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Objective: To evaluate clinical healthcare performance
in Aboriginal Medical Services in Queensland and to
consider future directions in supporting improvement
through measurement, target setting and standards
development.
Design: Longitudinal study assessing baseline
performance and improvements in service delivery,
clinical care and selected outcomes against key
performance indicators 2009–2010.
Setting: 27 Aboriginal and Islander Community
Controlled Health Services (AICCHSs) in Queensland,
who are members of the Queensland Aboriginal and
Islander Health Council (QAIHC).
Participants: 22 AICCHS with medical clinics.
Intervention: Implementation and use of an electronic
clinical information system that integrates with
electronic health records supported by the QAIHC
quality improvement programme—the Close the Gap
Collaborative.
Main outcome measures: Proportion of patients
with current recording of key healthcare activities and
the prevalence of risk factors and chronic disease.
Results: Aggregated performance was high on a
number of key risk factors and healthcare activities
including assessment of tobacco use and management
of hypertension but low for others. Performance
between services showed greatest variation for care
planning and health check activity.
Conclusions: Data collected by the QAIHC health
information system highlight the risk factor workload
facing the AICCHS in Queensland, demonstrating the
need for ongoing support and workforce planning.
Development of targets and weighting models is
necessary to enable robust between-service comparisons
of performance, which has implications for health reform
initiatives in Australia. The limited information available
suggests that although performance on key activities in the AICCHS sector has potential for improvement in
some areas, it is nonetheless at a higher level than for
mainstream providers.
Implications: The work demonstrates the role that the
Community Controlled sector can play in closing the gap in Aboriginal and Torres Strait Islander health outcomes by leading the
use of clinical data to record and assess the quality of services and
health outcome.