status quo of quo vadis? - KCE

KCE Reports 76 Quality development in general practice in Belgium: status quo or quo vadis ? 35
The 'Building on Quality' project was launched to put quality of care on the agenda. 124
This project outlined a framework for future themes like continuity of care, focus on
outcomes, benchmarking, evidence-based health care, consumer feedback, standards in
general practice, vocational registration through a 3 year cycle, improvement of
information technology. 42
Other quality initiatives that influence health care delivery include:
• Coordinated care trials for persons with chronic and/or complex needs;
• Health Connect and Mediconnect, e-health initiatives to share medical
records;
• National Primary Care Collaboratives, a quality improvement approach using
plan, do, study, act (PDSA) cycles.
2.4.5.2 Quality development in action: culture, legislation, financing, organisation and
implementation
In a recent paper on behalf of the Royal College, Booth at al. outlined all initiatives on
quality in general practice. 126 The overview covered initiatives at different levels i.e.:
• Individual GP level: fellowship of the Royal College, vocational training,
continuing professional development;
• General practice level: standards of accreditation, practice accreditation,
deputising services;
• Regional level: Divisions of General Practice, state governments;
• Australian national level: Faculties of general practice, national health
departments.
Subsequently a quality framework was designed for the Australian GP system. The
framework identifies health care initiatives that support quality in general practice and
can be used as a planning tool to improve quality by identifying gaps and overlaps.
The Framework suggests that quality relates to any one or combinations of six domains:
• Capacity (facilities, workforce);
• Competence (not only GPs but also other primary care personnel);
• Financing (funding mechanisms can hinder or support quality of care);
• Knowledge and information management (right information at the right
moment);
• Patient focus (improving self-care; working in harmony with patients and
within teams);
• Professional values.
Furthermore, the framework considers the aspects of acceptability, accessibility,
appropriateness, effectiveness, efficiency and safety. The Royal College compared the
current situation to its possible improvement in a gap analysis. It reports a prioritisation
process: this analysis suggest some new avenues for the Primary Health Care Strategy of
the Government. 127