Abstract
BackgroundMany nations have established primary health care (PHC) organizations that conduct PHC planning for defined geographical areas. The Australian Government established Primary Health Networks (PHNs) in 2015 to develop and commission PHC strategies to address local needs. There has been little written about the capacity of such organizations for evidence-informed planning, and no tools have been developed to assess this capacity, despite their potential to contribute to a comprehensive effective and efficient PHC sector.MethodsWe adapted the ORACLe tool, originally designed to examine evidence-informed policy-making capacity, to examine organizational capacity for evidence-informed planning in meso-level PHC organizations, using PHNs as an example. Semi-structured interviews were conducted with 14 participants from five PHNs, using the ORACLe tool, and scores assigned to responses, in seven domains of capacity.ResultsThere was considerable variation between PHNs and capacity domains. Generally, higher capacity was demonstrated in regard to mechanisms which could inform planning through research, and support relationships with researchers. PHNs showed lower capacity for evaluating initiatives, tools and support for staff, and staff training.Discussion and conclusionsWe critique the importance of weightings and scope of some capacity domains in the ORACLe tool. Despite this, with some minor modifications, we conclude the ORACLe tool can identify capacity strengths and limitations in meso-level PHC organizations. Well-targeted capacity development enables PHC organizations’ strategies to be better informed by evidence, for optimal impact on PHC and population health outcomes.
Highlights
Many nations have established primary health care (PHC) organizations that conduct PHC planning for defined geographical areas
This paper provides a reflective critique of the use of a slightly adapted version of the ORACLe tool to assess the organizational capacity of meso-level Primary health care organization (PHCO) for evidence-informed health planning critically, and presents the findings of applying the tool to Australian Primary Health Network (PHN)
Research context This research extends on a larger National Health and Medical Research Council-funded mixed-methods research programme that ran from 2014 to 2018, and examined various aspects of Australian PHCOs (PHNs and their predecessors, Medicare Locals): governance, health equity, comprehensive PHC approaches, population health planning, evidence use in planning and more
Summary
Many nations have established primary health care (PHC) organizations that conduct PHC planning for defined geographical areas. Windle et al Health Res Policy Sys (2021) 19:25 recent of these, building on lessons from earlier tools, is the ORACLe interview tool which examines seven domains of organizational capacity, and was developed by the Sax Institute in Australia, within a suite of tools and services to help policy agencies improve evidenceinformed policy-making [8, 11, 12] One such tool is the SAGE tool, which is based on qualitative assessment of research use in policy development, and has been used alongside the ORACLe tool [12]. Extensive literature on the use of evidence in decisionmaking spans a broad range of disciplines, and health policy-making and clinical practice are areas that feature prominently In between these realms of broad population-based approaches implemented by governments, and individual services delivered by health care professionals is the meso level of health planning, which involves devolved, relatively autonomous regional decision-making for a geographically defined population. Devolved decision-making, as with that of ‘higher’ levels of government, is likely to be most useful and least harmful when informed by the systematic and transparent use of a range of different types of evidence [14, 15], yet there is a paucity of literature exploring the use of evidence in this context
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