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Preventive medical care in remote Aboriginal communities in the Northern Territory: a follow-up study of the impact of clinical guidelines, computerised recall and reminder systems, and audit and feedback.

Bailie RS, Togni SJ, Si D, Robinson G, d'Abbs PH - BMC Health Serv Res (2003)

Bottom Line: Interventions to improve delivery of preventive medical services have been shown to be effective in North America and the UK.The intervention comprised the development and dissemination of best practice guidelines supported by an electronic client register, recall and reminder systems and associated staff training, and audit and feedback.Sustainability of improvements may be achieved by institutionalisation of relevant work practices and enhanced health centre capacity.

View Article: PubMed Central - HTML - PubMed

Affiliation: Menzies School of Health Research, PO Box 41096 Casuarina NT 0811, Darwin, Australia. rossb@menzies.edu.au

ABSTRACT

Background: Interventions to improve delivery of preventive medical services have been shown to be effective in North America and the UK. However, there are few studies of the extent to which the impact of such interventions has been sustained, or of the impact of such interventions in disadvantaged populations or remote settings. This paper describes the trends in delivery of preventive medical services following a multifaceted intervention in remote community health centres in the Northern Territory of Australia.

Methods: The intervention comprised the development and dissemination of best practice guidelines supported by an electronic client register, recall and reminder systems and associated staff training, and audit and feedback. Clinical records in seven community health centres were audited at regular intervals against best practice guidelines over a period of three years, with feedback of audit findings to health centre staff and management.

Results: Levels of service delivery varied between services and between communities. There was an initial improvement in service levels for most services following the intervention, but improvements were in general not fully sustained over the three year period.

Conclusions: Improvements in service delivery are consistent with the international experience, although baseline and follow-up levels are in many cases higher than reported for comparable studies in North America and the UK. Sustainability of improvements may be achieved by institutionalisation of relevant work practices and enhanced health centre capacity.

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Means of the percentages of services delivered to clients by health center in TIWI communities
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Figure 5: Means of the percentages of services delivered to clients by health center in TIWI communities

Mentions: Tiwi communities tended to have higher levels of service delivery at baseline and for the duration of follow-up (Figures 4 and 5, Table 7 and 8). The general pattern of improvement in levels of service delivery from baseline to year 1 and/or year 2, with a decline at year 3, is seen for most communities. However, two communities in Katherine West buck this trend (Figure 4). In both there is a decline in service delivery from year 1 to year 2, and a subsequent increase to year 3. Overall, 2 of the 3 Tiwi communities, and one of the Katherine West communities, showed a significantly increasing trend in service delivery across the study period.


Preventive medical care in remote Aboriginal communities in the Northern Territory: a follow-up study of the impact of clinical guidelines, computerised recall and reminder systems, and audit and feedback.

Bailie RS, Togni SJ, Si D, Robinson G, d'Abbs PH - BMC Health Serv Res (2003)

Means of the percentages of services delivered to clients by health center in TIWI communities
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC194217&req=5

Figure 5: Means of the percentages of services delivered to clients by health center in TIWI communities
Mentions: Tiwi communities tended to have higher levels of service delivery at baseline and for the duration of follow-up (Figures 4 and 5, Table 7 and 8). The general pattern of improvement in levels of service delivery from baseline to year 1 and/or year 2, with a decline at year 3, is seen for most communities. However, two communities in Katherine West buck this trend (Figure 4). In both there is a decline in service delivery from year 1 to year 2, and a subsequent increase to year 3. Overall, 2 of the 3 Tiwi communities, and one of the Katherine West communities, showed a significantly increasing trend in service delivery across the study period.

Bottom Line: Interventions to improve delivery of preventive medical services have been shown to be effective in North America and the UK.The intervention comprised the development and dissemination of best practice guidelines supported by an electronic client register, recall and reminder systems and associated staff training, and audit and feedback.Sustainability of improvements may be achieved by institutionalisation of relevant work practices and enhanced health centre capacity.

View Article: PubMed Central - HTML - PubMed

Affiliation: Menzies School of Health Research, PO Box 41096 Casuarina NT 0811, Darwin, Australia. rossb@menzies.edu.au

ABSTRACT

Background: Interventions to improve delivery of preventive medical services have been shown to be effective in North America and the UK. However, there are few studies of the extent to which the impact of such interventions has been sustained, or of the impact of such interventions in disadvantaged populations or remote settings. This paper describes the trends in delivery of preventive medical services following a multifaceted intervention in remote community health centres in the Northern Territory of Australia.

Methods: The intervention comprised the development and dissemination of best practice guidelines supported by an electronic client register, recall and reminder systems and associated staff training, and audit and feedback. Clinical records in seven community health centres were audited at regular intervals against best practice guidelines over a period of three years, with feedback of audit findings to health centre staff and management.

Results: Levels of service delivery varied between services and between communities. There was an initial improvement in service levels for most services following the intervention, but improvements were in general not fully sustained over the three year period.

Conclusions: Improvements in service delivery are consistent with the international experience, although baseline and follow-up levels are in many cases higher than reported for comparable studies in North America and the UK. Sustainability of improvements may be achieved by institutionalisation of relevant work practices and enhanced health centre capacity.

Show MeSH