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 ? 78 APPENDIX 3: LIST OF EXPERTS FOR THE INTERNATIONAL REVIEW FRANCE GERMANY Dr Jean Brami, Haute Autorité en Santé. Prof Dr Hector Falcoff. Département de Médecine Générale, Faculté de Médecine Paris V. Prof Dr Ferdinand M. Gerlach, MPH. Director des Instituts für Allgemeinmedizin, Klinikum der Johann Wolfgang Goethe-Universität Frankfurt am Main. Johannes Stock, AOK-Bundesverband, Stabsbereich Medizin, Kortrijker Str. 1, D-53177 Bonn. NETHERLANDS Dr van den Hombergh Pieter, PhD. Landelijke Huisarts Vereniging. Prof Dr Theo Voorn, PhD, Afdeling huissartsgeneeskunde, Radboud Universiteit Nijmegen. UNITED KINGDOM AUSTRALIA Prof Dr Glyn Elwyn, PhD, Research Chair at Cardiff University. Associate Editor of Quality and Safety in Healthcare and a visiting professor at the Centre for Quality of Care Research, Nijmegen, Netherlands Prof Dr Martin Roland, PhD Director of the National Primary Care Research and Development Centre (NPCRDC) and Professor of General Practice at Manchester University Dr Peter Delfante, General Practitioner, Medical Director, Adelaide Western Division of General Practice. Ms Teri Snowdon, National Manager – Quality Care and Research, Royal Australian College of General Practitioners.
KCE Reports 76 Quality development in general practice in Belgium: status quo or quo vadis ? 79 APPENDIX 4: SELECTED REVIEWS Author Research question Method Results Information/country Remarks for Belgium Grimshaw JM 2004{Grimshaw, 2004 #108} Rhydderch M 2005{Rhydderch, 2005 #53} Contencin P 2006{Contencin, 2006 #63} To undertake a systematic review of effectiveness and costs of different guideline development, dissemination and implementation strategies To inform the debate by reviewing the international peerreviewed literature on organizational assessments used in general practice settings To review performance assessment methods used in general practice Systematic review 1966-1998 All clinical guidelines including general practice and hospital settings Systematic review 1996-2003 Systematic review up to 2004. Key informants were used per country. Studies on cost-effectiveness are scarce. Multifaceted interventions, i.e. encompassing practice visits or written materials do not seem to be more effective than simple interventions Thirteen papers including 5 assessment instruments were included for appraisal The focus is on Europe - which countries use which methods - and on the following aspects: which authorities or bodies are responsible for setting up and running the systems, are the systems mandatory or voluntary, who takes part in assessments and what is their motivation, are patients views taken into account. Dominated by studies in the USA and UK Generic. USA (3), Netherlands (1), Australia (1) UK: negotiated a GMS contract for provision of care under the NHS whereby up to a third of a practice’s income cab depend on performance as judged by score points for quality indicators. France: The ANAES was commissioned to design a national system for voluntary performance assessment of Guideline development and implementation does not seem to be very efficient. Simple dissemination may be most cost-effective The authors differentiate between external led approach (professional led, external assessment, benchmarked) versus internal development. They suggest an incremental level (Australia); Minimal standards, demonstrate excellence on these minimal standard (VIP, Netherlands), growing towards higher standards hence growing towards an organisational culture along philosophies of the primary care system (i.e. community focus, continuity of care) A potentially successful assessment method in any country has to be in line with: • Prevailing healthcare management and regulation • Cultural factors • Patients’ expectations A key factor seems to be
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status quo of quo vadis? - KCE

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