Process redesign of a surgical pathway improves access to cataract surgery for Aboriginal and Torres Strait Islander people in South East Queensland
Lisa Penrose A C , Yvette Roe A , Natalie A. Johnson B and Erica L. James BA Institute for Urban Indigenous Health, 22 Cox Road, Windsor, Qld 4030, Australia.
B University of Newcastle, School of Medicine and Public Health, HMRI West Wing, University Drive, Callaghan, NSW 2308, Australia.
C Corresponding author. Email: lisa.penrose@iuih.org.au
Australian Journal of Primary Health 24(2) 135-140 https://doi.org/10.1071/PY17039
Submitted: 2 March 2017 Accepted: 1 November 2017 Published: 9 February 2018
Abstract
The Institute for Urban Indigenous Health (IUIH) aimed to improve access to cataract surgery in urban South East Queensland (SEQ) for Indigenous Australians, without compromising clinical visual outcomes. The Penchansky and Levesque concept of access as the ‘fit’ between the patient’s needs and the ability of the system to meet those needs was used to inform the redesign of the mainstream cataract surgical pathway. The IUIH staff and community stakeholders mapped the traditional external cataract surgical pathway and then innovatively redesigned it to reduce the number of patients being removed by the system at key transition points. The integration of eye health within the primary health care (PHC) clinic has improved the continuity and coordination of care along the surgical pathway, and ensured the sustainability of collaborative partnerships with key external organisations. Audit data demonstrated a significant increase in utilisation of cataract surgical services after the process redesign. Previous studies have found that PHC models involving integration, coordination and continuity of care enhance patient health outcomes; however, the IUIH surgical model extends this to tertiary care. There is scope to apply this model to other surgical pathways and communities who experience access inequity.
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