status quo of quo vadis? - KCE

44 Quality development in general practice in Belgium: status quo or quo vadis ? KCE Reports 76
3.2.3 The process of the practice visit
A team consisting of one coordinator, two co-organisers and ancillary staff from the
Department of General Practice of the University of Antwerp supported the
organisation. In total six external visitors, three in each region, performed on average
six visits each. Three visitors were GPs in training, one was a senior practice assistant,
one a quality engineer and one a non-GP medical doctor.
After agreeing on a visitation date, a team member personally delivered all
questionnaires and study material, and clarified any final questions. If a team member
was not available, the material was sent by post.
The analysis, interpretation and feedback of the visitation results took place at the
visitation day during the ‘team meeting’. The results could be demonstrated online-onthe-spot,
by use of a wireless internet connected laptop using the Visotool ® . As an
alternative and for backup reasons the feedback report was downloaded as a PDF file
(e.g. in case of connection problems).
After the visit, the practices received accreditation forms and completed feedback
reports.
3.2.4 Qualitative evaluation of the EPA process
3.2.4.1 Field notes of visitors
All visitors wrote field notes immediately after the practice visit, answering the
following questions:
• What were the practice and visitor’s first impressions about this EPA visit?
• Did the practice members perceive the EPA visit as useful?
• Did the practice members have ideas or plans for quality development
following this EPA visit?
The field notes were coded in QRS Nvivo ® 2.0 to synthesise these experiences.
3.2.4.2 Focus groups of general practitioners
A focus group method addressed the following questions:
• How did the GPs experience the EPA evaluation?
• Was this model of practice evaluation useful for their practice?
• Is this model of practice evaluation useful and applicable for the quality
evaluation of general practitioners in general?
All general practitioners who participated to the EPA study were invited to the focus
groups. Participants received 100 euros and accreditation points. One focus group was
held in Flanders and the other one with French-speaking GPs. A trained moderator led
the group. One of the co-researchers observed the process but none had been engaged
in the practice visits.
After the discussion, the investigators wrote up and agreed on the general perspectives
of the three topics. The texts were transcribed and analysed by two independent
researchers. All researchers received the final version for approval.