Healthy for Life Program Framework
The Program Framework provides an overview of the purpose, objectives and expected outcomes of the program and the supporting resources and infrastructure for participating organisations.
Healthy for Life is an Australian Government program that aims to:
- improve the health of Aboriginal and Torres Strait Islander mothers, babies and children;
- improve the quality of life for people with a chronic condition; and,
- over time, reduce the incidence of adult chronic disease.
Purpose
Healthy for Life provides funds to enhance the capacity of over 80 Aboriginal and Torres Strait Islander primary health care services to improve the quality of child and maternal health services, chronic disease care, and to improve the capacity of the Indigenous health workforce. Following a decision by Minister Roxon in July 2008, men’s health can now be included in new Healthy For Life services from Round 3.Healthy for Life is a program designed to allow health services to step back and review their current service delivery in child and maternal health and chronic disease, to identify priority action areas for improvement, and to develop further the child and maternal health and chronic disease care provided in their community.
Healthy for Life also provides opportunities for services to come together to share information and learn from each other’s experience.
Program Objectives
The objectives of Healthy for Life are to :1. improve the availability of child and maternal health care;
2. improve the prevention, early detection and management of chronic disease;
3. improve men’s health;
4. improve long term health outcomes for Aboriginal and Torres Strait Islander Australians;
5. increase the capacity of the Aboriginal and Torres Strait Islander health workforce through the Puggy Hunter Memorial Scholarship Scheme.
Expected Outcomes
Participating organisations are asked to demonstrate improvement, or movement towards improvement, in each of the key outcomes relating to the first three objectives of Healthy for Life.Short to medium term outcomes (1-4 years)
- increase in first attendance for antenatal care in first trimester;
- 10% increase per year of adult and child health checks, with associated plans for follow-up; and
- 30% improvement in best practice service delivery for people with chronic conditions.
Longer term outcomes (5-10 years)
- increase in mean birth-weight to within 200g of the non-Indigenous population;
- decrease in incidence of low birth-weight by 10%;
- reduction in selected behavioural risk factors (eg smoking, harmful alcohol intake among others) in pregnancy by 10%;
- 30% reduction in hospital admissions for chronic disease complications; and
- 30% improvement in numbers of patients with intermediate health outcomes within acceptable range.
Program Description
Healthy for Life's program design is based on delivering population health approaches in a primary health care context using quality improvement principles, processes and tools.Quality improvement and health service development is a dynamic process. At the beginning of a new project, it can be difficult to assess strengths and gaps in current service delivery and identify priorities for action, especially in the short timeframes usually associated with application processes. Priorities may also change over time as an organisation responds to identified needs, implements changes, and monitors and evaluates progress towards achieving their desired objectives.
For this reason Healthy for Life is implemented in 2 phases:
Phase 1: Knowing your starting point;
Phase 2: Service delivery begins.
Phase 1: Knowing your starting point
Organisations receive initial funding to complete Phase 1. These involve:i. Gathering and analysing information about the child and maternal health and chronic disease activity in their service to establish a baseline including:
- Mapping current activities and service systems supporting child and maternal health and the prevention, early detection and management of chronic diseases both within the service and including linkages to other relevant service providers in their region;
- Using quality improvement tools (eg process mapping) to describe the client care processes and develop a shared understanding throughout the organisation of the clients’ experience when they enter the health service;
- Conducting clinical audits through reviewing medical records to determine the key child and maternal health and chronic disease issues affecting the service; and
- Collecting measurements of 10-15 specific Healthy for Life performance indicators.
This baseline information is then used to help to identify strengths and gaps in service delivery and priority areas for action required to bring about improvements in the delivery of health services for the community.
The baseline information also provides a reference point for organisations to monitor their progress in achieving their objectives for improvement in child and maternal health and the prevention, early detection and management of chronic disease.
ii. Baseline information is used to develop a Healthy for Life proposal. The Healthy for Life proposal aims to improve the quality of care provided as well as build on existing child and maternal and chronic disease programs managed by the organisation. The proposal documents the:
- strategic long-term vision of the organisation in the delivery of child and maternal health and chronic disease care;
- agreed priority areas for action required to bring about improvement;
- proposed strategies to address the key priorities for action;
- roles and responsibilities (who will do what);
- how the impact of the strategies will be measured;
- estimated dates for milestones and completion; and
- detailed budget.
A template is provided to assist in the development of proposals.
It may take up to 6 months to complete Phase 1 - the actual time taken is largely dependent on the organisation itself. If completed sooner, the organisation moves more quickly to receive Phase 2 funding.
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Phase 2: Service delivery begins
Phase 2 involves implementation of the Healthy for Life proposal developed during Phase 1. Following approval by OATSIH of their Healthy for Life proposal (including budget), organisations receive further funding, as agreed.As part of their Phase 2 activities, organisations are required to monitor and review their baseline information and to revise their program plan according to changing priorities.
Program Infrastructure
A range of resources and support is available to assist organisations participating in Healthy for Life.1. Resource Package: Contextual program and policy information and the evidence base underpinning the Australian Government’s approach to improving child and maternal health and chronic disease for Aboriginal and Torres Strait Islander people is available to support this initiative and guide organisations in their own service planning. This package includes reports from other primary health care services on how they have approached improving child and maternal health and chronic disease outcomes for the communities they service.
2. Panel of Quality Improvement Facilitators: A panel of trained quality improvement facilitators is available to assist organisations undertaking Phase 1 and Phase 2 activities. The types of services that facilitators provide include:
- The provision of education, training and support:
- on population health approaches to maternal and child health and chronic diseases in the Aboriginal and Torres Strait Islander primary health care context;
- on data collection and analysis to inform health service system development, and specifically in maternal and child health and chronic diseases;
- on the development and implementation of service level action planning;
- on the development and implementation of an integrated service program design and overall program planning;
- to support evaluation and monitoring requirements for services participating in the Healthy for Life program; and
- to enhance the delivery of, and access to, effective services for maternal and child health and the early detection and management of chronic disease.
- The facilitation of workshops related to quality improvement initiatives/programs and the development of action plans to address identified priorities in enhancing health service delivery.
- Assisting in the preparation of reports for evaluation purposes.
- Assisting in the provision of feedback to Boards, local community members and the Department.
Organisations are able to engage their preferred facilitator directly. The Department of Health and Ageing has developed a 'template' contract to assist organisations to do this.
3. Service Toolkit: A Service Toolkit is available to support organisations completing Phase 1 activities and in service planning and implementation. This Toolkit will include how-to guides, tools for clinical audits, systems and process mapping activities (process mapping can be used to describe the client journey through the health clinic, including clinical care processes or information management), as well as templates for data collection, evaluation and reporting.
4. Orientation Meeting: All organisations participating in Healthy for Life are required to attend an Orientation Meeting before starting Phase 1 activities. This Meeting provides an opportunity for staff from participating organisations to:
- meet one another;
- learn more about the program requirements, including the evaluation component;
- meet the members of the Panel of Quality Improvement Facilitators; and
- attend in-service sessions on population health approaches to child and maternal health and chronic disease and quality improvement approaches.
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Page currency, Latest update: 12 September, 2008