status quo of quo vadis? - KCE

KCE Reports 76 Quality development in general practice in Belgium: status quo or quo vadis ? 91
Holden{Holden, 2004
#554}
Fraser{Fraser, 2006
#535}
Systematic
review of
published multipractice
audits
from British
general practice
Evaluation of an
interpractice visit
peer review
program for rural
Australian
general practice
registrars.
Jelly{Jelley, 2003 #179} Practice-based
peer appraisal in
general practice:
an idea whose
time has come?
McKay{McKay, 2006
#190}
Sheaff 2004{Sheaff,
2004 #920} (*)
McKinstry{McKinstry,
2005 #192} (*)
Variations in the
ability of general
medical
practitioners to
apply two
methods of
clinical audit: A
five-year study of
assessment by
peer review
Soft governance
and attitudes to
clinical quality in
English general
practice
GP experiences
of partner and
external peer
appraisal: a
qualitative study
UK Systematic review of
peer-reviewed
literature of audit
carried out in UK
general practice
AU Qualitative survey
among the 18 GPs
that enrolled in an
interpractice visit
peer review program
UK Purposive
Questionnaire study
aimed to get
informed about
progress of the
concept of in practice
UK,
Scotland
peer review
Two GPs reviewed
1002 audits in
Scotland between
199-2004. Audits and
event analysis were
delivered in standard
formats and scored
by peers
UK Survey (2001) of 437
GPs attitudes,
opinions and self
reported activity in
Primary Care Trusts
and six Primary Care
Trusts
UK Semi-structured
interview of 62 GPs
that undertook a
external peer
appraisel, which is a
structured practice
visit in Scotland
Audit can be
moderately effective.
Precise evaluation is
difficult as it is often
part of multitargeted
interventions
Organizers usually
choose subjects of
which data are
straightforward,
mostly on
prescribing and
chronic disease
management. No
complete failures
were described
Qualitative
description mostly
positive findings, and
only of the visiting
doctors, not on the
receiving GPs
18 percent of
practices had set up
practice based peer
appraisal systems
Using standard
protocols that were
used for
accreditation points,
55 percent were
scored as
satisfactory. A
significant
proportion of GPs
may be unable to
adequately apply
audit methods.
Most GPs reported
that their clinical
practice had changes
as because of clinical
governance although
40 percent reported
little difference in
the care that is being
provided. It seems to
be hard to extend
beyond clinical
domains.
There is unclearness
of the aspect of
revalidation. This
may lead to
superficial
engagement.
Protected time is
necessary