Please use this identifier to cite or link to this item: http://hdl.handle.net/2440/97099
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Type: Journal article
Title: Continuous quality improvement and metabolic screening during pregnancy at primary health centres attended by Aboriginal and Torres Strait Islander women
Author: Gibson-Helm, M.
Teede, H.
Rumbold, A.
Ranasinha, S.
Bailie, R.
Boyle, J.
Citation: The Medical journal of Australia, 2015; 203(9):369-370
Publisher: MJA
Issue Date: 2015
ISSN: 0025-729X
1326-5377
Statement of
Responsibility: 
Melanie E Gibson-Helm, Helena J Teede, Alice R Rumbold, Sanjeeva Ranasinha, Ross S Bailie and Jacqueline A Boyle
Abstract: To investigate associations between the provision of routine metabolic screening and follow-up in pregnancy and participation by primary health care centres in a large-scale continuous quality improvement (CQI) initiative.Longitudinal analysis of 2592 audited maternal health records.Seventy-six community-controlled or government-operated primary health care centres serving predominantly Aboriginal and Torres Strait Islander communities, in urban, regional or remote locations in five Australian states and territories.Up to four CQI cycles supported by the Audit and Best Practice for Chronic Disease Research Partnership. Screening and follow-up for body mass index (BMI), blood pressure and diabetes in pregnancy.Overall, 87.9% of women attending the participating health centres were Aboriginal or Torres Strait Islander. Women attending a health centre after it had conducted one or more CQI cycles were more likely to receive BMI, blood pressure and diabetes screening. For example, the proportion of women receiving diabetes screening at baseline (before the first CQI cycle) was 56.1%; after cycle 1 it was 63.7% (odds ratio [OR], 1.3; 95% CI, 1.0-1.6), after cycle 2, 61.6% (OR, 1.2; 95% CI, 0.9-1.7), after cycle 3, 63.7% (OR, 1.7; 95% CI, 1.1-2.6), and after cycle 4, 75.5% (OR, 3.4; 95% CI, 1.9-5.9). Diabetes screening was associated with higher self-ratings of overall organisational systems (P = 0.03), self-management support (P = 0.04) and organisational influence and integration (P = 0.01). These findings support the value of CQI approaches that focus on systems-level issues in primary care to improve the provision of recommended pregnancy care at primary health care centres in predominantly Aboriginal and Torres Strait Islander communities.
Keywords: Humans; Pregnancy Complications; Prenatal Diagnosis; Prenatal Care; Pregnancy; Adult; Oceanic Ancestry Group; Health Services, Indigenous; Primary Health Care; Australia; Female; Young Adult; Quality Improvement
Rights: © 2015 AMPCo Pty Ltd. Produced with Elsevier B.V. All rights reserved
RMID: 0030037923
DOI: 10.5694/mja14.01660
Grant ID: http://purl.org/au-research/grants/nhmrc/545267
http://purl.org/au-research/grants/nhmrc/1022996
http://purl.org/au-research/grants/nhmrc/1042516
http://purl.org/au-research/grants/nhmrc/1016755
http://purl.org/au-research/grants/arc/FT100100087
Appears in Collections:Medicine publications

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