An Integrated Model of Practice: Organisational Change to Achieve Population Health Outcomes

The move towards health outcomes internationally and in Australia has produced an agenda for meeting population health goals and targets which in the primary health care sector falls mainly on community health services. The workforce within these services is trained to deliver mainly secondary and tertiary care with a smattering of primary prevention. However, achieving population health outcomes will require health workers to become not only familiar with the language of Alma Ata and the Ottawa Charter, but also proficient in practice. The challenge for Wagga Wagga Community Health Services was to bring about this change by turning theory into practice in such a way as to make the change meaningful to the various disciplines working in it. An Integrated Model of Practice (IMP) was developed after examination of current practice revealed that deficits in skills and knowledge at health worker level and deficits in understanding about population health and health promotion at health service executive level specifically, would prevent the organisation achieving population health outcomes. The answer was the establishment of a task force response to identified health issues which addressed health problems systematically at the population level while retaining relevance to individual disciplines within the community health centre. The paper describes briefly the authors' experience with the process involved in organisational change towards achieving population health outcomes within a community health centre. It is the first of two papers, the second of which describes the gains made in the introduction of the Task Force Program within the Centre.