status quo of quo vadis? - KCE

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84 Quality development in general practice in Belgium: status quo or quo vadis ? KCE Reports 76 Author Research question Method Results Information/country Remarks for Belgium Seddon 2001{Seddon, 2001 #25} To summarize published evaluations of the quality of clinical care provided in general practice in the UK, Australia and New Zealand. The Purpose of this study was to evaluate just one of these components of quality – that of clinical or technical effectiveness Systematic review of published studies assessing the quality of clinical care in general practice for the period of 1995- 9. • Attitudes and approaches, including adaptability, inclusive decision making and planning Most of the studies were from the UK (80), with six from Australia and four from New Zealand. In almost all studies the processes of care did not attain the standards set out in national guidelines or those set by the researchers themselves. Most of the studies reported on quality of care for chronic conditions, and only a small number attempted to assess the management of acute conditions or preventive care. This is a significant gap, given that these modalities represent a major part of the work undertaken by GPs. Mainly UK. No differentiation between countries was made. We need more and better information on the quality of care in general practice. This is particularly true for acute conditions and preventative care. For a more valid representation of quality, the evaluations should focus on randomly selected samples of records drawn from populations rather than from self-selected practices. There is a need to focus on nontechnical aspects of care, particularly interpersonal care which is a fundamental component of general practice.
KCE Reports 76 Quality development in general practice in Belgium: status quo or quo vadis ? 85 APPENDIX 5: SELECTION OF ARTICLES FROM THE COMPLEMENTARY SEARCHES Author Title Country Type of article Summary Beacham 2003{Beacham, 2003 #221} Hearnshaw 2003{Hearnshaw, 2003 #550} Crampton 2004{Crampton, 2004 #248} Elwyn 2004{Elwyn, 2004 #524} Priorities for research in the area of primary health care. How relevant are recently completed General Practice Evaluation Program projects? Are audits wasting resources by measuring the wrong things? A survey of methods used to select audit review criteria What makes a good performance indicator? Devising primary care performance indicators for New Zealand Assessing organisational development in primary medical care using a group based assessment: the Maturity Matrix Australia Semi quantitative analysis of reports of 52 projects on quality of care in Australia. UK Using a questionnaire study, this study measured the extent to which a systematic approach was used to select criteria for audit, and identified problems in using such an approach with potential solutions. New Zealand Completed GPEP projects have relevance to the identified priority areas. They provide information to support research applications in the primary health care area funded through the National Health and Medical Research Council, and identify areas for further research. The agreement on indicators used in audit was low. Authors conclude that methods and review criteria were often less systematic than desirable. Reflective paper NZ currently lacks a national approach to primary care performance indicators. Discussion of papers of Campbell and McColl. A Delphi like technique is suggested to start the consensus UK Multifaceted analysis. Responses to a evaluation questionnaire, qualitative feedback and psychometric testing process. Validation studies of the maturity matrix. This instrument assesses the degree of organizational development achieved in primary medical care organizations.
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