The One21seventy CQI cycle

The One21seventy CQI cycle is implemented over a twelve-month period. The activities undertaken within the cycle assist health centres to understand and demonstrate the quality of their care processes and health outcomes.

Figure 1: The six stages of the One21seventy CQI cycle

Stages 1-5 should take less than three months to complete; health centres then implement their goals and actions over the remainder of the year.

The six stages of the One21seventy CQI cycle

1: Signed Agreement
The Participation Agreement encourages the development of a shared understanding, and provides formal documentation of the expectations and responsibilities of the One21seventy team and of the health centre staff and management.

Stage 2: Orientation/Training
Regional CQI Coordinators and/or Local CQI Facilitators provide the orientation and training to health centre staff about the key components of the CQI cycle, including the data collection tools and processes, access to the website for data input and reporting, optimal recommended timelines and the ongoing One21seventy support functions. Table 2.2 explains the naming convention used in this manual to refer to these various facilitation roles.

Stage 3: Data Collection: Clinical Audits, Systems Assessment, and Health Centre and Community Survey
In this step, data are collected through the clinical audit tools, the Systems Assessment Tool (also known as SAT) and the Health Centre and Community Survey (also known as HCCS). These data are then entered into the web-based information system. Data input is conducted by health centre staff under the guidance of the Regional CQI Coordinator or Local CQI Facilitator responsible for working with that health centre. Data are submitted via the website for cleaning by the One21seventy CQI Information Systems Officer before reports being generated.

Stage 4: Data Analysis and Reporting
Once the data are entered and cleaned, the One21seventy web-based information system can be used to produce reports. A report for each audit is available, with relevant systems assessment data, commentary on linkages between audit and system assessment data, and information on the previous years’ goals (where available). Reports from the HCCS and the current year’s goal setting are also available. Reports can be downloaded as a Microsoft Word document so they are easy to include in management or board reports, for example. If health centres have agreed to share their data with others, reports will also show comparative data at the cluster, State/Territory and national level. A ‘cluster’ of health centres is defined through agreement with the participating health centres and the agency that is funding their participation. These clusters may reflect administrative arrangements (such as districts or regions) or other arrangements related to CQI support.

Stage 5: Participatory Interpretation, Goal Setting and Action Planning
This is can be done over one or two sessions at the health centre. Participatory interpretation involves feedback to health centre staff on the findings in the reports, and facilitated discussion of the key messages by Local CQI Facilitators and/or Regional CQI Coordinators. A clinician from your health centre or local health centre network provides input into the interpretation of the reports. The purpose of these sessions is to:

• increase the level of shared understanding of the systems and clinical practices that operate in the health centre;
• discuss how well the health centre is performing across a range of services;
• promote understanding of current clinical best practice and systems to support client care; and
• review the links between the clinical audits and the systems assessment results to inform improvements in care and/or services in the health centre.

The local team identifies priority areas for improvement, sets their goals and develops strategies to attain these goals, all of which are fed into an action planning process. Action planning involves the development of a clear plan of action to address the priorities, goals and strategies identified in the participatory interpretation process.

Stage 6: Implementation
It is then up to the health centre’s management and staff to implement the action plan. Health centre staff may choose to use the networks established through their engagement with One21seventy to incorporate ideas and advice from other health centres about what has worked well for them.