There are no indicators for this criterion. However, because of its importance, it may be helpful for your health service to establish its own evidence or indicators for health promotion and preventive care activity. Some examples of evidence include:
Below is a description of the ways in which an Aboriginal Community Controlled Health Service can ensure effective health promotion and preventive care for its patients and community. Not all of these good practices are required by the Standards, but they illustrate the many practical and creative things that ACCHSs can do to ensure they deliver services of high safety and quality to their community.
The health service’s dietitian and Aboriginal health worker run a weekly cooking class that includes nutrition information, food preparation and healthy food choice education. They also run a fruit and vegetable program, where fruit and vegetable hampers are provided for families in conjunction with health checks, dental checks and hearing checks.
The service has effective systems in place for early detection of illness in its patients, and in the community as a whole. For patients it uses the National guide to a preventive health assessment for Aboriginal and Torres Strait Islander people (2nd edition) to ensure it provides appropriate screening and preventive care. At the community level the service provides school health checks at a certain time every year, and relevant community-wide health screenings. It also uses information from data collected in its health records to target health promotion activities; for example, it uses its data on anaemia in children under 5 years old for its No Anaemia Day promotion.
Staff members use large mirrors mounted at child height for the health service’s trachoma prevention program. This program involves the children washing their faces and then checking in the mirror to see how ‘clean and shiny’ they are. It also gives staff members the opportunity to screen for skin infections as well as for trachoma symptoms.
Service dental staff run dental hygiene programs at local preschools and primary schools, and distribute dental ‘show bags’ with toothbrushes, toothpaste, stickers and handouts.
The health service participates in national, state or territory reminder systems and registers, such as the Australian Childhood Immunisation Register and the National Cervical Screening Program. Staff also participate in NAIDOC Week and community days, and provide health information to patients and community members. Awareness calendars about state health events are made available in the service, and health promotion events and activities are planned to coincide with state and national promotions.
Clinical staff use regular consultations as an opportunity for health promotion and preventive care. In addition, the service runs an active reminder system to encourage patients to have appointments for reviews, screening and health assessments.
The service ensures that patient health information collected by clinical staff is routinely documented in consultation notes and transferred to a complete patient health summary. Consequently its patient health files have comprehensive, up-to-date health summaries, which include information on health risk factors (such as smoking status, weight, height and alcohol consumption) as well as relevant social and family history. As a result, these files are a useful place to find information about a patient’s health status, and a resource in the early detection of illness or management of a chronic disease.
The service’s pathology providers send reports that summarise its diabetes and cervical screening activities and these are included in the patient health summaries.
Regular systems are in place as part of the health service’s early detection strategy. These include patient disease-prevention surveys, disease registers, recall and reminder systems, and local service directories.
The health service uses a system of flags or other reminders in patients’ electronic or paper-based records to assist it in identifying and/or targeting health promotion and prevention activities. In electronic records, this system triggers an alert when transferring to patient files information collected from private pathology providers – diabetes or cervical screening results, for example. In paper-based records, it could include general information about a patient’s smoking status.
The service uses easy and effective ways to educate patients about illness prevention. This includes providing up-to-date, take-home information such as brochures, pamphlets and other resources, all written in plain language. Patients then have an opportunity to read the information, understand it in their own time and accept the importance of taking action themselves.
The service also provides culturally appropriate information (written, visual and audio-visual) in the community languages of its culturally diverse patients. It ensures that clinical staff use appropriate resources during consultations – for example, they may be spoken or visual and include diagrams and simple language. In addition, the waiting room and consultation rooms have a wide range of current, culturally appropriate brochures and pamphlets available for patients.
The health service is selective in the information it makes available to its patients and community, including information on the internet sites it uses or recommends. It uses the checklist in the RACGP green book (see Criterion 1.3.1 Health promotion and preventive care of the Standards for general practices) and asks appropriate questions before sharing information or making recommendations. Appropriate questions include:
- Is it well explained and clear?
Are there any culturally offensive materials attached?
- Is the information accurate and reliable?
- Does it apply to the local context?
Does it explain the importance of patients taking action themselves?
The service obtains the required consent when transferring patient information, such as immunisation or cervical screening data, to national registers or state- and territory-based systems. It informs patients of their right to opt out where it is available, using the RACGP’s new patient form, ordered via www.racgp.org.au/healthrecords