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1800 results in Nursing

Page 62 of 90

  • 2 - Implementing the macro level of the ICCCF

  • from Part 1 - Frameworks for Chronic Care Management
  • Linda Deravin-Malone, Charles Sturt University, Wagga Wagga, New South Wales, Judith Anderson, Charles Sturt University, Bathurst, New South Wales
  • Book:
    Chronic Care Nursing
    Published online:
    21 June 2018
    Print publication:
    01 July 2016, pp 20-32

  • Summary

    LEARNING OBJECTIVES

    After studying this chapter, you should be able to:

  • • explain how the macro level of the Innovative Care for Chronic Conditions Framework addresses care for the person with a chronic condition

  • • understand the importance of national health policy and strategic initiatives to improve primary care services

  • • describe quality and monitoring systems within a chronic care nursing context

  • • understand the importance of education for the nurse and other health professionals in the specialty of chronic care.

    • Introduction

    The macro level of the Innovative Care for Chronic Conditions Framework (ICCCF) reviews policy development and resource allocation. This level also considers the legislative framework and the ability of policymakers to adapt policies to meet changes in health care requirements and create effective intersectoral links. The fragmentation of financial incentives and its impact on health outcomes and services are considered. Maintaining quality health care and monitoring systems are included, together with continuing education for registered nurses.

    A positive policy environment is the macro level that is required to support the micro and meso levels of the ICCCF. It is this level that provides the leadership, regulation and financial support for the health organisation, community and patient interaction (Epping-Jordan, Pruitt, Bengoa & Wagner, 2004).

    Chronic conditions can be viewed as being on a continuum, spanning those with the condition to those without the condition, as these conditions develop over time, beginning with risk, developing into diagnosis and then moving into complications. An awareness of this continuum is required to understand the need to invest at all points in the development of chronic conditions in order to manage them effectively – this is why the ICCCF requires three levels in order to manage chronic conditions (Epping-Jordan et al., 2004).

    Competency

    Table 2.1 identifies the national competency standards for the registered nurse from the Nursing and Midwifery Board of Australia (NMBA) and the Nursing Council of New Zealand (NCNZ) that are addressed in this chapter.

    Describing the macro level

    The macro level of the ICCCF describes the positive policy environment that supports the care provided for people with chronic conditions (see Figure 2.1).

  • 5 - The Australian and New Zealand health care systems

  • from Part 1 - Frameworks for Chronic Care Management
  • Linda Deravin-Malone, Charles Sturt University, Wagga Wagga, New South Wales, Judith Anderson, Charles Sturt University, Bathurst, New South Wales
  • Book:
    Chronic Care Nursing
    Published online:
    21 June 2018
    Print publication:
    01 July 2016, pp 64-76

  • Summary

    LEARNING OBJECTIVES

    After studying this chapter you should be able to:

  • • describe the Australian and New Zealand health care systems

  • • identify and describe the health care challenges faced by rural communities in Australia and New Zealand, including Aboriginal and Torres Strait Islander and Māori rural communities

  • • identify the national health priorities and strategies for achieving improved health outcomes in Australia and New Zealand

  • • critically analyse health differentials and health inequality and their interaction on individuals, groups and communities

  • • discuss the impact that vulnerability has on individuals and populations, and the importance of resilience.

    • Introduction

    This chapter describes the Australian and New Zealand health care systems, which are both predominantly publically funded and aim to provide equity in access to health care for all citizens. In Australia, there is also a private market model that provides a significant amount of funding for health care services. In New Zealand, the Treaty of Waitangi is most important in underpinning all health and social policies, assuring partnership, participation and protection of Māori (NZMOH, 2014b). As in many countries around the world, the Australian and New Zealand governments and health care systems face the significant challenges of an increasing burden of chronic disease among ageing populations. Another challenge in both Australia and New Zealand is that some people live in rural and remote locations where morbidity and mortality are higher than in metropolitan areas. Rurality is classified in Australia according to three systems that determine the level of remoteness and funding available (AIHW, 2004). The impact of rurality is greater in Aboriginal and Torres Strait Islander and Māori peoples and is reflected in their overall poorer health status compared to the non-Indigenous populations (AIHW, 2014; NZMOH, 2014a).

    The Integrated Care for Chronic Conditions Framework (ICCCF) provides a model for change to address these challenges. National health priorities, developed in response to the World Health Organization (WHO) ‘Health for All’ global strategy (WHO, 1981), provide guidance for governments in promoting the health of their citizens and addressing the needs of the most vulnerable groups. Health differentials and inequalities are caused by a range of complex factors including social and economic factors, health behaviours, physical factors, environmental issues, and access to health services and their utilisation.

Page 62 of 90