Aboriginal Controlled Health Services Undergo Rethink

The release of a national framework could spark a rethink in the way primary health services are delivered to Aboriginal and Torres Strait Islander people, creating a fairer and more accessible system.  

The Continuous Quality Improvement (CQI) Framework, published by the National Aboriginal Community Controlled Health Organisations (NACCHO), was backed by a $2.8 million federal government commitment to give Aboriginal and Torres Strait Islander the highest level of care, in a culturally sensitive way.

Dr Maureen Davey, NACCHO public health medical advisor, told Pro Bono News the CQI was about multiple cycles of small change rather than bigger evaluations of whole programs, and collecting data to identify areas that needed improvement.

“CQI is underpinned by a philosophy that emphasises the importance of organisational commitment and whole team involvement to improve service systems and processes for delivering care,” Davey said.

“It encourages team members to continuously ask: ‘How are we doing?’; ‘What problem are we trying to solve?’; ‘Can we do it better?’; ‘How will we know if it is better?’.”  

Ken Wyatt, federal Indigenous health minister, said the government recognised the importance of Aboriginal Community Controlled Health Services (ACCHS) but to achieve better health outcomes, support was needed.

“We need to support accountability, quality improvement and accurate data reporting,” Wyatt said.

CEO of NACCHO Pat Turner said they had used the lessons they had learnt over the past five decades of delivering community controlled health services to compile the framework.    

“We have learnt many lessons over the last 50 years about how to structure, deliver and improve care so that it best meets the needs of our communities across Australia,” Turner said.

“This experience is used in the framework to describe how to do, support and inform culturally respectful continuous quality improvement in primary health care.”

Currently, the levels of preventable hospital admissions and deaths for Aboriginal and Torres Strait Islander people are threefold those of other Australians, which the framework said was due to them not feeling comfortable accessing the health system.

“A significant driver behind these numbers is that Aboriginal and Torres Strait Islander peoples can often feel unsafe in accessing the health care they need,” the framework said.

Davey said she hoped primary health services around the country would learn from the framework, and work with Aboriginal and Torres Strait Islander people to make CQI part of their daily practice.

“They can do this through networking, regional forums, conferences and published case studies,” she said.