"Putting more effort into prevention, early intervention,
and effective management of chronic illness will reduce the
complications, disability and death associated with these diseases
and conditions. It has been proven that patients who receive
effective treatments, self management support, and regular follow
ups, do better than those who do not. Evidence suggests that
organised systems of care, not just individual health care workers,
are essential in producing postitive outcomes"
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"Putting more effort into prevention, early intervention, and effective management of chronic illness will reduce the complications, disability and death associated with these diseases and conditions.
It has been proven that patients who receive effective treatments, self-management support, and regular follow-up, do better than those who do not.
Evidence also suggests that organised systems of care, not just individual health care workers, are essential in producing positive outcomes"
-- WHO 2002
It's as simple as... ABCD... Audit and Best practice for Chronic Disease.
The ABCD project is a joint effort of several of the partners of the CRC for Aboriginal Health, including community controlled health services, State/Territory and Commonwealth Government agencies and research organisations.
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ABCD is an action-research project that is supporting health services to develop state-of-the -art continuous improvement approaches to strengthen primary health care.
ABCD has been operating in a range of government and non-government health centres across the Top End of the Northern Territory of Australia since 2002. Our initial focus on prevention and management of chronic disease has already resulted in significant improvements in service delivery and health outcomes.
The project takes an evidence based approach to assessing health centre systems, service delivery and health outcomes. We work with the health centre staff, drawing on their local knowledge, experience, and commitment to identify goals and strategies for improvement.
During the process we check that changes have actually led to improvement, and share information about systems that are working effectively.
The project is being expanded with regional support hubs being established in a number of States.
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We will work with health centre staff to conduct an assessment of Health Centre systems and activities in specified areas such as prevention and management of chronic disease and maternal and child health.
Then, through a process of annual cycles of assessment, feedback and workshops, we will introduce and facilitate a process of quality improvement specifically aimed at improving systems to support best practice in these areas.
As part of the project we will provide tools, training and information systems that will enable health centres to integrate continuous improvement processes into their routine work activities.
Health service staff will be given access to the ABCD website which allows for local data entry and immediate automated analysis and reporting on health centre performance, and comparison with performance of other (de-identified) health centres.
We will link Health Centre staff to other practitioners involved in the project and with experts in specific aspects of primary health care to share lessons and experience.
The project aims to make a significant contribution to improving the quality of primary care systems and the quality of care in Aboriginal and Torres Strait Islander communities.
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We recognise that there is a lot happening already, so the project is designed to:
Build on existing or planned accreditation or continuous improvement processes;
Coordinate with other related projects that health centres are or may become involved in; Support the development of a learning environment in your Health Centre.
ABCD will provide a mechanism for ongoing evaluation of the impact of many of the activities in which your service is involved.
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We are now working with over 50 Indigenous primary care services in Central Australia, Western Australia, Far West NSW and the Top End of the NT to support a systematic approach to improving systems and the quality of care for Indigenous people.
Our approach of working through regional hubs is designed to draw on and build local expertise and capacity.
Negotiations are underway to establish hubs in Queensland, SA and other areas of NSW. The Healthy for Life Program funded through the Office for Aboriginal and Torres Strait Islander Health has been very important in assisting services to engage in this sort of quality improvement activity.
We are also working on new tools related to other aspects of clinical care and public health:
- Maternal Health
- Child Health
- Mental Health
- Rheumatic Heart Disease
- Health Promotion
- Environmental Health
- Nutrition and Community Stores.
We would like to hear from services which are interested in working with us to refine and test these tools.
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The Healthy for Life Program is an Australian government funded program which aims to enhance the capacity of Aboriginal and Torres Strait Islander primary health care services to improve the quality of child and maternal health services and chronic disease care, and to improve the capacity of the Indigenous health workforce.
ABCD is an action research project which can provide services with:
1) a clear framework and standardised and tested tools to meet the requirements of the H4L program;
2) access to a team of experienced facilitators; and
3) access to a support structure and a wide network of other services involved in similar initiatives.
The ABCD project has made a significant contribution to the development of the Healthy for Life Program through developing quality improvement approaches and tools suitable for use in Indigenous primary care settings, in providing training on the use of the ABCD tools and in providing facilitation services to many organisations funded through the Healthy for Life Program.
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The ABCD tools are available free of charge to anyone who wants to use them. However, it is very helpful to us if you let us know you are using our tools and if you acknowledge the use of the tools in any relevant reports.
BUT, ABCD is much more than just using these tools. The project is about an integrated approach to quality improvement, including a cyclical participatory approach to system and performance assessment, sharing ideas and research evidence, action planning and working together to make a difference in agreed priority areas. Our team of facilitators and our interactive website can assist services in using this approach.
There are two possible arrangements through which we can work with services:
1. Services can contract us to provide facilitation services designed to meet your specific needs, including access to your own secure and private section on the website. OR
2. Services can become formally involved in the ABCD research project. This requires a) the signing of a participation agreement which sets out the roles and responsibilities of the ABCD team and of the health service staff and b) research ethics approval from your local health research ethics committee. Both the participation agreement and the ethics approval ensure appropriate and confidential use of information for research purposes.
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