Quality Management in Primary Care Dietetics

Abstract

Background: Health is influenced by many determinants, including the social and physical environment, economic factors, and individual characteristics. Diet and nutrition play a critical role in health, both in the prevention and treatment of non-communicable diseases, with dietary risk factors alone causing 5.3% of the total disease burden in Australia. Dietetic care has been shown to improve consumer outcomes, demonstrating its role in addressing the burden caused by poor diet. While quality has been extensively explored in tertiary and, to a lesser degree, in primary healthcare settings, there is limited research exploring quality in primary care dietetics. The overarching aim of this doctoral research program was to explore quality management in primary care dietetics through the lens of complexity science. Five aims were addressed in four sequential stages of research using a qualitatively driven mixed methods design. The five aims were: i) to describe and evaluate the literature on quality improvement strategies used to enhance health outcomes achieved by dietetic care that is delivered in the primary care setting (Stage 1); ii) to explore primary care dietetics through the lens of complexity science (Stage 2); iii) to explore how healthcare consumers describe nutrition care (Stage 3); iv) to explore how healthcare consumers and professionals describe dietetic care (Stage 3); and v) to develop a theoretical approach to quality management for primary care dietetic services (Stage 4). The research was designed and executed from a pragmatic philosophical positioning and, consequently, focused on exploring quality with a solution- and action-orientated purpose.