Puszka Stefanie, Nagel Tricia, Matthews Veronica, Mosca Diana, Piovesan Rebecca, Nori Annapurna, Bailie Ross
Menzies School of Health Research, PO Box 41096, Casuarina, NT 0810 Australia.
Menzies School of Health Research, PO Box 41096, Casuarina, NT 0810 Australia ; One21seventy, The National Centre for Quality Improvement in Indigenous Primary Health Care, PO Box 10639, Adelaide Street, Brisbane, QLD 4000 Australia.
Int J Ment Health Syst. 2015 Jul 13;9:28. doi: 10.1186/s13033-015-0019-5. eCollection 2015.
The mental health needs of young people are often inadequately met by health services. Quality improvement approaches provide a framework for measuring, assessing and improving the quality of healthcare. However, a lack of performance standards and measurement tools are an impediment to their implementation. This paper reports on the initial stages of development of a clinical audit tool for assessing the quality of primary healthcare for Australian Indigenous youth aged 12-24 including mental health services provided within primary care.
Audit items were determined through review of relevant guidelines, expert reference group consensus opinion and specific inclusion criteria. Pilot testing was undertaken at four Indigenous primary healthcare services. A focus group discussion involving five staff from a health service participating in pilot testing explored user experiences of the tool.
Audit items comprise key measures of processes and outcomes of care for Indigenous youth, as determined by the expert reference group. Gaps and conflicts in relevant guidelines and a lack of agreed performance indicators necessitated a tool development process that relied heavily on expert reference group advice and audit item inclusion criteria. Pilot testing and user feedback highlighted the importance of feasibility and context-specific considerations in tool development and design.
The youth health audit tool provides a first step in monitoring, assessing and improving the way Indigenous primary healthcare services engage with and respond to the needs of youth. Our approach offers a way forward for further development of quality measures in the absence of clearly articulated standards of care.
卫生服务往往无法充分满足年轻人的心理健康需求。质量改进方法为衡量、评估和提高医疗保健质量提供了一个框架。然而，缺乏绩效标准和测量工具阻碍了这些方法的实施。本文报告了一种临床审计工具开发的初始阶段，该工具用于评估澳大利亚12至24岁原住民青年的初级卫生保健质量，包括初级保健中提供的心理健康服务。
通过审查相关指南、专家参考小组的共识意见和特定纳入标准来确定审计项目。在四个原住民初级卫生保健服务机构进行了试点测试。一个由参与试点测试的一家卫生服务机构的五名工作人员组成的焦点小组讨论，探讨了该工具的用户体验。
审计项目包括专家参考小组确定的原住民青年护理过程和结果的关键指标。相关指南中的差距和冲突以及缺乏商定的绩效指标，使得工具开发过程严重依赖专家参考小组的建议和审计项目纳入标准。试点测试和用户反馈突出了在工具开发和设计中可行性和因地制宜考虑的重要性。
青年健康审计工具为监测、评估和改进原住民初级卫生保健服务机构与青年互动及满足青年需求的方式迈出了第一步。在缺乏明确阐述的护理标准的情况下，我们的方法为质量指标的进一步发展提供了一条前进的道路。
