- Title
- Using quality improvement collaboratives in Australian general practice 2004 to 2015
- Creator
- Knight, Andrew Walter
- Relation
- University of Newcastle Research Higher Degree Thesis
- Resource Type
- thesis
- Date
- 2023
- Description
- Research Doctorate - Doctor of Philosophy (PhD)
- Description
- Introduction. Health systems face challenges related to an increase in chronic diseases and rising costs. Effective and efficient primary care can help address these challenges. Quality improvement collaboratives (QICs) are an effective strategy for improving aspects of health systems. This research examines the Australian Primary Care Collaboratives Program (APCC), which was a large implementation of QICs in Australian general practices between 2004 and 2015. Research Aims. 1. To describe quality improvement collaborative implementation in Australian general practice through the APCC (2004–2015). 2. To describe changes in patient clinical outcomes, lifestyle risk factors and the culture of quality improvement in chronic and complex conditions observed during the APCC (2004–2015). 3. To make recommendations for future use of quality improvement collaboratives in Australian general practice based on the implementation of the APCC (2004–2015). Methods. The research aims were addressed through six peer-reviewed articles. Four quality improvement reports, consistent with Standards for Quality Improvement Reporting Excellence (SQUIRE) guidelines, described aspects of the implementation and outcomes of the APCC. A qualitative systematic review explored the role of QICs in general practice. A discussion article analysed the APCC project using the categories of the systematic review and provided recommendations for future application of the methodology in Australia. Results. The systematic review found that QICs implemented in general practice were seen to have a role in improving target topics, developing practices and providers, developing the health system and building quality improvement capacity. The four quality improvement reports described the implementation and development of the APCC. They reported that the APCC produced changes related to: • target topics such as chronic disease management, access, self-management, prevention, electronic health records and leading quality improvement; • development of practices and providers through increased knowledge and skills, systems such as disease registers, improved data management, more proactive care models, increased team motivation, improved teamwork and team culture changes • development of the health system through enhanced regional support; organisations, relationships between practices and support officers, data sharing from practices to regional organisations and spread of innovations; • building chronic disease capacity through establishing a culture of quality improvement, creating infrastructure such as data extraction tools, providing data and teaching quality improvement skills. Discussion. The APCC demonstrated that QICs can be successfully implemented in Australian general practice. The outcomes recorded in the four published reports of the APCC align with the findings of the systematic review of international literature describing important effects in improved target topics, development of practices and providers, development of the health system and the building of quality improvement capacity. Future use of QICs in Australian general practice is likely to result in positive effects on the challenges facing the health system. QICs should be provided at a national level to trial and create proposed innovations and develop national leaders. They should be provided at regional levels to address local variation and build integration of health care. Continued use of QICs in Australian general practice will create a new generation of general practice leaders. Implementation should be designed to maximise improvement in all four categories of outcomes. Effective evaluation of future QICs should be planned, funded and published.
- Subject
- general practice; family medicine; quality improvement; quality improvement collaboratives; thesis by publication
- Identifier
- http://hdl.handle.net/1959.13/1477604
- Identifier
- uon:50006
- Rights
- Copyright 2023 Andrew Walter Knight
- Language
- eng
- Full Text
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| View Details Download | ATTACHMENT01 | Thesis | 10 MB | Adobe Acrobat PDF | View Details Download | ||
| View Details Download | ATTACHMENT02 | Abstract | 282 KB | Adobe Acrobat PDF | View Details Download |