A mixed-methods retrospective study: 10 years of diabetic retinopathy screening in urban Aboriginal and Torres Strait Islander primary care
Clare Villalba
A B , Deborah Askew C , Anjali Jaiprakash A B I , Jared Donovan D , Jonathan Roberts A B , Anthony Russell E F , Ross Crawford A B G and Noel Hayman H
+ Author Affiliations
- Author Affiliations
A Medical and Healthcare Robotics, Faculty of Science and Engineering, Queensland University of Technology, Level 11, S Block, 2 George Street, Brisbane, Qld 4000, Australia.
B Institute of Health and Biomedical Innovation (IHBI), Queensland University of Technology, Q Block, 60 Musk Avenue, Kelvin Grove, Qld 4059, Australia.
C Primary Care Clinical Unit, Faculty of Medicine, The University of Queensland, Health Sciences Building, Building 16/910, Royal Brisbane and Women’s Hospital, Herston, Qld 4029, Australia.
D School of Design, Faculty of Creative Industries, Queensland University of Technology, Level 11, S Block, 2 George Street, Brisbane, Qld 4000, Australia.
E School of Medicine, The University of Queensland, Princess Alexandra Hospital, Woolloongabba, Qld 4102, Australia.
F Department of Diabetes and Endocrinology, Princess Alexandra Hospital, Woolloongabba, Qld 4102, Australia.
G Holy Spirit Hospital, 627 Rode Road, Chermside, Qld 4032, Australia.
H Southern Queensland Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care, 37 Wirraway Parade, Inala, Qld 4077, Australia.
I Corresponding author. Email: anjali.jaiprakash@qut.edu.au
Australian Journal of Primary Health 25(1) 24-30 https://doi.org/10.1071/PY18030
Submitted: 13 February 2018 Accepted: 1 October 2018 Published: 30 January 2019
Abstract
This research applies a mixed-method approach to retrospectively study the history of diabetic retinopathy (DR) screening in an urban Aboriginal and Torres Strait Islander general practice. Data from administrative practice software and publications were extracted and presented as a timeline data visualisation to staff, in six focus groups. Eighteen key staff from the Southern Queensland Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care (CoE) were purposively recruited. The main outcome measures were retrospective administrative practice data, publications and staff interpretations regarding DR screening at the CoE. The CoE DR screening initially increased screening rates to 93%. Participants reported that CoE DR screening provides eye care from screening to treatment; all annual care is provided in one appointment; and in a client-focussed environment. From 2012 to 2016, the number of regular CoE clients with diabetes increased by 46%. Consequently, DR screening rates dropped from 44% to 22%. Participants’ recognised the service could reach its full potential if it implements continuous quality improvement focussed on client experience, using rigorous data and supported by engaged staff. Initial investment in setting-up DR screening is not enough, instead ongoing quality improvement is integral to a sustainable, successful service long-term.
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