status quo of quo vadis? - KCE
status quo of quo vadis? - KCE
status quo of quo vadis? - KCE
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<strong>KCE</strong> Reports 76 Quality development in general practice in Belgium: <strong>status</strong> <strong>quo</strong> or <strong>quo</strong> <strong>vadis</strong> ? 49<br />
Questionnaires and checklists<br />
The questionnaires were sometimes difficult to understand. They could be shorter and<br />
simpler. Furthermore, not all items have the same importance. For example, the item<br />
about the printer seems less relevant but the access for handicapped people is<br />
important. The lack <strong>of</strong> questions about the home visit was perceived as a problem.<br />
The GP noted interesting questions about staff or about practical aspects like the fridge<br />
temperature or the expiry date <strong>of</strong> drugs. Some missing areas included the sterilisation<br />
<strong>of</strong> equipment for instance.<br />
Validity<br />
The validity <strong>of</strong> the items is an important issue to convince the GPs that this tool is<br />
relevant for their practice. They need reassurance that the items reflect the quality <strong>of</strong><br />
care at the patient level.<br />
´Ce que j’entends, si on le propose, c’est qu’il faut aussi prouver que les items sont<br />
valides, en tout cas dire : voilà, ces items-là ont été incorporés dans le questionnaire<br />
parce que, à grande échelle, on a pu prouver que ça améliorait la qualité.´<br />
Visitor and feed back<br />
The role <strong>of</strong> the visitor is very important but some GPs did not receive yet the written<br />
evaluation. Other ones did not understand their results and needed help for the<br />
interpretation.<br />
´La grosse conclusion de l’étude, c’est que ça nous a amenés à voir ça plus en face.<br />
Nous on ne voyait que notre côté, on ne voyait pas le côté du personnel. On pense<br />
qu’on pense pour l’autre, hein, toujours. Mais en pratique on voit qu’on ne pensait pas<br />
tout à fait comme l’autre pensait. Et donc on est dans la problématique et on va y<br />
travailler´<br />
Is this model <strong>of</strong> practice evaluation useful and applicable for the quality<br />
evaluation <strong>of</strong> general practitioners in general?<br />
More quality <strong>of</strong> care and more pr<strong>of</strong>essionalism in the service <strong>of</strong>fered to the population<br />
are positive consequences <strong>of</strong> this evaluation. The GP identified the risk <strong>of</strong> using a tool<br />
that is not fully adapted: the credibility among GPs will be lost.<br />
Suggestions for improvement were the followings:<br />
• The questionnaires should be linked to the objectives and to the national<br />
context;<br />
• The GPs should be convinced that items are valid and suitable for their own<br />
practice;<br />
• Data collection must be a smooth process without any problem like<br />
translation errors, presentation, s<strong>of</strong>tware problems, incorrect feedback;<br />
• The presentation and interpretation <strong>of</strong> the results must be attractive and lead<br />
to the reflection <strong>of</strong> the participants.<br />
According to the GPs, EPA can be used in the pr<strong>of</strong>ession. Its large-scale implementation<br />
requires a pr<strong>of</strong>essional organisation. It should be organised by a scientific society and<br />
not for instance, by ‘test achats – test aankoop’ because there is no clear link between<br />
the quality <strong>of</strong> care and the perception <strong>of</strong> the patients.<br />
The question about the accreditation or recertification raised a controversy: if there is a<br />
quality <strong>of</strong> care improvement and financial consequences, why not? However, the GPs<br />
were afraid <strong>of</strong> new constraints put upon them.<br />
´Je pense qu’il faudrait présenter ça, à nouveau que ce ne soit pas un outil de contrainte,<br />
et voilà. Il y en aura toujours certains qui ne le feront pas, et même dans ceux qu’on<br />
pense qui sont les plus volontaires.