Asq manuscript central12/16/2023 Improved organizational efficiencies also arise from the availability of good quality, timely local data such as a self-sustaining ability to recognize, analyze, and improve quality issues by controlling and allocating available resources more effectively ( 13, 14). In addition, studies document increased workforce capabilities, capacities, and enthusiasm to deliver best practice primary care ( 11, 12). Studies report reduced hospital admissions among patients with chronic conditions and reduced emergency department visits among older patients ( 10). Multiple impacts of implementing CQI in clinical health care are reported internationally. There is no clear evidence that any one CQI model is better than another ( 8, 9). CQI models vary according to local diversity between primary health-care services, the CQI team, and the external environment. ( 7) highlighted four key elements of CQI approaches as follows: (1) implemented in or by a health-care service (2) collecting qualitative or quantitative data on intervention effectiveness, impacts, or success (3) reporting client (or caregiver) health outcomes and (4) aiming to change how delivery of care is routinely structured. Further, government and primary health-care service investment is needed to support and extend such integration of CQI efforts.Ĭontinuous quality improvement in health care is “a structured organizational process for involving people in planning and executing a continuous flow of improvement to provide quality health care that meets or exceeds expectations” ( 6) (p. We argue that optimal benefit for health care from CQI will be attained through a systems approach, whereby comprehensive primary health-care services are better enabled to make evidence-based and locally responsive decisions through integrating CQI vertically in linkages with governments and community members and horizontally in linkages with other sectors. Yet, since the relative contribution of health care on health outcomes is estimated to account for only between 10 and 20% of gain ( 3– 5), the improvement of health-care performance alone is not enough to achieve improved health outcomes. Implementation of CQI approaches has also resulted in a CQI workforce, appropriate health system supports, and engagement with other organizations and community members ( 2). Further, government and primary health-care service investment is required to support and extend integration and evaluation of CQI efforts vertically and horizontally.Ĭontinuous quality improvement (CQI) approaches in primary health care have enabled adherence to best practice clinical guidelines and improved regularity of client attendance ( 1). The framework describes the integration of CQI vertically to improve linkages with governments and community members and horizontally with other sectors to influence the social and cultural determinants of health. Referring to the Aboriginal and Torres Strait Islander Australian context as an example, the authors provide a systems framework that includes strategies and conditions to facilitate evidence-based and local decision making by primary health-care services. This perspective paper argues that health care and health outcomes can be enhanced through applying CQI as a systems approach to comprehensive primary health care. But only 10–20% of gain in health outcomes is contributed by health-care services a much larger share is determined by social and cultural factors. Continuous quality improvement (CQI) processes for improving clinical care and health outcomes have been implemented by primary health-care services, with resultant health-care impacts.
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