ArticleBMJ open2017
Impact of policy support on uptake of evidence-based continuous quality improvement activities and the quality of care for Indigenous Australians: a comparative case study.
Article in BMJ open, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 1 of them a synthesis that pooled it.
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Who cites it
23 citing papers in PubMed, 1 synthesis or guideline pooled it.
- A systematic review of approaches to improve practice, detection and treatment of unhealthy alcohol use in primary health care: a role for continuous quality improvement.BMC family practice · 2020Pooled it
- Support for Aboriginal health services in reducing harms from alcohol: 2-year service provision outcomes in a cluster randomized trial.Addiction (Abingdon, England) · 2022Trial
- Looking Back to Move Forward: A Narrative Review of Indigenous Health Intervention Research by the University Departments of Rural Health Against a Contemporary National Framework.International journal of environmental research and public health · 2026Review
- Contributions of Australian University Departments of Rural Health to Indigenous Health Intervention Research: A Narrative Review.Healthcare (Basel, Switzerland) · 2026Review
- Let them eat (birthday) cake: reframing healthy eating in healthcare organizations.Global health promotion · 2025Article
- Access to preventive health assessments for people with intellectual disability: a systematic scoping review informed by the Levesque Access Framework.BMC health services research · 2025Article
- Exploring the barriers and facilitators of continuous quality improvement for health promotion within healthcare food environments.Health promotion international · 2025Article
- A realist synthesis of multicentre comparative audit implementation: exploring what works and in which healthcare contexts.BMJ open quality · 2024Review
- Decision-maker roles in healthcare quality improvement projects: a scoping review.BMJ open quality · 2024Article
- Producing knowledge together: a participatory approach to synthesising research across a large-scale collaboration in Aboriginal and Torres Strait Islander health.Health research policy and systems · 2024Review
- Article
- Bridging the Knowledge Gap for Pressure Injury Management in Nursing Homes.International journal of environmental research and public health · 2022Article
- Enablers and barriers to implementing care quality improvement program in nursing homes in China.BMC geriatrics · 2021Article
- Article
- A qualitative exploration of priorities for quality improvement amongst Aboriginal and Torres Strait Islander primary health care services.BMC health services research · 2021Article
- Service Level Factors Associated with Cervical Screening in Aboriginal and Torres Strait Islander Primary Health Care Centres in Australia.International journal of environmental research and public health · 2019Article
- Observational
- Application of the i-PARIHS framework for enhancing understanding of interactive dissemination to achieve wide-scale improvement in Indigenous primary healthcare.Health research policy and systems · 2018Article
- Alliances and evidence: Building the capacity and effectiveness of rural health advocacy in Australia.The Australian journal of rural health · 2018Article
- Wide-Scale Continuous Quality Improvement: A Study of Stakeholders' Use of Quality of Care Reports at Various System Levels, and Factors Mediating Use.Frontiers in public health · 2018Article
Corrections and comments
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo examine the impact of state/territory policy support on (1) uptake of evidence-based continuous quality improvement (CQI) activities and (2) quality of care for Indigenous Australians.
designMixed-method comparative case study methodology, drawing on quality-of-care audit data, documentary evidence of policies and strategies and the experience and insights of stakeholders involved in relevant CQI programmes. We use multilevel linear regression to analyse jurisdictional differences in quality of care.
settingIndigenous primary healthcare services across five states/territories of Australia.
participants175 Indigenous primary healthcare services.
interventionsA range of national and state/territory policy and infrastructure initiatives to support CQI, including support for applied research. PRIMARY AND SECONDARY OUTCOME MEASURES: (i) Trends in the consistent uptake of evidence-based CQI tools available through a research-based CQI initiative (the Audit and Best Practice in Chronic Disease programme) and (ii) quality of care (as reflected in adherence to best practice guidelines).
resultsProgressive uptake of evidence-based CQI activities and steady improvements or maintenance of high-quality care occurred where there was long-term policy and infrastructure support for CQI. Where support was provided but not sustained there was a rapid rise and subsequent fall in relevant CQI activities.
conclusionsHealth authorities should ensure consistent and sustained policy and infrastructure support for CQI to enable wide-scale and ongoing improvement in quality of care and, subsequently, health outcomes. It is not sufficient for improvement initiatives to rely on local service managers and clinicians, as their efforts are strongly mediated by higher system-level influences.
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