https://search.dev.ndltd.org/etd/unsw/oai:unsworks.library.unsw.edu.au:1959.4/54287
type: CreativeWork
name: An evaluation of the development, implementation, feasibility and impact of a tailored intervention to improve the quality of care for Aboriginal and Torres Strait Islander peoples attending urban general practice.
description: BACKGROUND: Aboriginal and Torres Strait Islander (Aboriginal) peoples have greater health needs than other Australians and those in urban areas experience greater disease. Approximately 60% of Aboriginal peoples use non-Aboriginal Community Controlled (mainstream) general practice. General practice may not provide culturally appropriate care to Aboriginal peoples, and few practices have effective systems in place to identify Indigenous status, resulting in inadequately targeted care. AIM: To develop and evaluate a tailor-made practice facilitation model to improve the acceptability of health care provided to Aboriginal peoples who attend urban mainstream general practice. METHODS: Set in two Medicare Local Areas in Sydney, a mixed-methods multiple-site case study was used, which was informed by an interpretivist constructionist paradigm. Data collection included focus groups with the two local Aboriginal communities; interviews with Medicare local staff (n=3); interviews and surveys with GPs, nurses and practice staff (n=29); a patient medical record audit, practice systems audit and Aboriginal unannounced standardised patient (USP) assessments at two time-points at seven general practices. The triangulated data were used to tailor quality improvement activities within each practice to improve their Indigenous-status recording systems and the quality of care offered to Aboriginal patients. The implementation of the intervention was evaluated using the Normalisation Process Theory (NPT). FINDINGS: Feedback from the USPs, combined with education and clinical audits, enabled practices to implement an organisational response consistent with the processes described in the NPT. At follow-up most practices improved their Indigenous-status identification systems, with a doubling in Indigenous-identified patients in six practices; and there was an increase in the number of Aboriginal Health Assessments performed and enrolments into the Closing the Gap Health Initiative sche…
abstract: BACKGROUND: Aboriginal and Torres Strait Islander (Aboriginal) peoples have greater health needs than other Australians and those in urban areas experience greater disease. Approximately 60% of Aboriginal peoples use non-Aboriginal Community Controlled (mainstream) general practice. General practice may not provide culturally appropriate care to Aboriginal peoples, and few practices have effective systems in place to identify Indigenous status, resulting in inadequately targeted care. AIM: To develop and evaluate a tailor-made practice facilitation model to improve the acceptability of health care provided to Aboriginal peoples who attend urban mainstream general practice. METHODS: Set in two Medicare Local Areas in Sydney, a mixed-methods multiple-site case study was used, which was informed by an interpretivist constructionist paradigm. Data collection included focus groups with the two local Aboriginal communities; interviews with Medicare local staff (n=3); interviews and surveys with GPs, nurses and practice staff (n=29); a patient medical record audit, practice systems audit and Aboriginal unannounced standardised patient (USP) assessments at two time-points at seven general practices. The triangulated data were used to tailor quality improvement activities within each practice to improve their Indigenous-status recording systems and the quality of care offered to Aboriginal patients. The implementation of the intervention was evaluated using the Normalisation Process Theory (NPT). FINDINGS: Feedback from the USPs, combined with education and clinical audits, enabled practices to implement an organisational response consistent with the processes described in the NPT. At follow-up most practices improved their Indigenous-status identification systems, with a doubling in Indigenous-identified patients in six practices; and there was an increase in the number of Aboriginal Health Assessments performed and enrolments into the Closing the Gap Health Initiative sche…
author: Schutze, Heike
language: EN
keywords: unannounced standardised patient, Aboriginal and Torres Strait Islander health, indigenous health, primary health care, quality improvement, cultural appropriateness
license: https://purl.org/coar/access_right/c_abf2
license: https://creativecommons.org/licenses/by-nc-nd/3.0/au/
date published: 2015
date modified: 2026-07-24T05:34:07Z
provider: University of New South Wales
publisher: Networked Digital Library of Theses and Dissertations
type: WebPage
source organization: UNSW, Sydney

PropertyValue
property ID: Handle
value: http://hdl.handle.net/1959.4/54287

PropertyValue
property ID: DOI
value: 10.26190/unsworks/18118