PCD Strategy Evaluation 2007.pdf - NT Health Digital Library ...

More documents

Recommendations

Info

CHAPTER 6. DISCUSSION OF FINDINGSThis evaluation process has identified a number of improvements and there is general movementin the right direction to implement the actions contained in the NTPCDS. There is howeversignificant room for improvement in the overall planning, management and monitoring of chronicdisease prevention and management activities to facilitate engagement with all health serviceproviders in the Northern Territory. This will ensure that all service providers work together in acoordinated way to implement systems improvements and service enhancements.Key areas for improvement include: prevention activities Indigenous employment related to chronic disease programs the simplification, standardisation and coordination of information systems that cancommunicate across regions organisational structures that facilitate easy communication between those providingchronic disease programs and education, and dedicated investment to support these activities.6.1 Governance and planning for chronic disease activityAn issue that became very clear during the stakeholder interviews was that there had been verylittle engagement with external, and some internal, services when the PCDS framework wasdeveloped. Therefore in the non-government services and urban services the PCDS has verylittle relevance in influencing service planning and systems change. Most of the direction forthese services had come through programs such as Healthy for Life and Primary CareCollaboratives, which is consistent with the NTPCDS framework. However, these services do notsee their actions as contributing to an NT-wide PCDS. Many services identified that the ChronicDisease Network was a useful forum for swapping ideas and discussing new initiatives. Yet it isnot a decision making group that can influence policy to facilitate improved system support forchronic disease clients.The stakeholder interviews also identified very little direction as to how to apply the NTPCDSframework in urban areas, where there are multiple providers and many at risk groups. Forexample: in Darwin there are many high risk men with limited supports who would be a keytarget group for chronic disease initiatives. Work is required to develop a model for chronicChapter 6: Discussion – Evaluation of the NT Preventable Chronic Disease Strategy 2007 94
disease care in urban areas regarding the guidelines to be used, recall systems, care planningand team care arrangements involving urban community health services.The scope of the NT PCDS was canvassed with stakeholders and the response was mixed. Manyservices could see the benefit of expanding the scope of the NTPCDS to include mental healthand preventable cancers, while others felt that services should focus on getting the systems rightfor addressing the 5 conditions currently covered by the strategy. This issue is really one ofresources and capacity. Yet on balance, most people felt that it was logical to expand the scopeof the NT PCDS to include preventable cancers because the risk factors and prevention strategiesare similar to preventable chronic disease conditions and selected mental health conditions.Though secondary and specialist cancer services should be excluded. The review team also feltthat it is logical to include rheumatic heart disease because the systems of care required tomanage this condition are similar to chronic disease.The lack of an implementation plan for the NT PCDS means there is no basis for communicatingdirection, gaining commitment from other service providers to identify priorities or monitoringprogress. Some of the objectives in the PCDS have clearly been achieved without animplementation plan. However this is largely due to all service providers having recognised theneed to adopt a quality improvement and best practice approach to service delivery throughprograms that support these principles. To improve the efficiency and effectiveness of servicedelivery across the NT, there is a need for consistency in the use of clinical protocols, theapproaches to service delivery and the coordination of service providers to deliver comprehensivescreening, intervention and chronic disease care services.6.2 Ongoing monitoring and reviewA key barrier to undertaking the NTPCDS evaluation was the lack of systematic data collectionprocesses to inform the progress of the NT PCDS. Part of this is due to the lack of informationsystems in the community, but it also relates to the lack of a systematic approach to reporting ofhealth activities and outcomes. The ABCD project is supporting services participating in theproject to establish a quality improvement cycle based on a cycle of audit, planning and review.These principles need to be implemented into all health services, as they will serve a dualpurpose of making review and reporting relevant at the community level, while also providinginformation to feed into the bigger picture of chronic disease systems development across theNorthern Territory.Chapter 6: Discussion – Evaluation of the NT Preventable Chronic Disease Strategy 2007 95
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 and 44:
Ferret Miwatj, Numbulwar, Marngarr,
Page 45 and 46:
Medicare information is not for pub
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
Page 95 and 96: A recent ten-year follow-up of a co
Page 97 and 98: The NTDH&CS also collect birthweigh
Page 99 and 100: Figure 5.3 Vaccination coverage for
Page 101 and 102: It is also important to note that k
Page 103 and 104: eported that 50 per cent of the Ind
Page 105 and 106: The current action plan identifies
Page 107 and 108: The availability and cost of health
Page 109 and 110: Hoy et al in 1995-2000 (100) , and
Page 111: 5.6 Best practice management5.6.1 P
Page 115 and 116: PCIS was developed by NTDH&CS as th
Page 117 and 118: emote staff can access training and
Page 119 and 120: In the Top End there appeared to be
Page 121 and 122: APPENDIX 1EVALUATION OF THE NT PREV
Page 123 and 124: 2.10 Generally speaking, on a scale
Page 125 and 126: 4.4 Briefly recount any anecdotes y
Page 127 and 128: 5.9 Generally speaking, on a scale
Page 129 and 130: Section 8 • Summary questions8.1
Page 131 and 132: Preventable Chronic Disease Program
Page 133 and 134: Year Type Background What is it? /
Page 135 and 136: Year Type Background What is it? /
Page 137 and 138: An important background to this stu
Page 139 and 140: New beliefs do not replace the old,
Page 141 and 142: Other services are provided to the
Page 143 and 144: ecame the main priority in many peo
Page 145 and 146: to be healthy, how to get rid of di
Page 147 and 148: (Draft Version - © August 2006 Jan
Page 149 and 150: References1. Dunham, H., Ministeria
Page 151 and 152: 35. Smith, J.D., Progress report fo
Page 153 and 154: Research Centre for Aboriginal Heal
Page 155: 114. Senior, K., 'A Gudbala Laif? h
show all

PCD Strategy Evaluation 2007.pdf - NT Health Digital Library ...

Create successful ePaper yourself

Delete template?

Save as template?