학술논문
Quality management systems in Aboriginal Community Controlled Health Services: a review of the literature.
Document Type
Academic Journal
Author
Darr JO; College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia jenny.darr@my.jcu.edu.au.; Franklin RC; College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia.; McBain-Rigg KE; College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia.; Larkins S; College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia.; Roe Y; Molly Wardaguga Research Centre, Charles Darwin University, Brisbane, Queensland, Australia.; Panaretto K; Faculty of Medicine, The University of Queensland, Saint Lucia, Queensland, Australia.; Saunders V; First Peoples Health Unit, Griffith University Faculty of Health, Gold Coast, Queensland, Australia.; Crowe M; College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia.
Source
Publisher: BMJ Publishing Group Country of Publication: England NLM ID: 101710381 Publication Model: Print Cited Medium: Internet ISSN: 2399-6641 (Electronic) Linking ISSN: 23996641 NLM ISO Abbreviation: BMJ Open Qual Subsets: MEDLINE
Subject
Language
English
Abstract
Background: A national accreditation policy for the Australian primary healthcare (PHC) system was initiated in 2008. While certification standards are mandatory, little is known about their effects on the efficiency and sustainability of organisations, particularly in the Aboriginal Community Controlled Health Service (ACCHS) sector.
Aim: The literature review aims to answer the following: to what extent does the implementation of the International Organisation for Standardization 9001:2008 quality management system (QMS) facilitate efficiency and sustainability in the ACCHS sector?
Methods: Thematic analysis of peer-reviewed and grey literature was undertaken from Australia and New Zealand PHC sector with a focus on First Nations people. The databases searched included Medline, Scopus and three Informit sites (AHB-ATSIS, AEI-ATSIS and AGIS-ATSIS). The initial search strategy included quality improvement, continuous quality improvement, efficiency and sustainability.
Results: Sixteen included studies were assessed for quality using the McMaster criteria. The studies were ranked against the criteria of credibility, transferability, dependability and confirmability. Three central themes emerged: accreditation (n=4), quality improvement (n=9) and systems strengthening (n=3). The accreditation theme included effects on health service expenditure and clinical outcomes, consistency and validity of accreditation standards and linkages to clinical governance frameworks. The quality improvement theme included audit effectiveness and value for specific population health. The theme of systems strengthening included prerequisite systems and embedded clinical governance measures for innovative models of care.
Conclusion: The ACCHS sector warrants reliable evidence to understand the value of QMSs and enhancement tools, particularly given ACCHS (client-centric) services and their specialist status. Limited evidence exists for the value of standards on health system sustainability and efficiency in Australia. Despite a mandatory second certification standard, no studies reported on sustainability and efficiency of a QMS in PHC.
Competing Interests: Competing interests: None declared.
(© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Aim: The literature review aims to answer the following: to what extent does the implementation of the International Organisation for Standardization 9001:2008 quality management system (QMS) facilitate efficiency and sustainability in the ACCHS sector?
Methods: Thematic analysis of peer-reviewed and grey literature was undertaken from Australia and New Zealand PHC sector with a focus on First Nations people. The databases searched included Medline, Scopus and three Informit sites (AHB-ATSIS, AEI-ATSIS and AGIS-ATSIS). The initial search strategy included quality improvement, continuous quality improvement, efficiency and sustainability.
Results: Sixteen included studies were assessed for quality using the McMaster criteria. The studies were ranked against the criteria of credibility, transferability, dependability and confirmability. Three central themes emerged: accreditation (n=4), quality improvement (n=9) and systems strengthening (n=3). The accreditation theme included effects on health service expenditure and clinical outcomes, consistency and validity of accreditation standards and linkages to clinical governance frameworks. The quality improvement theme included audit effectiveness and value for specific population health. The theme of systems strengthening included prerequisite systems and embedded clinical governance measures for innovative models of care.
Conclusion: The ACCHS sector warrants reliable evidence to understand the value of QMSs and enhancement tools, particularly given ACCHS (client-centric) services and their specialist status. Limited evidence exists for the value of standards on health system sustainability and efficiency in Australia. Despite a mandatory second certification standard, no studies reported on sustainability and efficiency of a QMS in PHC.
Competing Interests: Competing interests: None declared.
(© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)