Quality and Effectiveness


It’s no accident that the first strategic objective for Medicare Locals is to improve the patient journey.  Medicare Local standards and the National Safety and Quality Health Service Standards further compel us to take this objective seriously.

To improve the journey we must first better understand it. Patient participation contributes to this person-centred ambition by promoting patient views on health care design and delivery.

There are six recognised dimensions of healthcare quality developed by the Institute of Medicine, USA.  They are:

  • Person centred – providing care that is responsive to individual personal preferences, needs and values and assuring that patient values guide all clinical decisions
  • Safe – avoiding injuries to patients from healthcare that is intended to help them
  • Effective – providing services based on scientific knowledge
  • Efficient – avoiding waste, including waste of equipment, supplies, ideas and energy
  • Equitable – providing care that does not vary in quality because of personal characteristics such as gender, ethnicity, geographic location or socio-economic status
  • Timely – reducing waits and sometimes harmful delays for both those who receive care and those who can give care.

But it is not about participation for participation’s sake. A recent review discusses the evidence that good quality patient participation in health care service design and development can contribute to each of these dimensions of healthcare quality. It also suggests that a positive culture of participation within healthcare services can contribute to these improvements as much as, if not more than, the patient participation itself.

ACTML is committed to continuous improvement and commissioning and delivering quality services. We are a transparent organisation that is accountable and we want to hear from health care consumers. To yield the full benefits of participation depends on conducting good quality patient participation processes as well as developing a positive culture of participation.

We have progressively implemented a number of activities designed to build in a patient and consumer perspective into our work. We have:

  • partnered with Health Care Consumers ACT (HCCA) to ensure we have a direct consumer voice in our 2014 comprehensive needs assessment, funding HCCA to organise and run a series of focus groups on our behalf
  • recently introduced Patient Opinion to capture real-time feedback. Patient Opinion has been running successfully in the UK since 2005 and grew to be the UK’s leading independent non-profit feedback platform for health services. Patient Opinion Australia was established in 2012. Patient Opinion is about honest and meaningful conversations between patients and health services based on the belief that your story can help make health services better. ACT consumers of ACTML programs can provide anonymous feedback at patientopinion.org.au by clicking on the ‘tell your story’ tab
  • We have used an innovative structured story gathering technique to help shape our “READ” refugee health promotion program underway in partnership with Companion House.  The story gatherer formulates open ended questions and works with participants, both individually and as a group to develop story lines and vignettes of interest that reflect the information required.  This technique requires time spent connecting with the participants about their lives at a broad level, before they are comfortable enough to talk on specific issues of interest.
  • ACTML has a way to go – and our plans are ambitious. This year, we plan to further build capacity and maturity into the way we go about improving the patient journey.  Two major initiatives will be the introduction of HealthPathways into the ACT in collaboration with ACT Health and the development of our own Experience Based Care Design (EBCD) program. HealthPathways is a combination of a web based portal and a process of redesign that support better linkages between general practice and specialist services. The name ‘HealthPathways’ reflects the referral lines or ‘pathways’ which link patients to the best treatment, local service or specialist. Our EBCD initiative will include elements such as an education program to help clinicians strengthen the skills they need to work in partnership with patients and outreach support to relevant PHC services to assist them to introduce innovate ways of gathering experiences from patients and change and improve the way their services respond to patient feedback.