Monitoring and assessing the quality of care for youth: developing an audit tool using an expert consensus approach.

Stefanie Puszka,Diana Mosca,Veronica Matthews,Tricia Nagel,Ross Bailie,Annapurna Nori,Rebecca Piovesan

doi:10.1186/s13033-015-0019-5

Abstract

BackgroundThe 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.MethodsAudit 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.ResultsAudit 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.ConclusionsThe 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.

Highlights

The mental health needs of young people are often inadequately met by health services
Further prioritisation of audit items was determined by the Expert Reference Group (ERG) according to best practice service delivery for the prevention, screening or treatment for risk factors and conditions identified as priority issues for the health and wellbeing of Indigenous youth and considerations of what could be reasonably expected of health service practice and documentation, in addition to the original criteria (Figure 2)
Further prioritisation of audit items was determined by the ERG according to best practice service delivery for the prevention, screening or treatment for risk factors and conditions identified as priority issues for the health and wellbeing of Indigenous youth and reasonable expectations of health services in the documentation and delivery of care, in addition to the original criteria (Figure 2)

Summary

Introduction

The mental health needs of young people are often inadequately met by health services. Australian Indigenous youth health Young Indigenous Australians have a higher burden of disease than other Australian youth, largely attributable to high rates of mental illness such as anxiety and depression, substance use and injuries [7]. In comparison to their non-Indigenous counterparts, Indigenous young people suffer from substantially higher rates of chronic conditions, including diabetes, hearing loss, skin diseases, rheumatic heart disease [8], poor sexual health [7] and experience considerable health challenges across a range of other indicators [7]

Methods

Results

Discussion

Conclusion