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

More documents

Recommendations

Info

Situation at baselinePrior to 1999 there were no dedicated chronic disease programs operating in the NorthernTerritory Department of Health and Community Services facilities. Trials of renal care hadoccurred in the Tiwi Islands and plans were underway for the Kidney Disease Research Program(KDRP), lead by Dr Wendy Hoy, to trial implementation of sustainable models of chronic diseasecare in three remote Indigenous communities in the Top End. The Coordinated Care Trials inKatherine and Tiwi Islands began to implement a systematic approach to chronic disease care,where patients known to have chronic diseases were entered into the CCTIS system and careplans assigned to them.3.4.1 Development in chronic disease programs since 1999There has been change in the approach to chronic disease care by all service providers in theNorthern Territory including the NT Department of Health and Community Services, AboriginalCommunity Controlled Organisations and Doctors in private practice.NT Department of Health and Community Services (DHCS)The NT Department of Health and Community Services has undertaken a number of restructuresin both title and organisation during the course of the NTPCDS. The current structure (Sept 2005)divides the DHCS into 10 divisions. Many of these divisions are responsible for various aspects ofchronic disease programs. The Preventable Chronic Disease Program was established to provideleadership for chronic disease programs. It is situated in the Health Development and Oral Healtharea, which is a part of the Health Services Division. The program is lead by a medical officer andthe programs employs Public Health Nurses, a Senior Health Promotion and Policy Officer,Aboriginal Health Promotion Officers, women‟s health educators, Regional Chronic Diseasecoordinators, Chronic Disease Network coordinator, in central Australia and the Top End. TheCommunity Physician position is located in the Centre for Disease Control (CDC) in the Top Endand the hospital in Central Australia. Professional Practice Nurses, whose role includesstandardising practice across the Territory, are situated in Remote Health. Both CDC and Remotehealth are part of the Health Services Division. Chronic Disease coordinators (although fundedthrough S100 along with some of the positions in the PCD program) are managed throughRemote Health. Staff at urban Health Centres are managed through Community Health. Staff onthe Tiwi Islands are managed through the Tiwi Health Services. Other Divisions responsible forcoordinating areas of chronic disease management include:Chapter 3: Progress Against PCDS Objectives – Evaluation of the NT Preventable Chronic Disease Strategy 2007 48
The Community Services Division – Alcohol and other Drugs,Information – the Health Gains Unit and PCIS,Acute Care – hospitals, dialysis facilities and visiting specialists,Corporate Management Services Division – educational activities such as orientationprograms, and theOffice of Aboriginal Health – Family and Social Policy.There are over 150 remote health clinics in the NT and there are a number of different modelsand organisations managing remote health clinics. Clinics situated in areas covered by theKatherine West and Sunrise Health Boards are staffed by employees of the Health Boards and actin accordance Health Board policies. Clinics that are funded through PHCAP are staffed withNTDH&CS staff, but are under the control of ATSI Regional Health Boards. Staff of NTDH&CSclinics that are not part of the health zones are funded by the NTDH&CS and respond toNTDH&CS policies. Staff in clinics run by Aboriginal Community Controlled Health Centres act inresponse to their own policies. While there is some co-ordination across all of these bodies andsome shared resources, such as the CARPA guidelines, there is a lack of consistency due to thesefactors.Chronic Disease Programs in NTDH&CS clinics and community healthIn 2001, Clarke attempted to record what chronic disease activities were taking place inNTDH&CS clinics. She reported that residents of Darwin and Alice Springs could access a range ofservices for prevention, early detection and best practice management. A number of these wereoffered through the non-government sector: GPs, Specialist Physicians, Lifestyle interventionsthrough nutrition counselling, regular incentives and opportunities for physical activity, supportgroups and counselling for those with chronic diseases to engage in self- management practices.Clarke found that a number of health zones appeared to have less access to chronic diseaseservices including: Northern Barkly, Pitjantjatjara, Darwin (Belyuen), Top End West and SouthEast Arnhem (62) . She also found preventive services were scant for physical activity and nutrition,and tobacco cessation programs only occurred spasmodically. Screening programs did occur inmost communities, but lacked targeted men‟s health programs. The area of best practicemanagement showed widespread gaps in the self-care management and rehabilitation focusedprograms (62) . Clarke recommended: highly prioritising primary prevention especially in the areaof community interventions to improve nutrition, increase exercise, and decrease smoking. Shealso recommended improving the coverage and quality of best practice management. A strongfocus of the next phase should be in professional development for remote area staff on how toChapter 3: Progress Against PCDS Objectives – Evaluation of the NT Preventable Chronic Disease Strategy 2007 49
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: delivering any prevention and healt
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 and 112: 5.6 Best practice management5.6.1 P
Page 113 and 114: disease care in urban areas regardi
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 ...

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?