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Improving physiotherapy services to Indigenous children with physical disability: Are client perspectives missed in the continuous quality improvement approach?

Greenstein, Caroline, Lowell, Anne and Thomas, David P. (2015). Improving physiotherapy services to Indigenous children with physical disability: Are client perspectives missed in the continuous quality improvement approach?. Australian Journal of Rural Health,24(3):176-181.

Document type: Journal Article
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IRMA ID 81144320xPUB170
Title Improving physiotherapy services to Indigenous children with physical disability: Are client perspectives missed in the continuous quality improvement approach?
Author Greenstein, Caroline
Lowell, Anne
Thomas, David P.
Journal Name Australian Journal of Rural Health
Publication Date 2015
Volume Number 24
Issue Number 3
ISSN 1038-5282   (check CDU catalogue  open catalogue search in new window)
Scopus ID 2-s2.0-84952333624
Start Page 176
End Page 181
Total Pages 6
Place of Publication Australia
Publisher Wiley-Blackwell Publishing Asia
Field of Research 1117 - Public Health and Health Services
HERDC Category C1 - Journal Article (DIISR)
Abstract Objective
To compare the outcomes of two cycles of continuous quality improvement (CQI) at a paediatric physiotherapy service with findings from interviews with clients and their carers using the service.

Design
Case study based at one paediatric physiotherapy service

Setting
Community-based paediatric allied health service in Northern Australia.

Participants
Forty-nine clinical records and four staff at physiotherapy service, five Indigenous children with physical disability aged 8–21 years, and nine carers of Indigenous children aged 0–21 years (current or previous clients).

Interventions
The CQI process based on the Audit and Best Practice for Chronic Disease involved a clinical audit; a workshop where clinicians assessed their health care systems, identified weaknesses and strengths, and developed goals and strategies for improvement; and reassessment through a second audit and workshop. Twelve open-ended, in-depth interviews were conducted with previous or current clients selected through purposive and theoretical sampling. CQI and interview results were then compared.

Main outcome measure
Comparison of findings from the two studies

Results
Both CQI and interview results highlighted service delivery flexibility and therapists' knowledge, support and advocacy as service strengths, and lack of resources and a child-friendly office environment as weaknesses. However, the CQI results reported better communication and client input into the service than the interview results.

Conclusion
The CQI process, while demonstrating improvements in clinical and organisational aspects of the service, did not always reflect or address the primary concerns of Indigenous clients and underlined the importance of including clients in the CQI process.
DOI http://dx.doi.org/10.1111/ajr.12258   (check subscription with CDU E-Gateway service for CDU Staff and Students  check subscription with CDU E-Gateway in new window)
 
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Created: Tue, 26 Jul 2016, 12:42:23 CST