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Australian Journal of Primary Health Australian Journal of Primary Health Society
The issues influencing community health services and primary health care
RESEARCH ARTICLE

Quality improvement initiatives in a case management service: case study

Deborah J. Davies
+ Author Affiliations
- Author Affiliations

125 Darlington Drive, Banora Point, NSW 2486, Australia. Email: markndeb123@bigpond.com

Australian Journal of Primary Health 21(1) 14-21 https://doi.org/10.1071/PY13111
Submitted: 15 August 2013  Accepted: 5 February 2014   Published: 6 March 2014

Abstract

This article explores the importance of quality practices in underpinning the person-centred approach at a Community Options Program (COP) case management service in northern NSW. The NSW community care sector does not have a statutory excellence body to identify, promote and support improved practices and quality and safety across community services, and therefore the COP provider decided to establish a dedicated role to focus on the quality improvement of its service. The subsequent quality improvement initiatives have included mapping the clients’ journey through the service, identifying areas to standardise practice, and creating service pathways. The clients’ journey was used as the framework to identify where standardised practice was required, and a robust process was implemented to develop over 25 good practice guidelines and tools that addressed the variations in practice and enabled the service pathways to be developed. Prior to trialling the guidelines and tools, staff received education sessions on the anticipated changes to practice, and the practicality and applicability of the guidelines were evaluated at the end of the trials. This information was reviewed and the guidelines were amended accordingly before being rolled out. The guidelines have been in use for over 12 months and have provided the benchmark against which to audit practice, and have resulted in key performance improvements such as an increase in client review rates and a rise in the feedback response rate from clients, with a noticeable shift in the comments about the brokered support worker to acknowledging the role of their case manager. Formalising informal supports for those clients that lived alone also increased, which means these people are less reliant on services and there is a reduced risk of social isolation.


References

Case Management Society of Australia (2008) National standards of practice for case management. Available at http://infostore.saiglobal.com/store/Details.aspx?ProductID=1091772 [Verified 6 April 2013]

Centre for Change and Innovation, NHS Scotland (2005) A guide to service improvement. Available at http://www.google.com/cse?cx=007197013444011456969%3All2jctu1uq8&ie=UTF-8&oe=UTF-8&q=process%20mapping [Verified 9 April 2013]

Clinical Excellence Commission (2010) Rising to excellence: quality systems assessments state wide report. Clinical Excellence Commission, Sydney.

Department of Health and Ageing (2010) Community care common standards. Available at http://www.adhc.nsw.gov.au/sp/delivering_hacc_services/community_care_common_standards [Verified 5 April 2013]

Medves J, Godfrey C, Turner C, Paterson M, Harrison M, MacKenzie L (2010) Systematic review of practice guideline dissemination and implementation strategies for healthcare teams and team-based practice. International Journal of Evidence-Based Healthcare 8, 79–89.

Rycroft-Malone J, Fontenla M, Bick D, Seers K (2008) Protocol-based care: impact on roles and service delivery. Journal of Evaluation in Clinical Practice 14, 867–873.
Protocol-based care: impact on roles and service delivery.Crossref | GoogleScholarGoogle Scholar | 19018920PubMed |

Australian Institute for Primary Care (2008) System reform and development for chronic disease management. La Trobe University, Melbourne.

NSW Attorney General’s Department (2008) Capacity toolkit. Available at http://www.diversityservices.lawlink.nsw.gov.au/agdbasev7wr/divserv/documents/pdf/capacity_toolkit0609.pdf [Verified 13 December 2013]

Tsasis P, Bains J (2008) Management of complex chronic disease: facing the challenges in the Canadian health-care system. Health Services Management Research 21, 228–235.
Management of complex chronic disease: facing the challenges in the Canadian health-care system.Crossref | GoogleScholarGoogle Scholar | 18957400PubMed |

Whittle C, Hewison A (2007) Integrated care pathways: pathways to change in health care? Journal of Health Organization and Management 21, 297–306.
Integrated care pathways: pathways to change in health care?Crossref | GoogleScholarGoogle Scholar | 17713189PubMed |