• Aryati Yashadhana, Anna Morse, Shaun Tatipata, Nicole Lim, Alison Rogers, Ling Lee, and Anthea M Burnett.
• School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW, Australia.
• Aust J Rural Health. 2020 Feb 1; 28 (1): 60-66.

ProblemIn the Katherine region, Northern Territory, barriers to eye care for Aboriginal and Torres Strait Islander people include unclear eye care referral processes, challenges coordinating patient eye care between various providers, complex socioeconomic determinants and a lengthy outpatient ophthalmology waiting list.DesignMixed methods participatory approach using a regional needs analysis, clinical file audit and stakeholder survey, to develop, implement and monitor quality improvement strategies.SettingCollaboration with Aboriginal Community Controlled Health Services and regional eye care stakeholders in the Katherine region.Key Measures For ImprovementClinical audit data captured frequency and rates of primary eye checks, ophthalmology referrals and spectacle prescriptions. A survey was developed and applied to assess stakeholder perspectives of regional eye care systems.Strategy For ChangeQuality improvement strategies informed by regional data (clinical audits and survey) included increasing service delivery to match eye care needs, primary eye care training for Aboriginal Community Controlled Health Services staff, updating Aboriginal Community Controlled Health Services primary care templates and forming a regional eye care coalition group.Effects Of ChangePost-implementation, rates and frequency of recorded optometry examinations, number of spectacles prescribed and rates of annual dilated fundus examinations for patients with diabetes increased. There was a decrease in the number of patients with diabetes who had never had an eye examination. Eye care stakeholders perceived a marked improvement in the effectiveness of the regional eye care system.Lessons LearntOur findings highlight the importance of engaging services and stakeholders to ensure a systems approach that is evidence-informed, contextually appropriate and reflects commitment to improved eye health outcomes.© 2020 National Rural Health Alliance Ltd.

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