Table 6 Summary of factors influencing performance of 6 remote NT health centres in delivering services to people with ARF/RHD (Ordered in terms of amenability to change)
Determinants of relatively good performance | Determinants of relatively poor performance |
|---|---|
1. Clear allocation of responsibility for RHD program among health centre staff | 1. Patient flows in health centre do not direct RHD clients to staff responsible for RHD care |
2. Good regional management – commitment to CQI, resourcing for CQI | 2. Lack of clear allocation of responsibility for RHD care |
3. Effective feedback and management action in response to feedback from CQI process | 3. Lack of effective outreach services |
4. Good Aboriginal Health Practitioner involvement in health centre operations | 4. Changes and inefficiencies in patient information systems |
5. Good outreach arrangements – including drivers, Aboriginal Health Practitioners | 5. Lack of regular/stable staffing, including medical practitioner service |
6. Public health-oriented chronic disease support from regional level to health centres | 6. Health Centre Management turnover, unstable management structure |
7. Staff stability and continuity, including availability of experienced GP | 7. Larger number of clients, complexities of urban environment |