numbulwar, Marngarr,
- Page 47 and 48: was in place in Central Australia i
- Page 49 and 50: What orientation and ongoing traini
- Page 51 and 52: programs focus on chronic disease p
- Page 53 and 54: The information collected as part o
- Page 55 and 56: Assessment against objectiveMost se
- Page 57 and 58: career development, and retention i
- Page 59 and 60: are. Indigenous employment is NTDH&
- Page 61 and 62: NTDH&CS Programs that encourage Hea
- Page 63 and 64: 2002 Aboriginal and Torres Strait I
- Page 65 and 66: delivering any prevention and healt
- Page 67 and 68: The Community Services Division - A
- Page 69 and 70: 1 x AHW Central Australia 2001 S100
- Page 71 and 72: One clinic stated it had no care pl
- Page 73 and 74: Identifies priority practices to in
- Page 75 and 76: There has been a significant growth
- Page 77 and 78: about 25 per cent of the hospital b
- Page 79 and 80: The level of funding provided by th
- Page 81 and 82: Central Australia and two zones cur
- Page 83 and 84: The diabetes education teams at HLN
- Page 85 and 86: maintenance group for people with l
- Page 87 and 88: Rebates for participating or arrang
- Page 89 and 90: Use of Medicine Programmes. Althoug
- Page 91 and 92: CHAPTER 4. CLINICAL OUTCOMES OF THE
- Page 93 and 94: improvements have been made to serv
Medicare information is not for publication for the <strong>NT</strong> and no new data could be identified since2004. Therefore could not be reported in this evaluation, although it is expected to haveincreased.In 2005 an agreement was signed to commit all Aboriginal primary health care service providersin the Northern Territory to report against one set of Aboriginal <strong>Health</strong> Key PerformanceIndicators (AHKPI). Regular monitoring of outcomes is an essential quality improvement activityand a website has been set up to facilitate data entry and analysis. In 2007 the first reportingagainst these indicators will occur.Quality Improvement activities related to chronic diseaseAcross the Northern Territory 12 community services are participating in the Audit and BestPractice in Chronic Disease (ABCD). Services participating in ABCD undertake a clinical audit anda systems assessment survey to establish a baseline position, to inform development of an actionplan to start addressing the systems issues identified for chronic disease prevention andmanagement. This Plan, Do, Study, Act (PDSA) cycle is completed over 3 annual cycles toestablish the practice of audit and review. The 2007 ABCD Report found that there had beenimprovements in all key aspects of systems to support chronic illness care for almost allparticipating centres (7) . ACCHS participating in ABCD that were interviewed stated that theyreported their annual ABCD audit results to their Boards.A significant proportion of general practitioners in the Northern Territory and many of the ACCHOhealth teams have participated in the National Primary Care Collaborative (NPCC). This initiativehas assisted with establishing PDSA cycles to improve access to services and chronic diseasemanagement. Services participating in the NPCC report that they provide monthly reportsagainst NPCC indicators.DiscussionThe extraordinary number of recall systems across the <strong>NT</strong> is a major barrier to theimplementation of effective chronic disease prevention and management. Staff who work acrossa number of clinics, or who move from one clinic to another, are unable to access patient recordsor prescribe without extensive orientation to the new systems. The systems do not talk to eachother, and require faxing of patient records between clinics when people move.The Territory Government is committed to introducing PCIS into all <strong>NT</strong>DH&CS remote clinicswhich will be approximately 54 sites over the next 2-3 year subject to funding and humanChapter 3: Progress Against <strong>PCD</strong>S Objectives – <strong>Evaluation</strong> of the <strong>NT</strong> Preventable Chronic Disease <strong>Strategy</strong> 2007 27