The National Aboriginal and Torres Strait Islander Health Plan 2013–2023 clearly articulates that effective, high quality primary health care for Aboriginal and Torres Strait Islander people wherever and whenever they seek care is a national priority. Aboriginal Community Controlled Health Services (ACCHSs) play a pivotal role in the provision of holistic, comprehensive and culturally appropriate primary health care for Aboriginal and Torres Strait Islander people. Non-Indigenous primary health care services, predominantly private general practices and state and territory government health centres also have a significant role in the delivery of services to Aboriginal and Torres Strait Islander people. At a system level it is important that both Indigenous and non-Indigenous services are capable of meeting the care needs of Aboriginal and Torres Strait Islander people.
Continuous Quality Improvement (CQI) is the central approach used by modern health care organisations (primary, secondary and tertiary) to improve health care quality along with other approaches such as accreditation and clinical and organisational governance. Over the past 10 years there has been increasing interest and activity in CQI in primary health care services for Aboriginal and Torres Strait Islander people. By improving the quality of their care, we are striving to improve health outcomes and close the gap in health status between Indigenous and non-Indigenous Australians.
The purpose of this National CQI Framework for Aboriginal and Torres Strait Islander Primary Health Care is to foster commitment and a coordinated approach to CQI in primary health care for Aboriginal and Torres Strait Islander people, wherever and whenever they seek care.
- Aboriginal and Torres Strait Islander participation and leadership is vital to the effective implementation of the framework. The framework’s aims of fostering cultural safety and competence and Aboriginal and Torres Strait Islander participation and leadership are addressed by promoting client and community centredness.
- Delivery of primary health care services takes place within a complex health system across local, regional, state and national levels. In order to embed CQI effectively in everyday practice at the local level, support must be provided across all four levels of this complex system.
- Cultural safety and competence help providers and clients achieve the best, most appropriate care. Cultural safety centres on the experiences of the client as they receive care. Cultural competence focuses on the capacity of the health system to improve health and wellbeing by integrating culture into the delivery of health services.
- Aboriginal and Torres Strait Islander people need good access to both Indigenous-specific and mainstream primary health care services. The framework will be implemented in primary health care sectors that have different governance, funding, administrative and workforce arrangements.
The knowledge exchange mechanism would also support communities, primary health care providers and practitioners to adopt and have sufficient supporting structures and resources to effectively move toward action.