status quo of quo vadis? - KCE

6 Quality development in general practice in Belgium: status quo or quo vadis ? KCE Reports 76
“Quality Development for general/family practice is a continuous process of planned
activities based on performance review and setting of explicit targets for good clinical
practice with the aim of improving the actual quality of patient care” 16 . Quality
management deals with the management of the implementation of quality development
in a practice.
This report will mostly use this concept of quality development.
STAKEHOLDERS
Quality can be seen from various perspectives. Three key groups each representing
their core values are identified. 17 The patients may have increasing demands and
expectations. Purchasers are financially responsible: in Belgium the government has a
main role to play in the financing of the health care system. Finally, the health care
providers (as the GPs for example) are responsible for delivering adequate care at
affordable costs.
1.3.2 Improving quality in general practice: the quality cycle
Quality development essentially deals with a cyclic process illustrated below. 18 Going
through the cycle is a process with the following steps:
• Selection of a relevant topic or set of topics for general practice: those topics
should be liable for improvement;
• Selection of guidelines, criteria and standards to be used for measurement;
• Measurement using valid, reliable instruments;
• Analysis and evaluation;
• Planning and implementation of improvement;
• Assessment of the improvement activities.
Figure 1. The quality cycle (with the permission of R. Grol)