status quo of quo vadis? - KCE

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KCE Reports 76 Quality development in general practice in Belgium: status quo or quo vadis ? 56 Scientific GP bodies Universities •Scientific content of Q measurement •Implementation • Guidelines and CME Scientific support Independent body IT support Feedback Follow-up Q cycle GP PRACTICE Authorities •Health objectives and quality policy •Tools definition •Budget Financial support Accreditation Anonymous or aggregated data Data Platform Administrative data GLEMs –LOKs
KCE Reports 76 Quality development in general practice in Belgium: status quo or quo vadis ? 57 Ten key issues can be identified for developing the framework. All stakeholders need to be involved in the development and the validation process of this framework in order to achieve success. The German and UK examples learn that legislation coupled with specific financial incentives is a powerful stimulus. 4.3.1 Need for professional culture change The GPs should continuously bear in mind the importance of quality improvement principles when performing their daily work. GPs should become familiar with the concepts of quality development, measurement of indicators and the use of the quality cycle. The involvement of GP opinion leaders and scientific bodies is the most critical precondition to succeed in quality development initiatives at the individual, practice, regional and national levels. Australia is the most outstanding example of the power of the profession to launch effective quality programs. Opinion leaders of general practice in the UK, Australia and the Netherlands closely interact with the academics. The GP opinion and scientific leaders in these countries outlined the concepts of the quality development programmes and subsequently marketed these to the professional bodies. In Belgium, academic departments and scientific bodies also have to take up their position in the quality debate. They must define the content of the quality initiatives and how the profession will achieve their successful implementation. 4.3.2 Health Authorities in a future quality system The role of the Health Authorities is first to address a quality policy that deals with priority aspects and anticipates the different steps from data collection to the use of results for further improvement. Authorities must also define the tools that should be promoted for quality improvement in general practice. The choice of the most appropriate tools must adhere to the scientific literature and experience from other countries, as described in this report. A very powerful drive for change is a legal framework that introduces the requirements for quality development. The UK and Dutch professional bodies have referred to implicit thread of formal regulations on quality. The UK and Australia are successful illustrations of the need for a pre-existing legal framework. The consequences of registration of data for quality measurement will be clearly determined beforehand. Political will and leadership are needed to put the development of quality in general practice on the political agenda, including the specification of a time frame in which general practice should adhere to a quality development scheme. Furthermore the Authorities have a facilitating role: • To support a platform that will collect the data and to create an independent trustworthy body that will provide feedbacks to the GPs and stakeholders; • To promote and financially support standardised IT equipment that allows the collection of routine data for the measurement of quality indicators. 4.3.3 Stakeholders All countries that have adopted successful quality development strategies have a finely tuned interaction between the key groups influencing the choice of quality measures i.e. purchasers, patients and physicians. 17 For Belgium the following stakeholders could take part in quality development i.e., general practitioners, scientific GP bodies, regional organisations of general practice, academic departments of general practice, other organisations of primary health care like nursing and regional multi-professional bodies, GP unions, sickness funds and the Intermutualistic agency (IMA/AMI), INAMI/RIZIV, organisations of patients and software suppliers.
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